Systemic Inflammatory Disorders, Immunosuppressive Treatment and Increase Risk of Head and Neck Cancers-A Narrative Review of Potential Physiopathological and Biological Mechanisms

Abstract

Head and neck cancers (HNCs) are known to present multiple factors likely to influence their development. This review aims to provide a comprehensive overview of the current scientific literature on the interplay between systemic inflammatory disorders, immunosuppressive treatments and their synergistic effect on HNC risk. Both cell-mediated and humoral-mediated systemic inflammatory disorders involve dysregulated immune responses and chronic inflammation and these inflammatory conditions have been associated with an increased risk of HNC development, primarily in the head and neck region. Likewise, the interaction between systemic inflammatory disorders and immunosuppressive treatments appears to amplify the risk of HNC development, as chronic inflammation fosters a tumor-promoting microenvironment, while immunosuppressive therapies further compromise immune surveillance and anti-tumor immune responses. Understanding the molecular and cellular mechanisms underlying this interaction is crucial for developing targeted prevention strategies and therapeutic interventions. Additionally, the emerging field of immunotherapy provides potential avenues for managing HNCs associated with systemic inflammatory disorders, but further research is needed to determine its efficacy and safety in this specific context. Future studies are warranted to elucidate the underlying mechanisms and optimize preventive strategies and therapeutic interventions.

Keywords: head and neck cancers; immunosuppression; systemic inflammatory diseases.

Figure 1

Head and neck cancer regions. This image shows the relation between the different anatomical regions of the head and neck and viral-associated cancers. Adapted from [2].

Figure 2

Inflammatory bowel disease (IBD) is a term referring to two conditions: Crohn’s disease (CD) and ulcerative colitis (UC), both of which are characterized by chronic inflammation and damage of the gastrointestinal tract. CD (left) has inflammation in patches throughout the large bowel, while UC has uniform and continuous inflammation throughout. If not managed well, IBD flare-ups can be aggressive and debilitating to a person’s quality of life. Adapted from [102]. Image made using BioRender software (2023).

Figure 3

Structures of drugs azathioprine (1), cyclosporine (2), cyclophosphamide (3) and methotrexate (4). All structures were obtained using ChemDraw software (version 12.0, PerkinElmer, Inc., Waltham, MA, USA).