Abstract:
Oral squamous cell carcinoma (SCC) represents more than 90% of all oral cancers and
is the most frequent SCC of the head and neck region. It may affect any oral mucosal subsite
but most frequently the tongue, followed by the floor of the mouth. The use of tobacco and betel
nut, either smoked or chewed, and abuse of alcohol are the main risk factors for oral SCC. Oral
SCC is characterized by considerable genetic heterogeneity and diversity, which together have
a significant impact on the biological behaviour, clinical course, and response to treatment and on the
generally poor prognosis of this carcinoma. Characterization of spatial and temporal tumour-specific
molecular profiles and of person-specific resource availability and environmental and biological
selective pressures could assist in personalizing anti-cancer treatment for individual patients, with
the aim of improving treatment outcomes. In this narrative review, we discuss some of the events in
cancer evolution and the functional significance of driver-mutations in carcinoma-related genes in
general and elaborate on mechanisms mediating resistance to anti-cancer treatment.
