Oral squamous cell carcinoma: A Modern Review of Pathogenesis and Treatment

Oral cancer (OC), predominantly oral squamous cell carcinoma (OSCC), is a serious global health burden with high mortality rates, especially in South and Southeast Asia. OC is a severe worldwide health issue that is mostly caused by a sedentary lifestyle, alcohol, tobacco, and areca nut intake. The highest prevalence of OSCC is in India and Southeast Asia. Complex genomic and epigenetic changes, such as TP53 dysfunction, enhanced EGFR alteration, and dysregulation of the PI3K/AKT/mTOR signalling pathways, in conjunction with tumor-promoting alterations in the tumor microenvironment, contribute to oral carcinogenesis ( Tan et al., 2023). Oral submucous fibrosis (a chronic condition that causes precancerous progression in mouth), and leukoplakia (white or grey patches to form on mucus membrane) are instances of oral potentially malignant disorders (OPMDs), which are key indicators of cancer conversion. Even with advances in histopathology and imaging, delayed diagnosis remains a major limitation. Salivary biomarkers, liquid biopsy devices, and artificial intelligence-based screening tools are examples of novel diagnostic methods with potential for early diagnosis. Therapeutically, novel approaches such as immunotherapy, targeted therapy, nanoparticle-based drug delivery systems, electro spun nanofibers, and plant-derived phytoformulations offer innovative, multi-targeted strategies with enhanced efficacy and reduce toxicity. However, surgery, radiation, and chemotherapy continue to be the primary treatment approaches. Improving new interventions for OC treatment needs a multifaceted approach that integrates early detection strategies, advanced therapeutic strategies, the use of plant-derived therapeutics, nanotechnology, artificial intelligence, and public health awareness to get better therapeutic outcomes.