Combinatorial Effects of Monocarboxylate Transporter 1 and ATP Synthase in Inhibiting Head and Neck Cancer Metabolism

Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer with an annual incidence of with 890,000 new cases and 450,000 deaths worldwide according to the Global Cancer Observatory 2021 data. It is the most common Cancer in men in India constituting 70,000 new cases annually accounted for 30% of all the cancers. It arises from the oral cavity, larynx, pharynx, oropharynx, hypopharynx, nasopharynx, sinosal tract and paranasal sinuses. Exposure to carcinogens such as tobacco, consumption of alcohol and infection of human papilloma virus (HPV) are the major risk factors that are associated with the poor survival and progression of HNSCC. HNSCC is broadly classified as HPV negative HNSCC (HPV-ve) and HPV positive HNSCC (HPV+ve). HPV+ve HNSCC are majorly associated with the oropharyngeal part of the head and neck region. With respect to invasion, migration, and chemotherapeutic response, HPV associated HNSCC cells have different metabolic and molecular profile and different clinical behaviour as compared to HPV+ve HNSCC. The routine methods for detecting HNSCC tumor includes Positron Emission Tomography-Computed Tomography (PET-CT) scan imaging, that state the metabolic activity of the HNSCC cells. This reveals that a particular metabolic pathway may trigger the progression and promotion of HNSCC tumor. Over the past few decades, irrespective of the latest scientific and therapeutic advancements, there has been not much significant improvement in the patient's survival rate suffering from HNSCC. Conventional treatment methodologies such as radiotherapy, chemotherapy, along with surgical procedures is associated with a poor overall and disease-free survival rate. Therefore, a poor response rate against treatment procedures and therapeutics has urged an important need for an improved understanding of tumor biology in HNSCC.