Neoadjuvant chemotherapy in oral cancer: Current status and future possibilities

Eighty-five percent of oral cavity cancers present as locally advanced disease and are treated with multimodality approach. Patients who can undergo radical resection have the best outcomes, although the overall results are still unsatisfactory. Neoadjuvant chemotherapy (NACT) has been studied in oral cavity cancers with the aim of improving locoregional control and overall survival (OS) and as an organ preservation tool in resectable oral cavity cancers, It has also been studied in borderline resectable/technically unresectable tumors in order to reduce surgical margins, increase resectability, and achieve R0 resection and in unresectable tumors in order to improve disease-free survival and OS. In this review, we will critically analyze the current evidence for the use of NACT in oral squamous cell carcinoma (OSCC) and suggest an approach to select a patient who might benefit from NACT.