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Advances in Chemoprevention of Head and Neck Cancer

^a Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA; ^b Winship Cancer Institute, Emory University, Atlanta, Georgia, USA

Correspondence: Dong M. Shin, M.D., F.A.C.P., Head and Neck Cancer Program, Winship Cancer Institute, Emory University, 1365-C Clifton Road, Atlanta, Georgia 30322, USA. Telephone: 404-778-5990; Fax: 404-778-5520; e-mail: dong_shin{at}emoryhealthcare.org

Head and neck squamous cell carcinoma is a devastating disease with a poor outcome in advanced stages, accounting for approximately 3% of all malignancies, with an estimated 37,200 new cases and 11,000 deaths annually in the U.S. Second primary tumors are estimated to occur at an annual rate of 3%–10% and are significant threats to long-term survivors. Chemoprevention is an appealing strategy, and its success has been demonstrated in breast cancer and familial adenomatous polyposis. High-dose retinoids have been shown to be active against oral premalignant lesions and in prevention of second primary tumors in the head and neck. New targets include the epidermal growth factor receptor, cyclooxygenase-2, and other molecular targets. Challenges in future head and neck cancer chemoprevention investigations include achieving long-lasting efficacy with retinoids and/or new agents, and determining the optimal dose and duration of therapy while maintaining acceptable toxicities.

Key Words. Head and neck cancer • Biochemoprevention • Retinoids • Epidermal growth factor receptor • Cyclooxygenase-2 inhibitors

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