What are the research gaps in head and neck oncopathology?

From the Guidelines

Research gaps in head and neck oncopathology remain significant, with a need for improved molecular characterization, standardized digital pathology protocols, and more accurate predictive biomarkers, as highlighted in the most recent study 1. The most pressing research needs in head and neck oncopathology include:

• Improved molecular characterization of rare tumor subtypes
• Standardization of digital pathology protocols
• Development of more accurate predictive biomarkers for treatment response
• Better understanding of tumor heterogeneity within head and neck squamous cell carcinomas, particularly regarding the interplay between HPV-positive and negative subtypes and their distinct molecular pathways, as discussed in 1
• More research on early detection methods for oral potentially malignant disorders before they progress to invasive carcinomas
• Further investigation into the role of the tumor microenvironment and immune cell interactions to optimize immunotherapy approaches
• Gaps in understanding the mechanisms of treatment resistance, particularly to targeted therapies and radiation, as noted in 1
• Development of liquid biopsy techniques specific to head and neck cancers for early detection and monitoring
• Integration of artificial intelligence tools for pathological diagnosis and prognosis prediction, an area that requires more research, as mentioned in 1
• Standardized reporting systems and quality assurance protocols for molecular testing in head and neck specimens need improvement to ensure consistent clinical application of research findings across different institutions, a point emphasized in 1. Key areas of focus should include the development of more effective treatment strategies, improved patient outcomes, and enhanced quality of life for individuals with head and neck cancers, as the most recent study 1 suggests.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Research Gaps in Head and Neck Oncopathology

The current state of head and neck oncopathology research has several gaps that need to be addressed. Some of the key areas that require further investigation include:

• The molecular profiles of many rare head and neck cancer types are unknown 2
• The molecular alterations underlying advanced disease, such as recurrent and metastatic head and neck cancer, are not fully understood 2
• The role of molecular markers and gene profiling in the diagnosis, prognosis, and treatment of head and neck cancers is still being explored 3
• The management of bulky cN3 disease remains an issue, with aggressive multidisciplinary strategies or innovative combined treatments not yet significantly improving prognosis 4
• The molecular genetics of head and neck cancer is not yet fully comprehended, with a need for further research into concepts such as field cancerization and the development of biomarkers for diagnosis, staging, monitoring, and prognostication 5
• Despite advances in understanding head and neck tumor biology, the optimization of radiation, chemotherapy, and surgical treatment modalities, head and neck squamous cell carcinoma (HNSCC) remains a major cause of cancer-related morbidity and mortality, highlighting the need for continued research into molecular aspects of HNSCC biology and potential diagnostic and therapeutic agents 6

Key Areas for Further Research

Some of the key areas that require further research include:

• The molecular landscape of advanced disease and rare cancer subtypes 2
• The role of human papillomavirus (HPV) in head and neck cancer, including its impact on prognosis and treatment response 3, 4
• The development of personalized neck management strategies, including the use of positron-emission tomography/computed tomography to monitor radiation response and the omission of neck dissection in certain cases 4
• The identification of targetable alterations in advanced cancers, including the use of next-generation sequencing to guide therapy 2
• The investigation of de-escalation of neck dissection and prophylactic nodal irradiation in combination with other treatments 4