Targeted Next-Generation Sequencing in Head and Neck Cancer

Abstract

Rapid technical advances in the molecular characterization of tumors, enabling complete gene sequencing of multiple cancers in the Cancer Genome Project, have led to a largely increased knowledge of the molecular pathways that underlie cancer. The integration of high-throughput sequencing, known more commonly as “next-generation” sequencing (NGS), into standard clinical practice has enabled more targeted treatment of various malignancies based on the presence of specific alterations. Despite notable successes in other tumor entities, individual treatment selection for patients with squamous cell carcinoma of the head and neck (HNSCC) based on molecular tumor profiles has not yet become clinical practice. In the following chapters, we describe the genomic alterations detected in NGS studies of HNSCC which define specific molecular subgroups and whose contribution to oncogenesis provide a biological rationale for the use of a specific targeted therapy. We highlight different tumor sequencing strategies currently used for precision oncology and describe their individual strengths and weaknesses. We also discuss unresolved hurdles in the translation of molecular findings into concepts for personalized HNSCC treatment.