[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-376552-105":59,"doc-detail-376552-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","tumour-genetic-heterogeneity-in-relation-to-oral-squamous-cell-carcinoma-and-anti-cancer-treatment","Tumour Genetic Heterogeneity in Relation to Oral Squamous Cell Carcinoma and Anti-Cancer Treatment","","Oral squamous cell carcinoma (SCC) accounts for over 90% of oral cancers and commonly affects the tongue and the floor of the mouth. Tobacco and betel nut use, whether smoked or chewed, together with alcohol abuse are key risk factors. The disease shows substantial genetic heterogeneity and diversity, shaping biological behaviour, clinical course, treatment response, and overall poor prognosis. Spatial and temporal tumour molecular profiling, combined with patient-specific and environmental selective pressures, may support personalized anti-cancer therapy and improved outcomes. This narrative review outlines cancer evolution events and the functional roles of driver mutations, including mechanisms underlying resistance.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/tumour-genetic-heterogeneity-in-relation-to-oral-squamous-cell-carcinoma-and-anti-cancer-treatment/376552/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/tumour-genetic-heterogeneity-in-relation-to-oral-squamous-cell-carcinoma-and-anti-cancer-treatment/376552.png","ImageObject",300,407,{"name":92,"@type":93},"MrHarris58","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What are the main risk factors for oral squamous cell carcinoma mentioned in the document?","Question",{"text":113,"@type":114},"The document highlights tobacco and betel nut use (smoked or chewed) and alcohol abuse as the main risk factors.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How does tumour genetic heterogeneity influence oral SCC treatment outcomes?",{"text":118,"@type":114},"Genetic heterogeneity affects biological behaviour, clinical course, response to treatment, and contributes to generally poor prognosis, with heterogeneity linked to resistance and treatment failure.",{"name":120,"@type":111,"acceptedAnswer":121},"What does the review aim to achieve regarding anti-cancer therapy?",{"text":122,"@type":114},"It considers factors influencing tumour genetic heterogeneity in oral SCC and explains how heterogeneity affects response to anti-cancer treatment, supporting improved prognosis through personalization.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},376552,1790293178,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},687212988360,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Review  \nTumour Genetic Heterogeneity in Relation to Oral Squamous Cell Carcinoma and Anti-Cancer Treatment  \nGal Feller 1, Razia Abdool Gafaar Khammissa 2,*, Raoul Ballyram 3, Mia-Michaela Beetge 2, Johan Lemmer 4 and Liviu Feller 5  \nCitation: Feller, G.;  \nKhammissa, R.A.G.; Ballyram, R.; Beetge, M.-M.; Lemmer, J.; Feller, L. Tumour Genetic Heterogeneity in Relation to Oral Squamous Cell Carcinoma and Anti-Cancer Treatment. Int. J. Environ. Res. Public Health 2023, 20, 2392. [https://](https://)[ ](https://)[doi.org/10.3390/ijerph20032392](doi.org/10.3390/ijerph20032392)  \nAcademic Editor: Paul B. Tchounwou  \nReceived: 1 December 2022  \nRevised: 24 January 2023  \nAccepted: 26 January 2023  \nPublished: 29 January 2023  \nCopyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Department of Radiation Oncology, University of Witwatersrand, Johannesburg and Charlotte Maxeke Academic Hospital, Johannesburg 2193, South Africa  \n2 Department of Periodontics and Oral Medicine, School of Oral Health Sciences, Faculty of Health Sciences, University of Pretoria, Pretoria 0084, South Africa  \n3 Department of Periodontology and Oral Medicine, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa  \n4 Retired Professor, Silvela Street, Sandton, Johannesburg 2031, South Africa  \n5 Retired Professor, Bantry Bay, Cape Town 8005, South Africa  \n* Correspondence: [razia.khammissa@up.ac.za](razia.khammissa@up.ac.za); Tel.: +27-123-192-651  \nAbstract: 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.  \nKeywords: genetic heterogeneity; genetic diversity; natural selection; cancer-evolution; oralsquamous cell carcinoma; driver mutation; passenger mutation; resistance to anti-cancer treatment  \n1. Introduction  \nNatural selection is a key factor in the evolutionary dynamics of cancer. Positive selection induces an increase in the frequency of cancer-fostering genetic variants in the cell population, thereby promoting tumour progression, while negative selection brings about a reduction in the frequency of cancer-fostering genetic variants, thereby subduing tumour evolution. However, the “branching” of the neoplastic polygenetic tree is not entirely by Darwinian selection but can also be generated by a “mutator phenotype” within tumour cells, giving rise to rates of mutation that can be unfavourable, neutral, or advantageous to the growth of the neoplasm [1] .  \nAt the cellular and molecular level, cancer comprises an intricate, complex mosaic of spatially separated subclones of cancer cells, which differ in population size, genetic profile, and phenotypic feat","cbCaipi27qwG1S1Z","https://ap.wps.com/l/cbCaipi27qwG1S1Z","pdf",766373,"English","# Abstract\n# Introduction\n# Oral Squamous Cell Carcinoma Genetic Heterogeneity","[{\"question\":\"What are the main risk factors for oral squamous cell carcinoma mentioned in the document?\",\"answer\":\"The document highlights tobacco and betel nut use (smoked or chewed) and alcohol abuse as the main risk factors.\"},{\"question\":\"How does tumour genetic heterogeneity influence oral SCC treatment outcomes?\",\"answer\":\"Genetic heterogeneity affects biological behaviour, clinical course, response to treatment, and contributes to generally poor prognosis, with heterogeneity linked to resistance and treatment failure.\"},{\"question\":\"What does the review aim to achieve regarding anti-cancer therapy?\",\"answer\":\"It considers factors influencing tumour genetic heterogeneity in oral SCC and explains how heterogeneity affects response to anti-cancer treatment, supporting improved prognosis through personalization.\"}]","Tumour Genetic Heterogeneity in Relation to Oral Squamous Cell Carcinoma and Anti-Cancer Treatment | PDF",1790219934,25]