Oncogenomics/Proteomics of Head and Neck Cancers

Head and neck cancer treatment has experienced great advances in surgical techniques, radiation therapy, chemotherapy, and molecular targeted strategies through the years. In addition, there has been explosive growth in our understanding of tumor biology through research focusing on individual genes and their gene products. However, poor overall survival persists despite this progress, in large part because treatment decisions continue to be based on traditional parameters, such as tumor size, tumor site, and presence of regional or distant metastases. Head and neck cancer represents an extremely heterogeneous disease with dysregulation of multiple interrelated cellular pathways, including differentiation, apoptosis, angiogenesis, and metastasis. The complexity of interactions between genes and proteins and the environment and the difficulty of finding the right combinations of targets to study pose fundamental problems with successful identification of therapeutic targets and predictive elements. Oncogenomic and proteomic analyses offer the opportunity to accelerate the pace of discovery for clinically relevant targets. A variety of high-throughput technologies including expression profiling and mass spectrometry technologies are being used to analyze cancer genomes and proteomes with the ultimate goal of identifying new cancer genes and therapeutic targets. Potentially, the identification of disease-associated proteins and protein signatures could be used as tumor markers for early detection, response to therapy, or relapse. A greater understanding of the molecular events underpinning clinical outcomes will provide useful tools in the identification of new targets for future therapy. These advances have already begun to manifest in several key areas of treatment including early detection of cancer, evaluation of surgical margins, determination of necessary extent of surgery, and predictions of outcome and recurrence. In this chapter we review key technological advances leading to these recent changes as well as many of the studies helping to implement these technologies and apply them to patients with head and neck cancer.