Abstract

SCUTTI, Jorge Augusto Borin; PINEDA, Mariana; EMERICK JR, Enos  and  ALMEIDA, Eliete Rodrigues de. Head and neck squamous cell carcinoma (HNSCC): unmasking the tumor microenvironment. Rev. Assoc. Paul. Cir. Dent. [online]. 2016, vol.70, n.2, pp. 156-163. ISSN 0004-5276.

This article refers to a review about head and neck squamous cell carcinoma (HNSCC), which involves about 90% of all head and neck cancers, originated from the squamous lining of the upper aero digestive tract, including the oral cavity, pharynx, larynx and sinonasal tract. Currently, it is known as the 6th most common cancer in the world and only 50% of patients will remain alive for 5 years post-diagnosis. Due to its accelerated spreading and its high occurrence, this kind of cancer has become, in the last decades, one of the major threats to public health. Its development and progression has been gaining special attention, considering the new findings associated to the core instability of genetic and epigenetic, metabolomics, cellular remodeling and associated risk factors, especially with the involvement of viral infections and, more recently, to the immunological aspects inherent from the tumor microenvironment (TME) particularly cell profiles (fibroblast associated with cancer, regulatory T cells, lymphocytes, and macrophages with immunosuppressive profile Th2 and M2, respectively, and neutrophils associated with tumor) and humoral profile (chemokines, immunosuppressive cytokines such as TGF-B, IL-13, IL-10, proteins responsible for the breakdown of extracellular matrix- metalloproteinase and factors that contribute to the development and tumor progression mediated by angiogenesis, such as EGF and VEGF). In the upcoming years, understanding the immunobiology of head and neck squamous cell carcinoma will be accompanied simultaneously by important advances in the early detection of high-risk patients, based on the identification of biomarkers, on the manipulation of the immune system and on the understanding of the pharmacogenomics. Strategies based on immunotherapy, which have been successfully used in numerous types of cancer, can contribute positively to the rehabilitation of some microenvironment components and reduce the serious consequences associated with this type of malignancy.

Keywords : head and neck squamous cell carcinoma (HNSCC); tumor microenvironment; immunotherapy..