Pharmacological Management of Oral Squamous Cell Carcinoma: Current Therapeutic Strategies, Emerging Drugs, and Future Perspectives

Oral squamous cell carcinoma (OSCC) remains a major public health concern because of its aggressive clinical behaviour, frequent recurrence, and challenges associated with treatment resistance. Pharmacological management has evolved considerably, with conventional chemotherapy, molecularly targeted agents, and immunotherapy playing important roles in advanced and recurrent disease. This review discusses current therapeutic strategies, emerging drugs, molecular targets, mechanisms of resistance, and future directions in OSCC management. Platinum-based agents, fluorouracil, and taxanes remain important components of systemic treatment, while cetuximab provides targeted inhibition of epidermal growth factor receptor signalling. Immune checkpoint inhibitors, particularly pembrolizumab and nivolumab, have improved treatment options for selected patients with recurrent or metastatic head-and-neck squamous cell carcinoma. Recent advances in perioperative immunotherapy and biomarker-guided treatment have further expanded therapeutic possibilities. Investigational approaches involving PI3K pathway inhibitors, HRAS-targeted therapies, bispecific antibodies, antibody–drug conjugates, and novel drug-delivery systems offer additional opportunities for personalized treatment. Nevertheless, tumour heterogeneity, acquired drug resistance, treatment-related toxicity, and limited predictive biomarkers continue to restrict clinical outcomes. Most emerging strategies require further validation through prospective clinical trials, particularly in OSCC-specific populations. Integrating established pharmacological treatments with molecular profiling, improved drug-delivery technologies, and individualized therapeutic approaches could enhance treatment effectiveness, minimize adverse effects, and improve long-term patient outcomes.