4.1 Review

Oral potentially malignant disorders: new insights for future treatment

Journal

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOO.0000000000000695

Keywords

biomarkers; chemoprevention; immunotherapy; oral potentially malignant disorders

Funding

  1. AIRC IG 2018 [21740]

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This review aims to define the issues regarding oral potentially malignant disorders (OPMDs) and provide an overview of treatments and ongoing clinical trials. Surgery is currently the preferred treatment for OPMD, but biomarkers identification is crucial in predicting malignant transformation. New prevention strategies and the concept of immune equilibrium may offer promising approaches for OPMD.
Purpose of review The purpose of this review is to define the issues regarding oral potentially malignant disorders (OPMDs) and provide an overview of currently available treatments and ongoing clinical trials for future opportunities. Recent findings Nowadays, the treatment of choice of OPMD is surgery, whose role in preventing malignant transformation is however limited because of the high rate of recurrence and field cancerization. There have been several attempts of combining systemic therapies with surgery to reduce risk of malignant transformation. The identification of biomarkers that could predict malignant transformation is crucial in better tailoring the risk profile and possible therapeutic approaches. Loss of heterozygosity remains the most predictive marker of malignant transformation; however, role of specific microRNA and OPMD immune infiltration are emerging as potential biomarkers. Given the failure of previous trials with various chemopreventive strategies, new strategies should be defined to address the issue of systemic prevention of malignant transformation. Recent updates about immune infiltration and the immune-equilibrium concept for OPMD could shed light into new preventive approaches.

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