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WHAT DOES IT MEAN BY:

OSCC

OSCC is an acronym for Oral Squamous Cell Carcinoma. OSCC is one of the types of oral cancer. Likewise other cancers, uncontrolled growth of abnormal cells in the body takes place in OSCC. Most lip and oral cavity cancers start in squamous cells, the thin, flat cells lining the inside of the lips and oral cavity. Oral Squamous cell carcinoma usually develops in areas of leukoplakia (white patches of cells that do not rub off) .

CONVENTIONAL TREATMENT MODALITIES

CHEMOTHEARPY

> Works by stopping quickly growing and dividing cancer cells

> Also affects some fast-growing healthy cells, like those of the skin, hair, intestines, and bone marrow.

RADIOTHERAPY

> Works by aiming a high dose of radiation towards a person’s tumour, which damages cells’ fragile DNA – the code of instructions that cells need to survive and do their job.

> the radiation has to travel through healthy tissues to reach its target, non-cancerous cells may too become damaged by the treatment.

CHEMO-RADIO/SURGERY

> Surgery is used to treat cancer at advanced stages.

> It does not work to cure cancer, but to relieve discomfort.

> Chemotherapy and radiotherapy may be used after performing surgery, rendering more damage to normal/healthy cells. 

CURRENTLY FAVOuRABLE THERAPY

MONOCLONAL ANTIBODIES 





Monoclonal antibodies (mABs) are drugs that are produced from living organisms or contain components of living organisms. 

Monoclonal antibodies have revolutionized the cancer treatment.

They are designed to bind to antigen (toxic substances) that are generally more numerous on the surface of cancer cells than healthy cells. Treatment with mABs are also called targeted therapy.

This binding of mABs to antigens will in turn jeopardize antigens to facilitate tumor growth and development.

Monoclonal antibodies are recognized with suffix 'mab' in their generic name. Notably used mABs in curing OSCC are Cetuximab and Nivolumab.

Beside some side effects such as allergic reaction and redness/rash at the site of injection, monoclonal antibodies are very expensive drugs.

FUTURE STRATEGY

BIOSIMILARS

Introduction: A biosimilar is a highly similar copy of an existing biological drug. When the patent (copyright) for a biological medicine expires, drug companies can make a drug that is very similar to the original.

Distinction: They are cheaper than the original biological medicine. The NHS is encouraging doctors to use more biosimilars as they become available. 

Result: All biosimilars are as safe and effective as the original biological drug. 

However, evidence of outcomes for monoclonal antibody biosimilars in treating cancer patients, is not yet available in the published literature. Long-term studies with high power are still required to justify biosimilars as reliable alternatives to biologics.

 mAb Drugs & OSCC

RECent studies

Drug: NZ-1

John A. and colleagues, in 2015, confirmed that mABs NZ-1 can inhibit a protein (podoplanin) that promotes tumor cells motility. 


Drug: cEtuximab

NICE, in Aug 2017, showed confidence in cetuximab for treating recurrent or spreading (metastatic) cancer of head & neck.

Cetuximab plus Radiotherapy

A study by Scott A. and colleagues, in 2012, concluded that patients treated with cetuximab plus radiotherapy had significantly superior progression free survival (PFS) than those who received radiotherapy alone.

Drug: Bevacizumab

Yoshida and colleagues, in 2018, identified that  treatment with bevacizumab increased the death of cancer cells (apoptosis).

Drug: Nimotuzumab

In a study, Lian L. and colleagues, in 2019, reported that after 24 weeks treatment, the overall effective rates of nimotuzumab combined with chemoradiotherapy was 100%.

Further Critical Information on:

Oral Cancer Management


Ramage G and colleagues, in 2012,  provided in vitro evidence that Tea Tree oil (TTO) and its derivative components, specifically T-4-ol, exhibit strong antimicrobial properties against fungal biofilms in  cancer patients.  


Ketabat F and colleagues, in 2019, while talking on drug delivery strategies in oral cancer patients reported that there is an imperative requirement for new therapeutic methods with reduced side effects and systemic toxicity. 


Ahmad Othman (BDS, SBOMFS, MSc), has discussed, in his site, the future of oral cancer in regards to its diagnostic managemnet. He has brought the attention over the diagnosis of oral cancers using salivary biomarkers.

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