Hypoxia and tumor microenvironment in head and neck squamous cell carcinoma

Awareness increases that tumors are not a homogenous collection of cells but instead form a micro-environment together with non-cancer cells. Novel anti-cancer therapies such as immunotherapy target this micro-environment rather than tumor cells directly. Hypoxia (low oxygen levels within a tumor) often exists within solid tumors and is another potential treatment target in the tumor micro-environment. This research describes the occurrence and effects of tumor hypoxia in patients with head and neck squamous cell carcinoma. Hypoxia was encountered frequently and was in most cases associated with worse prognosis. In addition, the presence of hypoxia affected other tumor micro-environment factors as well. The studies in this dissertation highlight the potential role of hypoxia-targeted therapies. These therapies should be re-explored in the modern treatment paradigm.