Clinical Oncology

[Importance of hypoxia in tumor progression: road to Nobel price and novel therapeutic opportunities]

KOPPER László1, SEBESTYÉN Anna1, TÍMÁR József2

AUGUST 28, 2020

Clinical Oncology - 2020;7(3)

[It is now evident that cancer hypoxia is one of the new hallmark of cancer due to its consequences in gene expression, metabolism and biology. The importance of cancer hypoxia was recognized by the Nobel-price award in 2019. There are three major causes of cancer hypoxia: insuffi cient vascularization, systemic hypoxia of the host and constitutive activation of oncogene driven signaling pathways, all leading to a unique form of genetic reprogramming by HIF transcription factors. The consequences of HIF activation in cancer is the angiogenic phenotype, a new metabolic profi le and an immunsuppressive microenvironment. Furthermore, cancer hypoxia and the cellular adaptation lead to therapy resistance. Accordingly there is an urgent need to develop target therapies of hypoxia to improve effi cacies of various therapeutic modalities.]

AFFILIATIONS

  1. Semmelweis Egyetem, I. Sz. Patológiai és Kísérleti Rákkutató Intézet, Budapest
  2. Semmelweis Egyetem, II. Sz. Patológiai Intézet, Budapest

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[Treatment of head and neck squamous cell carcinomas (HNSCC) is exceptionally complex, requiring the close cooperation of the head and neck surgeon, radiation oncologist and medical oncologist. Excellent tumor control should be our primary goal, however, the selection of treatment should not only be guided by oncologic radicality but by the need of satisfactory quality of life (as most local therapies affect respiratory, swallowing and/or speech function), too. Based on the appropriate diagnostic workup, these cancers are classifi ed into early, locoregionally advanced or recurrent/metastatic stages. Each category requires different treatment modalities, further complicated by the localization of the primary tumor and its metastases, performance status of the patient, comorbidities, and the biology of the lesion. In the present review, the authors summarize the basics of the therapy of head and neck cancers.]

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[The effects of diet on development cancer and tumor control has been studied for along time, because diet has a key role in treatment of cancer. A multidisciplinary team is needed for proper use of vitamins and trace elements in cancer patients. This multidisciplinary team (oncologist, dietitian, laboratory assistant) can provide the professional supervision from the medical examination to the practical implementation, which can control the proper intake of these nutrients and the individual conditions. Dietetian is helped by appropriate health assessment (blood testing, gut microbiome and nutrigenetics) and targeting to determine the accurate amount and methods (food or dietary supplements) of vitamins and trace elements. Dietitans can help the patients to analyze the nutrients intake by food, determine the needs of the nutrients, and implement the results in practice.]

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