Clinical applications of genomics in head and neck cancer

Advances in gene expression analyses have allowed global assessment of expressed genes in clinical samples. Gene expression profiles derived from clinical specimens have been used to distinguish differences in tumors that are not obvoius by clinical, radiographic, or histologic characteristics. Despite its common histology and presentation, head and neck squamous cell carcinoma (HNSCC) is associated with widely varying clinical behavior and response to therapy. Currently, clinicians have a dearth of tools to predict response to therapy or to identify patients at high risk of poor outcome. Recently comprehensive analyses of gene expression patterns of individual tumors have shown promise to improve discovery of biomarkers for 1) progression of premalignant lesions, 2) disease presence or absence, 3) prediction of clinical outcome, and 4) identification of targets for therapy. In this review, we will discuss advances, limitations and future directions of genomics as it applies to HNSCC.