Another NOTCH for Cancer

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Science  26 Aug 2011:
Vol. 333, Issue 6046, pp. 1102-1103
DOI: 10.1126/science.1210986

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Squamous cell carcinomas of the head and neck (HNSCCs) that arise in the mucosal linings of the upper respiratory and digestive tracts are the sixth leading cancer by incidence worldwide, with ∼600,000 new cases each year (1). The most important risk factors for these cancers are tobacco use and alcohol consumption, while a subgroup is caused by infection with human papillomaviruses that also cause cervical cancer (2). Patients with early-stage disease are treated by either surgery or radiotherapy, whereas patients in advanced stages receive a combination of these modalities or concurrent chemotherapy and localized radiation. Only 40 to 50% of patients will survive for 5 years after treatment (2). Antibodies directed against the epidermal growth factor receptor have been the only recent new therapy for this life-threatening disease (3). Two papers in this issue—by Agrawal et al. (4) on page 1154 and Stransky et al. (5) on page 1157—provide new insight into the genetic changes causing HNSCC that may guide the development of alternative treatment strategies.