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Yuanbo Z, Tianyi L, Xuejing S, Xinpeng L, Jianqun W, Wenxia X, Jingshu G. Using formalin fixed paraffin embedded tissue to characterize the microbiota in p16-positive and p16-negative tongue squamous cell carcinoma: a pilot study. BMC Oral Health 2024; 24:283. [PMID: 38419008 PMCID: PMC10900712 DOI: 10.1186/s12903-024-04051-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 02/19/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Tongue squamous cell carcinoma (TSCC) is the most common oral cavity cancer, and p16 immunohistochemistry is an exact and available tool in the prognostic and predictive characterization of squamous cell cancers in the head and neck. Microorganisms have a close relationship with the development of TSCC. However, the association between oral bacteria and p16 status has not been well defined in the case of TSCC. Compared with traditional clinical microbial collection methods, formalin-fixed paraffin-embedded (FFPE) tissue samples have several advantages. METHODS To compare the microbiota compositions between p16-positive and p16-negative patients with TSCC, we performed a small pilot study of microbiological studies of TSCC by paraffin tissue. DNA from FFPE tissue blocks were extracted and microbiomes were profiled by sequencing the 16 S-rRNA-encoding gene (V1-V2/V3-V4/V4 regions). Alterations in the functional potential of the microbiome were predicted using PICRUSt, Tax4Fun, and BugBase. RESULTS A total of 60 patients with TSCC were enrolled in the study, however, some challenges associated with DNA damage in FFPE tissues existed, and only 27 (15 p16-positive and 12 p16-negative) passed DNA quality control. Nevertheless, we have tentatively found some meaningful results. The p16 status is associated with microbiota diversity, which is significantly increased in p16-positive patients compared with p16-negative patients. Desulfobacteria, Limnochordia, Phycisphaerae, Anaerolineae, Saccharimonadia and Kapabacteria had higher abundances among participants with p16-positive. Moreover, functional prediction revealed that the increase of these bacteria may enhance viral carcinogenesis in p16-positive TSCC. CONCLUSIONS Bacterial profiles showed a significant difference between p16-positive TSCC and p16-negative TSCC. These findings may provide insights into the relationship between p16 status and the microbial taxa in TSCC, and these bacteria may provide new clues for developing therapeutic targets for TSCC.
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Affiliation(s)
- Zhan Yuanbo
- Department of Periodontology and Oral Mucosa, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
- Department of pathology, Harbin Medical University Cancer Hospital, Harbin Medical University, Heilongjiang, Harbin, China
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Liu Tianyi
- Department of Pathology, the Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Song Xuejing
- Harbin Institute of Technology Hospital, Harbin, China
| | - Liu Xinpeng
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wang Jianqun
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xu Wenxia
- Institute of Hard Tissue Development and Regeneration, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Geng Jingshu
- Department of pathology, Harbin Medical University Cancer Hospital, Harbin Medical University, Heilongjiang, Harbin, China.
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Furlan KC, Saeed-Vafa D, Mathew TM, Saller JJ, Tabbara SO, Boyle TA, Wenig BM, Hernandez-Prera JC. Utility of UV Signature Mutations in the Diagnostic Assessment of Metastatic Head and Neck Carcinomas of Unknown Primary. Head Neck Pathol 2024; 18:11. [PMID: 38393464 PMCID: PMC10891032 DOI: 10.1007/s12105-024-01620-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 01/25/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Metastatic carcinoma of unknown primary origin to the head and neck lymph nodes (HNCUP) engenders unique diagnostic considerations. In many cases, the detection of a high-risk human papillomavirus (HR-HPV) unearths an occult oropharyngeal squamous cell carcinoma (SCC). In metastatic HR-HPV-independent carcinomas, other primary sites should be considered, including cutaneous malignancies that can mimic HR-HPV-associated SCC. In this context, ultraviolet (UV) signature mutations, defined as ≥ 60% C→T substitutions with ≥ 5% CC→TT substitutions at dipyrimidine sites, identified in tumors arising on sun exposed areas, are an attractive and underused tool in the setting of metastatic HNCUP. METHODS A retrospective review of institutional records focused on cases of HR-HPV negative HNCUP was conducted. All cases were subjected to next generation sequencing analysis to assess UV signature mutations. RESULTS We identified 14 HR-HPV negative metastatic HNCUP to either the cervical or parotid gland lymph nodes, of which, 11 (11/14, 79%) had UV signature mutations, including 4 (4/10, 40%) p16 positive cases. All UV signature mutation positive cases had at least one significant TP53 mutation and greater than 20 unique gene mutations. CONCLUSION The management of metastatic cutaneous carcinomas significantly differs from other HNCUP especially metastatic HR-HPV-associated SCC; therefore, the observation of a high percentage of C→T with CC →TT substitutions should be routinely incorporated in next generation sequencing reports of HNCUP. UV mutational signatures testing is a robust diagnostic tool that can be utilized in daily clinical practice.
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Affiliation(s)
- Karina Colossi Furlan
- Department of Pathology, Moffitt Cancer Center 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Daryoush Saeed-Vafa
- Department of Pathology, Moffitt Cancer Center 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Tiffani M Mathew
- Department of Pathology, Moffitt Cancer Center 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - James J Saller
- Department of Pathology, Moffitt Cancer Center 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Sana O Tabbara
- Department of Pathology, Moffitt Cancer Center 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Theresa A Boyle
- Department of Pathology, Moffitt Cancer Center 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Bruce M Wenig
- Department of Pathology, Moffitt Cancer Center 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Juan C Hernandez-Prera
- Department of Pathology, Moffitt Cancer Center 12902 Magnolia Drive, Tampa, FL, 33612, USA.
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Constantin M, Chifiriuc MC, Mihaescu G, Vrancianu CO, Dobre EG, Cristian RE, Bleotu C, Bertesteanu SV, Grigore R, Serban B, Cirstoiu C. Implications of oral dysbiosis and HPV infection in head and neck cancer: from molecular and cellular mechanisms to early diagnosis and therapy. Front Oncol 2023; 13:1273516. [PMID: 38179168 PMCID: PMC10765588 DOI: 10.3389/fonc.2023.1273516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 11/30/2023] [Indexed: 01/06/2024] Open
Abstract
Head and neck cancer (HNC) is the sixth most common type of cancer, with more than half a million new cases annually. This review focuses on the role of oral dysbiosis and HPV infection in HNCs, presenting the involved taxons, molecular effectors and pathways, as well as the HPV-associated particularities of genetic and epigenetic changes and of the tumor microenvironment occurred in different stages of tumor development. Oral dysbiosis is associated with the evolution of HNCs, through multiple mechanisms such as inflammation, genotoxins release, modulation of the innate and acquired immune response, carcinogens and anticarcinogens production, generation of oxidative stress, induction of mutations. Thus, novel microbiome-derived biomarkers and interventions could significantly contribute to achieving the desideratum of personalized management of oncologic patients, regarding both early diagnosis and treatment. The results reported by different studies are not always congruent regarding the variations in the abundance of different taxons in HNCs. However, there is a consistent reporting of a higher abundance of Gram-negative species such as Fusobacterium, Leptotrichia, Treponema, Porphyromonas gingivalis, Prevotella, Bacteroidetes, Haemophilus, Veillonella, Pseudomonas, Enterobacterales, which are probably responsible of chronic inflammation and modulation of tumor microenvironment. Candida albicans is the dominant fungi found in oral carcinoma being also associated with shorter survival rate. Specific microbial signatures (e.g., F. nucleatum, Bacteroidetes and Peptostreptococcus) have been associated with later stages and larger tumor, suggesting their potential to be used as biomarkers for tumor stratification and prognosis. On the other hand, increased abundance of Corynebacterium, Kingella, Abiotrophia is associated with a reduced risk of HNC. Microbiome could also provide biomarkers for differentiating between oropharyngeal and hypopharyngeal cancers as well as between HPV-positive and HPV-negative tumors. Ongoing clinical trials aim to validate non-invasive tests for microbiome-derived biomarkers detection in oral and throat cancers, especially within high-risk populations. Oro-pharyngeal dysbiosis could also impact the HNCs therapy and associated side-effects of radiotherapy, chemotherapy, and immunotherapy. HPV-positive tumors harbor fewer mutations, as well as different DNA methylation pattern and tumor microenvironment. Therefore, elucidation of the molecular mechanisms by which oral microbiota and HPV infection influence the HNC initiation and progression, screening for HPV infection and vaccination against HPV, adopting a good oral hygiene, and preventing oral dysbiosis are important tools for advancing in the battle with this public health global challenge.
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Affiliation(s)
- Marian Constantin
- Department of Microbiology, Institute of Biology of Romanian Academy, Bucharest, Romania
- The Research Institute of the University of Bucharest, ICUB, Bucharest, Romania
| | - Mariana Carmen Chifiriuc
- The Research Institute of the University of Bucharest, ICUB, Bucharest, Romania
- Microbiology Immunology Department, Faculty of Biology, University of Bucharest, Bucharest, Romania
- Department of Life, Medical and Agricultural Sciences, Biological Sciences Section, Romanian Academy, Bucharest, Romania
| | - Grigore Mihaescu
- Microbiology Immunology Department, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Corneliu Ovidiu Vrancianu
- The Research Institute of the University of Bucharest, ICUB, Bucharest, Romania
- Microbiology Immunology Department, Faculty of Biology, University of Bucharest, Bucharest, Romania
- DANUBIUS Department, National Institute of Research and Development for Biological Sciences, Bucharest, Romania
| | - Elena-Georgiana Dobre
- The Research Institute of the University of Bucharest, ICUB, Bucharest, Romania
- Immunology Department, “Victor Babes” National Institute of Pathology, Bucharest, Romania
| | - Roxana-Elena Cristian
- The Research Institute of the University of Bucharest, ICUB, Bucharest, Romania
- DANUBIUS Department, National Institute of Research and Development for Biological Sciences, Bucharest, Romania
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Coralia Bleotu
- The Research Institute of the University of Bucharest, ICUB, Bucharest, Romania
- Cellular and Molecular Pathology Department, Ştefan S. Nicolau Institute of Virology, Bucharest, Romania
| | - Serban Vifor Bertesteanu
- Coltea Clinical Hospital, ENT, Head & Neck Surgery Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Raluca Grigore
- Coltea Clinical Hospital, ENT, Head & Neck Surgery Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Bogdan Serban
- University Emergency Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Catalin Cirstoiu
- University Emergency Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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Magalhaes IA, Barbosa KC, Juliao Costa GA, de Oliveira Filho OV, da Silva Junior JE, Gonzaga e Silva LF, Juacaba SF, Sousa FB, de Barros Silva PG. Influence of p16 Protein Immunostaining on Histopathological Features of Pleomorphic Adenoma and Carcinoma ex- Pleomorphic Adenoma. Asian Pac J Cancer Prev 2023; 24:3815-3824. [PMID: 38019239 PMCID: PMC10772772 DOI: 10.31557/apjcp.2023.24.11.3815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 11/20/2023] [Indexed: 11/30/2023] Open
Abstract
The objective of this study was to evaluate the role of p16 in histologic characteristics and transition of Pleomorphic Adenoma (PA) to Carcinoma ex-PA (CxPA). So, 60 PA and 4 CxPA were histologic reviewed based on microscopic characteristics proposed by Hellquist, Triantafyllou and Dulguerov (PA) and Morais, Antony and Toluie (CxPA). Immunostaining for p16 was associated in different parenchyma and stroma of both tumors and Fisher's/chi-square tests and Mann-Whitney test were performed (SPSS v20.0, p<0.05). In PA the periductal cells were predominantly p16- and that ductal and myoepithelial cells showed a significant increase in p16+ cells (p<0.001). In CxPA, none of the cases showed p16+ in periductal cells, most parotid cases showed p16+ in ductal cells, and one case of parotid and the submandibular case showed mild immunostaining for myoepithelial cells. There was a small reduction in p16+ in CxPA compared to PA (p=0.537), but in both tumors there was less p16+ cells in solid stroma than other (p<0.001). The p16+ cases of PA had a higher capsular thickness (p=0.047). So, the loss of p16 immunostaining does not seem to be associated with the transition from PA to CxPA, but in both tumors the loss of p16+ cells are related to microscopic aggressiveness.
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Affiliation(s)
| | | | - Gabriela Alves Juliao Costa
- Unichristus, Department of Dentistry, Fortaleza, Ceará, Brazil.
- Haroldo Juaçaba Hospital, Ceará Cancer Institute, Fortaleza, Ceará, Brazil.
| | | | | | | | | | | | - Paulo Goberlanio de Barros Silva
- Unichristus, Department of Dentistry, Fortaleza, Ceará, Brazil.
- Haroldo Juaçaba Hospital, Ceará Cancer Institute, Fortaleza, Ceará, Brazil.
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Burruss CP, Sharrer C, Porterfield JZ, Kejner AE. Extranodal Extension Improves AJCC-8 Accuracy in HPV+ Oropharyngeal Cancer in a High-Risk Population. Laryngoscope 2023; 133:2621-2626. [PMID: 36655591 DOI: 10.1002/lary.30572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/27/2022] [Accepted: 01/01/2023] [Indexed: 01/20/2023]
Abstract
OBJECTIVES The American Joint Committee on Cancer's 8th edition (AJCC-8) separates oropharyngeal squamous cell carcinomas (OPSCCs) into human papillomavirus-positive (HPV+) tumors and HPV-negative tumors. Although AJCC-8 improves prognostic prediction for survival for the majority of HPV+ OPSCC, outliers are still encountered. The goal of this manuscript is to validate the AJCC-8 as a better metric of survivability than the AJCC-7 in an historically under-served rural population with confounding variables, such as tobacco use, alcohol consumption, and poor health care access and to analyze the role of extranodal extension (ENE) in this population. DESIGN Retrospective cohort study. RESULTS Compared to AJCC-7, AJCC-8 had a higher odds ratio (OR) for predicting mortality of stage IV HPV+ OPSCCs versus stages I-III. On multivariate analysis, HPV+ OPSCCs with ENE had a higher OR of mortality compared to ENE- OPSCCs. In addition, HPV+ OPSCC patients with a Charlson Comorbidity Index (CCI) > 3 had a higher OR of mortality compared to those with a CCI ≤ 3. Patients with Medicaid/self-pay status had a higher OR of mortality compared to those with private insurance/Medicare. Finally, patients from rural populations had a higher OR of presenting with stage IV disease, a CCI > 3, and Medicaid/self-pay status. CONCLUSIONS Despite not being a discrete part of the AJCC-8 staging rubric, ENE was found to have a significant impact on mortality among this population, whereas tobacco use had no effect. Rural patients were more likely to present with stage IV disease, CCI > 3, and Medicaid/self-pay status. Stage IV disease was also associated with a higher OR of mortality. LEVEL OF EVIDENCE 4 Laryngoscope, 133:2621-2626, 2023.
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Affiliation(s)
| | - Christine Sharrer
- University of Kentucky, College of Medicine, Lexington, Kentucky, USA
| | - James Zachary Porterfield
- University of Kentucky, Department of Otolaryngology-Head and Neck Surgery, Lexington, Kentucky, USA
- University of KwaZulu-Natal, Department of Otorhinolaryngology, Durban, South Africa
| | - Alexandra Eva Kejner
- Medical University of South Carolina, Department of Otolaryngology, Charleston, South Carolina, USA
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Vazquez-Guillen JM, Palacios-Saucedo GC, Alanis-Valdez AY, Huerta-Escobedo A, Zavala-Pompa A, Rivera-Morales LG, Martinez-Torres AC, Gonzalez-Villasana V, Serna-Hernandez JC, Hernandez-Martinez SJ, Castelan-Maldonado EE, Montalvo-Bañuelos MS, Alonso-Tellez CA, Sanchez-Fresno EC, Tamez-Guerra RS, Rodriguez-Padilla C. p16 INK4a and pRb expression in laryngeal squamous cell carcinoma with and without infection by EBV or different genotypes of HPV: a retrospective study. Infect Agent Cancer 2023; 18:43. [PMID: 37434200 DOI: 10.1186/s13027-023-00514-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 05/24/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Laryngeal squamous cell carcinoma (LSCC) represents one of the principal tumors of the head and neck. Human papillomavirus (HPV) and Epstein-Barr virus (EBV) are considered risk factors for the development and the clinical prognosis of LSCC. High levels of p16INK4a are suggested as a surrogate marker of HPV or EBV infection in some head and neck tumors but in LSCC is still controversial. Furthermore, pRb expression may be considered an additional biomarker but it has not been clearly defined. This work aimed to compare the expression of pRb and p16INK4a as possible biomarkers in tumor tissues with and without infection by EBV or different genotypes of HPV from patients with LSCC. METHODS Tumor samples from 103 patients with LSCC were previously investigated for the presence and genotypes of HPV using the INNO-LiPA line probe assay and for the infection of EBV by qPCR. p16 INK4a and pRb expression was assessed by immunohistochemistry. RESULTS Of the 103 tumor samples, expression of p16INK4a was positive in 55 (53.4%) and of this, 32 (56.1%) were positive for HPV whereas 11 (39.3%) were EBV positive but both without a significantly difference (p > 0.05). pRb expression was positive in 78 (75.7%) and a higher frequency of this expression was observed in HPV negative samples (87.0%) (p = 0.021) and in high-risk HPV negative samples (85.2%) (p = 0.010). No difference was observed when comparing pRb expression and EBV infection status (p > 0.05). CONCLUSION Our results support the suggestion that p16INK4a is not a reliable surrogate marker for identifying HPV or EBV infection in LSCC. On the other hand, most of our samples had pRb expression, which was more frequent in tumors without HPV, suggesting that pRb could indicate HPV negativity. However, more studies with a larger number of cases are required, including controls without LSCC and evaluating other molecular markers to determine the real role of p16INK4a and pRb in LSCC.
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Affiliation(s)
- Jose Manuel Vazquez-Guillen
- Laboratorio de Inmunologia y Virologia, Facultad de Ciencias Biologicas, Universidad Autonoma de Nuevo Leon, San Nicolas de los Garza, Nuevo Leon, Mexico
| | - Gerardo C Palacios-Saucedo
- Division de Investigacion, Departamento de Otorrinolaringologia y Departamento de Anatomia Patologica, Unidad Medica de Alta Especialidad, Hospital de Especialidades No. 25, Instituto Mexicano del Seguro Social, Monterrey, Nuevo Leon, Mexico.
| | - Alondra Yamileth Alanis-Valdez
- Laboratorio de Inmunologia y Virologia, Facultad de Ciencias Biologicas, Universidad Autonoma de Nuevo Leon, San Nicolas de los Garza, Nuevo Leon, Mexico
| | - Andrea Huerta-Escobedo
- Laboratorio de Inmunologia y Virologia, Facultad de Ciencias Biologicas, Universidad Autonoma de Nuevo Leon, San Nicolas de los Garza, Nuevo Leon, Mexico
| | - Angel Zavala-Pompa
- Laboratorio Medicina Diagnostica S.A. de C.V., Monterrey, Nuevo Leon, Mexico
| | - Lydia Guadalupe Rivera-Morales
- Laboratorio de Inmunologia y Virologia, Facultad de Ciencias Biologicas, Universidad Autonoma de Nuevo Leon, San Nicolas de los Garza, Nuevo Leon, Mexico
| | - Ana Carolina Martinez-Torres
- Laboratorio de Inmunologia y Virologia, Facultad de Ciencias Biologicas, Universidad Autonoma de Nuevo Leon, San Nicolas de los Garza, Nuevo Leon, Mexico
| | - Vianey Gonzalez-Villasana
- Departamento de Biologia Celular y Genetica, Facultad de Ciencias Biologicas, Universidad Autonoma de Nuevo Leon, San Nicolas de los Garza, Nuevo Leon, Mexico
| | - Julio Cesar Serna-Hernandez
- Division de Investigacion, Departamento de Otorrinolaringologia y Departamento de Anatomia Patologica, Unidad Medica de Alta Especialidad, Hospital de Especialidades No. 25, Instituto Mexicano del Seguro Social, Monterrey, Nuevo Leon, Mexico
| | - Silvia Judith Hernandez-Martinez
- Division de Investigacion, Departamento de Otorrinolaringologia y Departamento de Anatomia Patologica, Unidad Medica de Alta Especialidad, Hospital de Especialidades No. 25, Instituto Mexicano del Seguro Social, Monterrey, Nuevo Leon, Mexico
| | - Edmundo Erbey Castelan-Maldonado
- Division de Investigacion, Departamento de Otorrinolaringologia y Departamento de Anatomia Patologica, Unidad Medica de Alta Especialidad, Hospital de Especialidades No. 25, Instituto Mexicano del Seguro Social, Monterrey, Nuevo Leon, Mexico
| | - Martha Socorro Montalvo-Bañuelos
- Departamento de Foniatria, Hospital General de Zona No. 6, Instituto Mexicano del Seguro Social, San Nicolas de los Garza, Nuevo Leon, Mexico
| | - Cesar Alejandro Alonso-Tellez
- Division de Investigacion, Departamento de Otorrinolaringologia y Departamento de Anatomia Patologica, Unidad Medica de Alta Especialidad, Hospital de Especialidades No. 25, Instituto Mexicano del Seguro Social, Monterrey, Nuevo Leon, Mexico
| | - Ethel Corinthia Sanchez-Fresno
- Division de Investigacion, Departamento de Otorrinolaringologia y Departamento de Anatomia Patologica, Unidad Medica de Alta Especialidad, Hospital de Especialidades No. 25, Instituto Mexicano del Seguro Social, Monterrey, Nuevo Leon, Mexico
| | - Reyes S Tamez-Guerra
- Laboratorio de Inmunologia y Virologia, Facultad de Ciencias Biologicas, Universidad Autonoma de Nuevo Leon, San Nicolas de los Garza, Nuevo Leon, Mexico
| | - Cristina Rodriguez-Padilla
- Laboratorio de Inmunologia y Virologia, Facultad de Ciencias Biologicas, Universidad Autonoma de Nuevo Leon, San Nicolas de los Garza, Nuevo Leon, Mexico
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Pinkiewicz M, Dorobisz K, Zatoński T. Human Papillomavirus-Associated Head and Neck Cancers. Where are We Now? A Systematic Review. Cancer Manag Res 2022; 14:3313-3324. [PMID: 36465708 PMCID: PMC9709860 DOI: 10.2147/cmar.s379173] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 10/19/2022] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Human papillomavirus targets the skin and mucous membranes, producing benign hyperplastic lesions and precancerous and cancerous lesions. An increasing number of head and neck cancersin particular, oropharyngeal squamous cell carcinoma, laryngeal squamous cell carcinoma, and oral squamous cell carcinoma, are attributable to HPV infection. HPV-induced HNCs typically affect younger, nonsmoking patients with no prior history of heavy alcohol use, more extensive sexual history, and higher socioeconomic status. AIM The purpose of the review is to present the most recent and well-established findings concerning HPV-induced head and neck cancers and consequently to provide medical specialists with essential information regarding the epidemiology, the role of HPV in HNC cancerogenesis, prevention, diagnosis, and treatment. MATERIAL AND METHODS All authors independently have searched The EMbase, Medline/Pubmed, and Cochrane databases by using the following keywords "head and neck cancer", "human papillomavirus", "HPV", "HPV biology", "oropharyngeal squamous cell carcinoma", "carcinogenesis", "transoral surgery", "robotic surgery". The last search was conducted in March 2022. The references of the publications of interest were also screened for relevant papers. There were no limitations in regard to the publication date. CONCLUSION Aiming to avoid the epidemic of HPV-induced HNC, it is paramount to improve the access to vaccination as well as resolve parental concerns regarding vaccine safety. Physicians should rely on reduced-dose radiation and aim to reduce the overall treatment time. Thanks to a more elaborate understanding of the genomic background of HPV-induced HNC, precision medicine could become a relevant part of patients' management. In comparison to traditional techniques and non-operative treatment, transoral robotic surgery (TORS) offers similar oncologic and functional outcomes, with a possible benefit on long-term quality of life. However, more research is needed to establish clear guidelines indicating when TORS resections should be supported with adjuvant therapy.
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Affiliation(s)
- Miłosz Pinkiewicz
- Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Karolina Dorobisz
- Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Wroclaw, Poland
| | - Tomasz Zatoński
- Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, Wroclaw, Poland
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Mandal AP, Saha R, Das C, Sengupta A. Sinonasal mass lesions: A clinicopathological study with p63 and p16 immunohistochemical expressions. J Oral Maxillofac Pathol 2022; 26:501-508. [PMID: 37082072 PMCID: PMC10112076 DOI: 10.4103/jomfp.jomfp_120_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 10/17/2022] [Accepted: 11/14/2022] [Indexed: 04/22/2023] Open
Abstract
Introduction The worldwide annual incidence of carcinomas of the sinonasal tract is 0.5 to 1.0 patients per 100,000 per year. P63 plays a role in epithelial development and is used as a marker for basal and myoepithelial cells. Expression of p16 occurs as a result of functional inactivation of the retinoblastoma protein (pRb) by the human papilloma virus (HPV) E7 protein. Aims This study aims to study the histological spectrum of benign and malignant sinonasal mass lesions and to study the immunohistochemical expression of p63 in different type of sinonasal mass lesions. It also aims to ascertain the incidence of high-risk HPV in primary sinonasal mass lesions with p16 immunohistochemistry and delineate the histological spectrum of HPV-related sinonasal lesions. Materials and Methods This cross-sectional study was conducted on 80 cases from June 2018 to June 2020 at a tertiary care hospital. Clinical history including demographic parameters were collected in the study proforma. The gross findings of the specimens noted and histopathological examination by H&E staining done. Immunohistochemistry staining for p63 and p16 expression was performed on all cases. Results Most common age group affected was 41-60 years with male:female ratio of 1.67:1. Nonneoplastic lesions (38.7%) comprised majority of the cases followed by benign neoplastic lesions (31.3%) and malignant neoplastic lesions (30%). Among the malignant neoplastic lesions, p63 showed positive expression in 75% (p = 0.005) and p16 showed positive expression in 41.7% (p = 0.023). Among benign and nonneoplastic lesions, p63 showed positivity in 21.4% (p = 0.000) and p16 showed positivity in 44.6% (p = 0.040). Conclusion We analyzed p63 and p16 expression in varied lineages like carcinomas, papillomas, and neuroectodermal differentiation arising from the sinonasal tract and also in relation to other clinicopathological parameters. This study revealed p63 expression was associated more with the squamous cell carcinomas and nasopharyngeal carcinomas. Sinonasal tract malignancies are also associated with HPV infections that are identifiable by p16 immunostaining and, thus, could provide new prospects in identifying any definite biological and clinical characteristics associated with HPV as well as advancement in the targeted therapies for this patient population.
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Affiliation(s)
| | - Rama Saha
- Department of Pathology, IPGME&R, Kolkata, West Bengal, India
| | - Chhanda Das
- Department of Pathology, IPGME&R, Kolkata, West Bengal, India
| | - Arunabha Sengupta
- Department of Otorhinolaryngology, IPGME&R, Kolkata, West Bengal, India
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McKeon MG, Gallant JN, Kim YJ, Das SR. It Takes Two to Tango: A Review of Oncogenic Virus and Host Microbiome Associated Inflammation in Head and Neck Cancer. Cancers (Basel) 2022; 14:cancers14133120. [PMID: 35804891 PMCID: PMC9265087 DOI: 10.3390/cancers14133120] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/04/2022] [Accepted: 06/21/2022] [Indexed: 12/04/2022] Open
Abstract
Simple Summary Certain viruses, specifically, human papillomavirus (HPV) and Epstein–Barr virus (EBV), have been linked with the development of head and neck cancer. In this study, we review the mechanisms by which (these) viruses lead to cellular transformation and a chronic inflammatory state. Given that the head and neck host a rich microbiome (which itself is intrinsically linked to inflammation), we scrutinize the literature to highlight the interplay between viruses, cellular transformation, inflammation, and the local host microbiome in head and neck cancer. Abstract While the two primary risk factors for head and neck squamous cell carcinoma (HNSCC) are alcohol and tobacco, viruses account for an important and significant upward trend in HNSCC incidence. Human papillomavirus (HPV) is the causative agent for a subset of oropharyngeal squamous cell carcinoma (OPSCC)—a cancer that is impacting a rapidly growing group of typically middle-aged non-smoking white males. While HPV is a ubiquitously present (with about 1% of the population having high-risk oral HPV infection at any one time), less than 1% of those infected with high-risk strains develop OPSCC—suggesting that additional cofactors or coinfections may be required. Epstein–Barr virus (EBV) is a similarly ubiquitous virus that is strongly linked to nasopharyngeal carcinoma (NPC). Both of these viruses cause cellular transformation and chronic inflammation. While dysbiosis of the human microbiome has been associated with similar chronic inflammation and the pathogenesis of mucosal diseases (including OPSCC and NPC), a significant knowledge gap remains in understanding the role of bacterial-viral interactions in the initiation, development, and progression of head and neck cancers. In this review, we utilize the known associations of HPV with OPSCC and EBV with NPC to investigate these interactions. We thoroughly review the literature and highlight how perturbations of the pharyngeal microbiome may impact host-microbiome-tumor-viral interactions—leading to tumor growth.
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Affiliation(s)
- Mallory G. McKeon
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, Suite A2200, Nashville, TN 37232, USA;
- Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (J.-N.G.); (Y.J.K.)
| | - Jean-Nicolas Gallant
- Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (J.-N.G.); (Y.J.K.)
| | - Young J. Kim
- Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA; (J.-N.G.); (Y.J.K.)
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Suman R. Das
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, Suite A2200, Nashville, TN 37232, USA;
- Correspondence: ; Tel.: +1-(615)-322-0322; Fax: +1-(615)-343-6160
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Shi J, Wang L, Yao N, Sun L, Hu W, Li X, Yang Y, Wang Y, Zhu W, Li B. The effect of HPV DNA and p16 status on the prognosis of patients with hypopharyngeal carcinoma: a meta-analysis. BMC Cancer 2022; 22:658. [PMID: 35705893 PMCID: PMC9202146 DOI: 10.1186/s12885-022-09769-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To evaluate whether the presence of human papillomavirus (HPV) DNA and p16 might be associated with better prognosis in patients with hypopharyngeal carcinoma (HPC), especially on overall survival (OS) and disease-free survival (DFS). METHOD PubMed, the Cochrane Library, the Web of Science and EMBASE were searched from inception to April 2021 to search for HPV DNA- and p16-related prognostic articles on HPC. Meta-analysis was performed on the selected articles according to the inclusion and exclusion criteria. Publication bias was assessed for the included studies with Egger's test. All studies were analyzed by using Stata 16.0 statistical software. RESULTS A total of 18 studies were included, including 12 HPV DNA studies and 11 p16 studies. Meta-analysis showed that HPV DNA positivity was a strong prognostic factor for improved OS in patients with HPC, with a pooled hazard ratio (HR) of 0.61 (95% CI, 0.54-0.69), but there was no statistically significant difference in DFS (HR, 0.60; 95% CI, 0.31-1.16). Patients with p16-positive tumors had better OS (HR, 0.66; 95% CI, 0.49-0.89) and DFS (HR, 0.59; 95% CI, 0.44-0.78) than patients with p16-negative tumors. CONCLUSIONS This study suggests that the presence of HPV DNA leads to better OS in patients with HPC, and the presence of p16 also corresponds to better OS and DFS. Our results provide up-to-date evidence to clinicians and researchers. Larger studies adjusting for prognostic factors are needed in subsequent studies.
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Affiliation(s)
- Jinfeng Shi
- Department of Otolaryngology Head and Neck Surgery, The First Hospital of Jilin University, Xinmin Street No. 71, JiLin, 130021, Changchun, P.R. China
| | - Ling Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street 1163, 130021, Changchun, P. R. China
| | - Nan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street 1163, 130021, Changchun, P. R. China
| | - Le Sun
- Department of Otolaryngology Head and Neck Surgery, The First Hospital of Jilin University, Xinmin Street No. 71, JiLin, 130021, Changchun, P.R. China
| | - Wenyu Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street 1163, 130021, Changchun, P. R. China
| | - Xiaotong Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street 1163, 130021, Changchun, P. R. China
| | - Yixue Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street 1163, 130021, Changchun, P. R. China
| | - Yusheng Wang
- Department of Otolaryngology Head and Neck Surgery, The First Hospital of Jilin University, Xinmin Street No. 71, JiLin, 130021, Changchun, P.R. China
| | - Wei Zhu
- Department of Otolaryngology Head and Neck Surgery, The First Hospital of Jilin University, Xinmin Street No. 71, JiLin, 130021, Changchun, P.R. China.
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street 1163, 130021, Changchun, P. R. China.
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11
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Jun HW, Ji YB, Song CM, Myung JK, Park HJ, Tae K. Positive Rate of Human Papillomavirus and Its Trend in Head and Neck Cancer in South Korea. Front Surg 2022; 8:833048. [PMID: 35127812 PMCID: PMC8814325 DOI: 10.3389/fsurg.2021.833048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 12/29/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction This study aimed to investigate the positive rate of human papillomavirus (HPV) and its trend in head and neck squamous cell carcinoma (HNSCC) in South Korea and to evaluate the clinical differences between HPV-positive and -negative tumors. Methods We studied 300 patients with HNSCC arising in the oropharynx (n = 77), oral cavity (n = 65), larynx (n = 106), hypopharynx (n = 40), and sinonasal cavity (n = 12), treated in a tertiary university hospital in South Korea from January 2008 to July 2020. HPV status was determined using p16 immunohistochemical staining of formalin-fixed paraffin-embedded tissues. Results Of the 300 patients with HNSCC, the positive rate of p16 was 30.3% (91/300). The p16 positive rate was 70.1, 13.9, 20.8, 15, and 0% in the oropharynx, oral cavity, larynx, hypopharynx, and sinonasal cavity, respectively. HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) patients were significantly younger than HPV-negative OPSCC patients. The positive rate of HPV in OPSCC has increased over time from 2008 to 2020, but has not changed significantly in the other primary sites. The disease-free survival curve of HPV-positive OPSCC was significantly better than that of HPV-negative tumors. Conclusion The positive rate of HPV in Korean patients with OPSCC is significantly high (70.1%), similar to that in North America and Europe, and has increased abruptly in the past 12 years.
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Affiliation(s)
- Hyun Woong Jun
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea
| | - Yong Bae Ji
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea
| | - Chang Myeon Song
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea
| | - Jae Kyung Myung
- Department of Pathology, College of Medicine, Hanyang University, Seoul, South Korea
| | - Hae Jin Park
- Department of Radiation Oncology, College of Medicine, Hanyang University, Seoul, South Korea
| | - Kyung Tae
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, South Korea
- *Correspondence: Kyung Tae
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12
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Powell SF, Vu L, Spanos WC, Pyeon D. The Key Differences between Human Papillomavirus-Positive and -Negative Head and Neck Cancers: Biological and Clinical Implications. Cancers (Basel) 2021; 13:5206. [PMID: 34680354 PMCID: PMC8533896 DOI: 10.3390/cancers13205206] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/08/2021] [Accepted: 10/13/2021] [Indexed: 12/17/2022] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a unique malignancy associated with two distinct risk factors: exposure to typical carcinogens and infection of human papillomavirus (HPV). HPV encodes the potent oncoproteins E6 and E7, which bypass many important oncogenic processes and result in cancer development. In contrast, HPV-negative HNSCC is developed through multiple mutations in diverse oncogenic driver genes. While the risk factors associated with HPV-positive and HPV-negative HNSCCs are discrete, HNSCC patients still show highly complex molecular signatures, immune infiltrations, and treatment responses even within the same anatomical subtypes. Here, we summarize the current understanding of biological mechanisms, treatment approaches, and clinical outcomes in comparison between HPV-positive and -negative HNSCCs.
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Affiliation(s)
- Steven F. Powell
- Cancer Biology and Immunotherapies Group, Sanford Research, Sioux Falls, SD 57104, USA;
| | - Lexi Vu
- Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI 48824, USA;
| | - William C. Spanos
- Cancer Biology and Immunotherapies Group, Sanford Research, Sioux Falls, SD 57104, USA;
| | - Dohun Pyeon
- Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI 48824, USA;
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13
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Shestakova A, Tarabay J, Burtsev A, Ibe I, Kim J, Chandan V, Armstrong WB, Tjoson T, Wang B. Increased PD-L1 and p16 expression are common in oropharyngeal squamous cell carcinoma. Future Sci OA 2021; 7:FSO768. [PMID: 34737892 PMCID: PMC8558873 DOI: 10.2144/fsoa-2021-0039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/19/2021] [Indexed: 12/02/2022] Open
Abstract
Overexpression of p16 is closely related to human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (SCC) and pertains a prognostic relevance. Programmed cell death 1-ligand 1 (PD-L1) is another important marker, as anti-PD-L1 immunotherapy is available. Retrospective analysis of 57 cases of the SCC involving oropharynx (27 cases), hypopharynx (5 cases), larynx (11 cases), and oral cavity (14 cases) was performed. Each case was scrutinized for the basaloid morphology, p16, and PD-L1 expression. Basaloid morphology was identified in 47% of total cases. The majority of basaloid SCC variants were located in the oropharynx (89%). High expression of p16 was mostly observed in the oropharynx. High PD-L1 expression was seen predominantly in oropharyngeal and hypopharyngeal locations. Further studies in a larger cohort are necessary to correlate PD-L1 and p16 expression with survival.
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Affiliation(s)
- Anna Shestakova
- Department of Pathology, University of Utah and ARUP laboratories, Salt Lake City, UT 84108, USA
| | - Jana Tarabay
- Department of Pathology, University of California, Irvine, CA 92868, USA
| | - Anton Burtsev
- Department of Computer Science, University of California, Irvine, CA 92697, USA
| | - Ifegwu Ibe
- Department of Pathology, University of California, Irvine, CA 92868, USA
| | - Jeffrey Kim
- Department of Pathology, University of California, Irvine, CA 92868, USA
| | - Vishal Chandan
- Department of Pathology, University of California, Irvine, CA 92868, USA
| | - William B Armstrong
- Department of Otolaryngology – Head & Neck Surgery, University of California, Irvine, CA 92868, USA
| | - Tjoa Tjoson
- Department of Otolaryngology – Head & Neck Surgery, University of California, Irvine, CA 92868, USA
| | - Beverly Wang
- Department of Pathology, University of California, Irvine, CA 92868, USA
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Kordbacheh F, Farah CS. Molecular Pathways and Druggable Targets in Head and Neck Squamous Cell Carcinoma. Cancers (Basel) 2021; 13:3453. [PMID: 34298667 PMCID: PMC8307423 DOI: 10.3390/cancers13143453] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/02/2021] [Accepted: 07/08/2021] [Indexed: 12/30/2022] Open
Abstract
Head and neck cancers are a heterogeneous group of neoplasms, affecting an ever increasing global population. Despite advances in diagnostic technology and surgical approaches to manage these conditions, survival rates have only marginally improved and this has occurred mainly in developed countries. Some improvements in survival, however, have been a result of new management and treatment approaches made possible because of our ever-increasing understanding of the molecular pathways triggered in head and neck oncogenesis, and the growing understanding of the abundant heterogeneity of this group of cancers. Some important pathways are common to other solid tumours, but their impact on reducing the burden of head and neck disease has been less than impressive. Other less known and little-explored pathways may hold the key to the development of potential druggable targets. The extensive work carried out over the last decade, mostly utilising next generation sequencing has opened up the development of many novel approaches to head and neck cancer treatment. This paper explores our current understanding of the molecular pathways of this group of tumours and outlines associated druggable targets which are deployed as therapeutic approaches in head and neck oncology with the ultimate aim of improving patient outcomes and controlling the personal and economic burden of head and neck cancer.
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Affiliation(s)
- Farzaneh Kordbacheh
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA;
- ACRF Department of Cancer Biology and Therapeutics, The John Curtin School of Medical Research, Australian National University, Canberra, ACT 0200, Australia
| | - Camile S. Farah
- The Australian Centre for Oral Oncology Research & Education, Perth, WA 6009, Australia
- Genomics for Life, Brisbane, QLD 4064, Australia
- Anatomical Pathology, Australian Clinical Labs, Subiaco, WA 6008, Australia
- Peter MacCallum Cancer Centre, Head and Neck Cancer Signalling Laboratory, Melbourne, VIC 3000, Australia
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15
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Zhou P, Yu YF, Lian CL, Wang J, Zhuo RG, Wu SG. Survival Outcomes and Treatment Decision by Human Papillomavirus Status Among Patients With Stage IVC Head and Neck Squamous Cell Carcinoma. Front Oncol 2021; 11:668066. [PMID: 34136400 PMCID: PMC8201515 DOI: 10.3389/fonc.2021.668066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/12/2021] [Indexed: 11/28/2022] Open
Abstract
Purpose To investigate the influence of human papillomavirus (HPV) status on survival outcomes and treatment decisions for patients with de novo stage IV head and neck squamous cell cancers (HNSCC). Methods Patients initially diagnosed with de novo stage IVC HNSCC between 2010 and 2015 were identified from the Surveillance, Epidemiology, and End Results database. Cox multivariable analyses were performed to determine prognostic factors associated with head and neck cancers specific survival (HNCSS) and overall survival (OS). Results We identified 303 patients who received chemotherapy in this study, including 52.5% of them had HPV-positive disease. HPV-positive HNSCC had better HNCSS (P < 0.001) and OS (P < 0.001) compared to those with HPV-negative disease. The results of Cox multivariable analyses showed that HPV-negative status (P = 0.007), N3 stage (P = 0.004), bone metastases (P < 0.001), and lung metastases (P = 0.003) were associated with worse HNCSS. Similar results were found regarding the OS. The sensitivity analyses indicated that HPV-positive HNSCC patients who were treated with radiotherapy had better survival outcomes. However, no survival benefits were found in those with HPV-positive disease receiving surgery. For HPV-negative patients, no survival benefit was observed among those treated with radiotherapy or surgery. Conclusions Approximately half of the stage IVC HNSCC patients are HPV-related. The presence of HPV infection appears to be strongly associated with the survival outcome in patients with de novo stage IV HNSCC. Determination of HPV status may help guide clinicians in prognostic assessment and treatment decision-making in this population.
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Affiliation(s)
- Ping Zhou
- Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Yi-Feng Yu
- Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Chen-Lu Lian
- Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Jun Wang
- Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Ren-Gong Zhuo
- Xiamen Key Laboratory of Chiral Drugs, Medical College, Xiamen University, Xiamen, China
| | - San-Gang Wu
- Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, China
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De Keukeleire SJ, Vermassen T, Hilgert E, Creytens D, Ferdinande L, Rottey S. Immuno-Oncological Biomarkers for Squamous Cell Cancer of the Head and Neck: Current State of the Art and Future Perspectives. Cancers (Basel) 2021; 13:1714. [PMID: 33916646 PMCID: PMC8038541 DOI: 10.3390/cancers13071714] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/19/2021] [Accepted: 03/26/2021] [Indexed: 12/24/2022] Open
Abstract
The era of immune checkpoint inhibitors has altered the therapeutic landscape in squamous cell cancer of the head and neck (SCCHN). Our knowledge about the tumor microenvironment has fueled the research in SCCHN, leading to several well-known and less-known prognostic and predictive biomarkers. The clinical staging, p16/HPV status, and PD-L1 expression are currently the main tools for assessing the patients' diagnosis and prognosis. However, several novel biomarkers have been thoroughly investigated, some reaching actual significant clinical contributions. The untangling of the immune infiltrate with the subtyping of tissue-associated tumor infiltrating lymphocytes, tumor-associated macrophages, and circulating blood-based biomarkers are an interesting avenue to be further explored and prospectively assessed. Although PD-L1 expression remains the most important response predictor for immune checkpoint inhibitors, several flaws impede proper assessment such as technical issues, different scoring protocol, and intra-, inter-, and temporal heterogeneity. In addition, the construction of an immune-related gene panel has been proposed as a prognostic and predictive stratification but lacks consensus. Recently, the role of microbioma have also been explored regarding its systemic and antitumor immunity. This review gives a comprehensive overview of the aforementioned topics in SCCHN. To this end, the integration of these clinically advantageous biomarkers via construction of an immunogram or nomogram could be an invaluable tool for SCCHN in future prospects.
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Affiliation(s)
- Stijn J. De Keukeleire
- Department of Medical Oncology, University Hospital Ghent, 9000 Ghent, Belgium; (T.V.); (S.R.)
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (E.H.); (D.C.); (L.F.)
- Drug Research Unit Ghent, University Hospital Ghent, 9000 Ghent, Belgium
| | - Tijl Vermassen
- Department of Medical Oncology, University Hospital Ghent, 9000 Ghent, Belgium; (T.V.); (S.R.)
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (E.H.); (D.C.); (L.F.)
- Drug Research Unit Ghent, University Hospital Ghent, 9000 Ghent, Belgium
| | - Elien Hilgert
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (E.H.); (D.C.); (L.F.)
- Centre for Medical Genetics Ghent (CMGG), University Hospital Ghent, 9000 Ghent, Belgium
| | - David Creytens
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (E.H.); (D.C.); (L.F.)
- Department of Pathology, University Hospital Ghent, 9000 Ghent, Belgium
| | - Liesbeth Ferdinande
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (E.H.); (D.C.); (L.F.)
- Department of Pathology, University Hospital Ghent, 9000 Ghent, Belgium
| | - Sylvie Rottey
- Department of Medical Oncology, University Hospital Ghent, 9000 Ghent, Belgium; (T.V.); (S.R.)
- Cancer Research Institute Ghent (CRIG), 9000 Ghent, Belgium; (E.H.); (D.C.); (L.F.)
- Drug Research Unit Ghent, University Hospital Ghent, 9000 Ghent, Belgium
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Genotyping and Characterization of HPV Status, Hypoxia, and Radiosensitivity in 22 Head and Neck Cancer Cell Lines. Cancers (Basel) 2021; 13:cancers13051069. [PMID: 33802339 PMCID: PMC7959143 DOI: 10.3390/cancers13051069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/22/2021] [Accepted: 02/25/2021] [Indexed: 11/17/2022] Open
Abstract
To study head and neck squamous cell carcinomas (HNSCC) in vitro, a large variety of HNSCC cell lines have been developed. Here, we characterize a panel of 22 HNSCC cell lines, thereby providing a tool for research into tumor-specific treatment options in HNSCC. Both human papillomavirus (HPV) positive and HPV negative tumor cell lines were collected from commercial and collaborative sources. Short tandem repeat profiling was used to confirm or characterize the identity of the cell lines. Targeted sequencing was performed using a standard pathology single molecule Molecular Inversion Probe panel to detect mutations for 23 tumor suppressors and oncogenes. HPV status, p16 status, radiosensitivity data, and hypoxia data are summarized from all cell lines. We detected HPV transcripts in five cell lines, all of which overexpressed p16. One HPV negative cell line was also p16 positive. We detected mutations in KIT (SCCNij185), PIK3CA (SCCNij185), and CDKN2A (UT-SCC-5 and UT-SCC-38). TP53 mutations were the most frequent, occurring in 16/22 cell lines. HPV infection and TP53 mutations were almost mutually exclusive, with the exception of 93-VU-147T. The cell lines exhibited a wide range of sensitivities towards hypoxia and irradiation. Here, we provide a description of a set of frequently used HNSCC cell lines with diverse characteristics as found in HNSCC patients.
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Sahovaler A, Kim MH, Mendez A, Palma D, Fung K, Yoo J, Nichols AC, MacNeil SD. Survival Outcomes in Human Papillomavirus-Associated Nonoropharyngeal Squamous Cell Carcinomas: A Systematic Review and Meta-analysis. JAMA Otolaryngol Head Neck Surg 2021; 146:1158-1166. [PMID: 33057610 DOI: 10.1001/jamaoto.2020.3382] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Importance Although the survival impact of human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (OPSCC) is well known, there has been conflicting and scarce evidence on the role of HPV in non-OPSCC. Objective To undertake a Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)-compliant systematic review and meta-analysis of all published studies on the association between HPV status and survival outcomes in patients with non-OPSCC, analyzing each site separately. Data Sources PubMed, CINAHL, and Embase were searched from 1946 to December 16, 2019, for English-language articles. Study Selection Analysis comprised randomized clinical trials or observational studies that each included at least 10 patients with non-OPSCC in which the presence of HPV was analyzed, survival outcomes were reported, and a clinical follow-up of 1 year or more was performed. Studies excluded were those in which data on OPSCC and non-OPSCC were not distinguished between both cohorts and studies on patients with distant metastatic tumors at diagnosis. Final analysis included outcomes that were analyzed in at least 3 studies. Data Extraction and Synthesis Two reviewers independently abstracted the data. Risk of bias was estimated with the Newcastle-Ottawa Scale. Meta-analysis was performed using the random-effects model. Main Outcomes and Measures The primary end point was overall survival (OS); secondary end points were disease-specific survival (DSS) and disease-free survival (DFS). Results Of the 3947 articles screened, a total of 22 observational and 2 randomized clinical trials were included in the analysis, representing 24 854 patients. In oral cavity locations, OS was not significantly associated with HPV positivity (hazard ratio [HR], 1.16; 95% CI, 0.83-1.61; I2 = 71%); however, HPV-positive tumors showed worse DFS (HR, 1.81; 95% CI, 1.12-2.91; I2 = 47%). Laryngeal and hypopharyngeal HPV-positive tumors were associated with improved OS (HR, 0.71; 95% CI, 0.54-0.92; I2 = 38% and HR, 0.60; 95% CI, 0.47-0.76; I2 = 0%), respectively, whereas, in nasopharyngeal locations HPV was not associated with OS (HR, 0.82; 95% CI, 0.49-1.38; I2 = 46%) or DSS (HR, 0.55; 95% CI, 0.22-1.42; I2 = 65%). Conclusions and Relevance In this meta-analysis of 24 studies, HPV was associated with improved OS in laryngeal and hypopharyngeal locations but not in the oral cavity and the nasopharynx. This information may be useful for future clinical studies of laryngeal and hypopharyngeal tumors and whether HPV status should be incorporated in prognostication of patients with these cancers.
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Affiliation(s)
- Axel Sahovaler
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada.,Guided Therapeutics Program, Techna Institute, University Health Network, Toronto, Ontario, Canada
| | - Min Hui Kim
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| | - Adrian Mendez
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| | - David Palma
- Department of Radiation Oncology, Western University, London, Ontario, Canada
| | - Kevin Fung
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| | - John Yoo
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| | - Anthony C Nichols
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
| | - S Danielle MacNeil
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
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Rezaei M, Mohajerani H, Moslemi H, Shafiei S, Tabrizi MAA, Tabrizi R. Does P16 Protein Expression Affect Treatment Prognosis in Oral Squamous Cell Carcinoma - A Comparative Study. Ann Maxillofac Surg 2021; 11:17-20. [PMID: 34522648 PMCID: PMC8407645 DOI: 10.4103/ams.ams_321_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 01/18/2021] [Accepted: 01/25/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION P16 is an independent and reliable surrogate for the detection of human papillomavirus (HPV) in oral squamous cell carcinoma (OSCC). The aim of this study was to assess the P16 expression as a marker for HPV infection in OSCC and its impact on the treatment outcome. METHODS AND MATERIALS A cross-sectional study was conducted on patients with a definite diagnosis of OSCC. Patients were assigned into two groups with and without recurrence or metastasis. Tumour resection was performed in the same manner for all patients. P16 expression was evaluated by immunohistochemical staining. Independent t-test and Chi-square tests were used to find significant differences in age, gender, stage of the disease, tumour size, lymph node involvement, and P16 expression between the two groups. RESULTS Of 50 patients, 37 did not show any recurrence or metastasis (group 1), while 13 had a relapse (group 2). There was no significant difference for age, gender distribution, stage of the disease, or lymph node involvement between the two groups (P > 0.05). A significant difference in tumour size was noted between the two groups (P = 0.001). The mean expression of P16 was 38.92 ± 24.36 in group 1 and 51.54 ± 33.63 in group 2. No significant difference was found between the two groups for the mean expression of P16 (P = 0.23). DISCUSSION A review of the recent literature revealed that the HPV role in OSCC treatment is controversial. According to the results of this study, there was no significant difference in terms of P16 expression between OSCC patients with and without recurrence or metastasis.
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Affiliation(s)
- Mitra Rezaei
- Department of Pathology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Virology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Mohajerani
- Department of Oral and Maxillofacial Surgery, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Moslemi
- Department of Oral and Maxillofacial Surgery, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shervin Shafiei
- Department of Oral and Maxillofacial Surgery, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Amir Alizadeh Tabrizi
- Department of Oral and Maxillofacial Surgery, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Tabrizi
- Department of Oral and Maxillofacial Surgery, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Meng HX, Yang XX, Liu RQ, Bao JJ, Hou YJ, Sun J, Miao SS, Qu GF. The Relationship Between Human Papillomavirus, OFD1 and Primary Ciliogenesis in the Progression of Oropharyngeal Cancer: A Retrospective Cohort Study. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2020; 13:633-644. [PMID: 33244255 PMCID: PMC7685095 DOI: 10.2147/pgpm.s271735] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 10/08/2020] [Indexed: 12/13/2022]
Abstract
Purpose Infection with human papillomavirus (HPV) has been indicated to be a important risk factor for oropharyngeal squamous cell carcinoma (OPSCC). Primary ciliogenesis defects contribute to tumorigenesis, and OFD1 at centriolar satellites is a crucial suppressor of primary ciliogenesis. To identify novel markers associated with HPV-induced carcinogenesis, the interactions between HPV infection and primary ciliogenesis in the tumorigenesis and progression of OPSCC were investigated in this study. Patients and Methods The 1530 OPSCC patients recruited in this research were treated from 2000 to 2017. Immunohistochemistry and RT-PCR were performed on tissue samples to compare the expression of p16, TSLP, TGFβ1, IFNγ, OFD1, and their relationship with clinical characteristics of patients. Results We speculate that the positive expression of p16 is related to early primary OPSCC, and the survival rate of p16 positive patients after radiotherapy and surgery is higher. Expression of TSLP on dendritic cells in HPV-positive OPSCC correlated with the expression of OFD1. HPV-positive OPSCC showed increased expression of OFD1 combined with reduced ciliogenesis. Hence, TSLP induced by HPV infection may reduce the invasive potential of OPSCC cells by promoting OFD1 expression, thereby inhibiting primary ciliogenesis. Conclusion Our study demonstrated that HPV may be related to the progression of OPSCC by regulating OFD1 expression and primary ciliogenesis, making this protein a potential therapeutic target.
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Affiliation(s)
- Hong-Xue Meng
- Department of Pathology, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China.,Department of Pathology, Harbin Medical University, Harbin, People's Republic of China
| | - Xin-Xin Yang
- Department of Pathology, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Rui-Qi Liu
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Hospital, Guangzhou, People's Republic of China
| | - Jun-Jie Bao
- Department of Orthopedics, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Yun-Jing Hou
- Department of Pathology, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Ji Sun
- Department of Otolaryngology, Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Su-Sheng Miao
- Department of Otolaryngology, Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Guo-Fan Qu
- Department of Orthopedics, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
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Marshall DC, Kao DD, Bakst R, Sharma S, Ferrandino R, Rosenzweig K, Wisnivesky J, Sigel K. Prognostic role of human papilloma virus status in hypopharyngeal squamous cell carcinoma. Laryngoscope Investig Otolaryngol 2020; 5:860-867. [PMID: 33134533 PMCID: PMC7585257 DOI: 10.1002/lio2.443] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/25/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Although the prognostic role of human papilloma virus (HPV) status in oropharyngeal head and neck squamous cell carcinoma (SCC) is well established, growing evidence shows that there may be a prognostic role for HPV status in hypopharyngeal SCC. The objective of this study was to determine the prognostic role of HPV status in hypopharyngeal SCC. METHODS We performed a retrospective, population-based analysis of 1934 adult patients with HNSCC diagnosed between 2010-2016 and treated with a combination of surgery and/or radiotherapy, with or without chemotherapy, and a subset of 641 patients with hypopharyngeal SCC and known HPV status included in the Surveillance, Epidemiology, and End Results (SEER) Head and Neck with HPV Status Database. Patient data were used to determine the adjusted 2-year cancer-specific survival (CSS) and overall survival (OS) for the entire cohort and the specific subgroup of hypopharyngeal cancer patients with known HPV status. RESULTS Of the 1934 hypopharynx SCC cases, HPV status was unknown in 1294 (66.9%), and 167 (8.6%) were HPV positive; among hypopharynx cases with known HPV status, 21.6% were HPV positive. In models adjusting for sex, age, race/ethnicity, marital status and stage, patients with HPV-positive hypopharyngeal tumors had improved CSS compared with patients with HPV-negative tumors (CSS: HR: .57, 95% CI = .38 to .86, P = .008; OS: HR: .49, 95% CI = .34 to .71, P = <.001). CONCLUSION Our findings in a large cohort of hypopharyngeal SCC with known HPV status and cancer-specific survival support the hypothesis that HPV has a prognostic role in hypopharyngeal cancer. Consideration should be given to increased testing for HPV in hypopharyngeal SCC. LEVEL OF EVIDENCE 4.
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Affiliation(s)
| | - Derek D. Kao
- Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Richard Bakst
- Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Sonam Sharma
- Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | | | | | | | - Keith Sigel
- Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
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22
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Saba NF, Dinasarapu AR, Magliocca KR, Dwivedi B, Seby S, Qin ZS, Patel M, Griffith CC, Wang X, El-Deiry M, Steuer CE, Kowalski J, Shin DM, Zwick ME, Chen ZG. Signatures of somatic mutations and gene expression from p16INK4A positive head and neck squamous cell carcinomas (HNSCC). PLoS One 2020; 15:e0238497. [PMID: 32986729 PMCID: PMC7521680 DOI: 10.1371/journal.pone.0238497] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 08/18/2020] [Indexed: 12/28/2022] Open
Abstract
Human papilloma virus (HPV) causes a subset of head and neck squamous cell carcinomas (HNSCC) of the oropharynx. We combined targeted DNA- and genome-wide RNA-sequencing to identify genetic variants and gene expression signatures respectively from patients with HNSCC including oropharyngeal squamous cell carcinomas (OPSCC). DNA and RNA were purified from 35- formalin fixed and paraffin embedded (FFPE) HNSCC tumor samples. Immuno-histochemical evaluation of tumors was performed to determine the expression levels of p16INK4A and classified tumor samples either p16+ or p16-. Using ClearSeq Comprehensive Cancer panel, we examined the distribution of somatic mutations. Somatic single-nucleotide variants (SNV) were called using GATK-Mutect2 (“tumor-only” mode) approach. Using RNA-seq, we identified a catalog of 1,044 and 8 genes as significantly expressed between p16+ and p16-, respectively at FDR 0.05 (5%) and 0.1 (10%). The clinicopathological characteristics of the patients including anatomical site, smoking and survival were analyzed when comparing p16+ and p16- tumors. The majority of tumors (65%) were p16+. Population sequence variant databases, including gnomAD, ExAC, COSMIC and dbSNP, were used to identify the mutational landscape of somatic sequence variants within sequenced genes. Hierarchical clustering of The Cancer Genome Atlas (TCGA) samples based on HPV-status was observed using differentially expressed genes. Using RNA-seq in parallel with targeted DNA-seq, we identified mutational and gene expression signatures characteristic of p16+ and p16- HNSCC. Our gene signatures are consistent with previously published data including TCGA and support the need to further explore the biologic relevance of these alterations in HNSCC.
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Affiliation(s)
- Nabil F. Saba
- Winship Cancer Institute, Emory University, Atlanta, GA, United States of America
- * E-mail: (ZGC); (NFS)
| | - Ashok R. Dinasarapu
- Department of Human Genetics, Emory University, Atlanta, GA, United States of America
| | - Kelly R. Magliocca
- Winship Cancer Institute, Emory University, Atlanta, GA, United States of America
| | - Bhakti Dwivedi
- Winship Cancer Institute, Emory University, Atlanta, GA, United States of America
| | - Sandra Seby
- Centers for Disease Control (CDC), Atlanta, GA, United States of America
| | - Zhaohui S. Qin
- Department of Biostatistics and Bioinformatics, Emory University Atlanta, Atlanta, GA, United States of America
| | - Mihir Patel
- Winship Cancer Institute, Emory University, Atlanta, GA, United States of America
| | | | - Xu Wang
- Winship Cancer Institute, Emory University, Atlanta, GA, United States of America
| | - Mark El-Deiry
- Winship Cancer Institute, Emory University, Atlanta, GA, United States of America
| | - Conor Ernst Steuer
- Winship Cancer Institute, Emory University, Atlanta, GA, United States of America
| | - Jeanne Kowalski
- Department of Oncology, Dell Medical School, Austin, Texas, United States of America
| | - Dong Moon Shin
- Winship Cancer Institute, Emory University, Atlanta, GA, United States of America
| | - Michael E. Zwick
- Department of Human Genetics, Emory University, Atlanta, GA, United States of America
| | - Zhuo Georgia Chen
- Winship Cancer Institute, Emory University, Atlanta, GA, United States of America
- Department of Hematology and Medical Oncology, Emory University Atlanta, Atlanta, GA, United States of America
- * E-mail: (ZGC); (NFS)
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23
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Gyawali BR, Acharya K, Sapkota R, Baskota DK, Sinha BK. Prevalence of p-16 Positive Laryngeal and Pharyngeal Tumors in Nepalese Population: A Hospital based Cross-sectional Study. ACTA ACUST UNITED AC 2020; 58:681-685. [PMID: 33068091 PMCID: PMC7580339 DOI: 10.31729/jnma.5132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Indexed: 11/16/2022]
Abstract
Introduction: P16 overexpression is considered as a good prognostic marker for oropharyngeal squamous cell carcinoma. However, there are very few literatures on the prevalence and outcomes of p16 overexpression in non-oropharyngeal squamous cell carcinoma and benign head and neck tumors. The aim of our study was to estimate the hospital based prevalence of p16 positive laryngeal and pharyngeal tumors and to compare it with the prevalence of p16 expression in the non tumor tissue (tonsils). Methods: This was a descriptive cross-sectional study. Cases of all genders >15 years presenting with malignant or benign tumors of larynx and all the subsites of pharynx were included in the study for evaluation of p16 expression by immunohistochemistry. Tonsillar tissue of cases undergoing tonsillectomy for recurrent acute tonsillitis were taken as non-tumorous tissue to evaluate for p16 expression. Results: A total of 48 cases were included in our study with 24 cases having different tumors of head and neck region and 24 cases having recurrent acute tonsillitis who were kept under non-tumor group. Eight cases (33.3%) in the tumor group showed positive stain for p16 in IHC. In non tumor group, 7 cases (29.1%) showed positive IHC staining for p16. Conclusions: P16 expression can be present in both benign and malignant tumors of various subsites of head and neck region and also in tonsillar tissue affected by inflammation.
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Affiliation(s)
- Bigyan Raj Gyawali
- Department of ENT-Head and Neck Surgery, Institute of Medicine, T.U. Teaching Hospital, Kathmandu, Nepal, *Sikhar Biotech Company, Lalitpur, Nepal
| | - Kunjan Acharya
- Department of ENT-Head and Neck Surgery, Institute of Medicine, T.U. Teaching Hospital, Kathmandu, Nepal, *Sikhar Biotech Company, Lalitpur, Nepal
| | | | - Dharma Kanta Baskota
- Department of ENT-Head and Neck Surgery, Institute of Medicine, T.U. Teaching Hospital, Kathmandu, Nepal
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24
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Yang JQ, Wu M, Han FY, Sun YM, Zhang L, Liu HX. High risk HPV detection by RNAscope in situ hybridization combined with Cdc2 protein expression by immunohistochemistry for prognosis of oropharyngeal squamous cell carcinoma. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2020; 13:2192-2200. [PMID: 32922620 PMCID: PMC7476946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Abstract
High risk human papillomavirus (HPV) infection is related to the development of head and neck squamous cell carcinoma (HNSCC). Oropharyngeal squamous cell carcinoma (OPSCC) is a common type of HNSCC, and its incidence has increased significantly in recent years. In this study, high risk HPV, the expression of P53, P21, and Cdc2 in OPSCC tissues was detected and the prognostic factors and clinical value of OPSCC were discussed. According to the WHO classification and diagnosis standard for head and neck tumors (2017 Edition), 49 OPSCC cases with complete clinical data were collected from Tangshan Head and Neck Disease Pathology Research Base from January 1, 2012 to December 31, 2018. The E6 and E7 mRNA of HPV 16 and HPV 18 were detected by RNAscope in situ hybridization. The expression of P53, P21, and Cdc2 protein was observed by SP immunohistochemical method and all cases were followed up for survival. Median survival time was analyzed by Kaplan-Meier method. The Log-rank test was used for single factor analysis and Cox regression model was used to analyze multiple prognostic factors. In 49 OPSCC cases the median age was 53 years; 14 were HPV-DNA positive (14/49, 28.6%) while 35 were negative (35/49, 71.4%). E6, E7 mRNA test showed that 20 cases (20/49, 40.8%) were positive for HPV-16. Among them 11 cases were positive for HPV-16 DNA. 2 cases were positive for HPV-18 mRNA (2/49, 4.08%). 27 cases were negative for mRNA16 and 18 (27/49, 55.1%). The prevalence of HPV was 68.8% (11/16) in the non-smoking group, which was higher than that of the smoking group (10/33, 33.3%), (χ2=5.463, P=0.019). There was no significant correlation between HPV detection and gender, age, drinking, tumor differentiation degree, and clinical stage (P > 0.05). The expression rates of P53, P21, and Cdc2 in OPSCC tissues were 63.3% (31/49), 65.3% (32/49), and 67.3% (33/49), respectively. There was no significant correlation between expression of all the three proteins and gender, age, HPV, smoking, drinking, tumor differentiation, and clinical stage (P > 0.05). Cox multifactor regression analysis showed that HPV (HR=0.275, 95% CI: 0.146-0.517), tumor differentiation (HR=1.751, 95% CI: 1.231-2.492), stage (HR=3.268, 95% CI: 1.758-6.074) and expression of Cdc2 protein (HR=1.804, 95% CI: 0.990-3.286) were related to the survival time of patients (P < 0.05). Our findings support that most of the HPV-positive OPSSC patients were non-smokers. The patients with negative HPV, low differentiation, late stage, and Cdc2 positive expression have poor prognosis and need to be followed up.
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Affiliation(s)
- Jun-Quan Yang
- Department of Radio-Chemotherapy Oncology, Tangshan People’s HospitalTangshan, P. R. China
| | - Meng Wu
- Department of Pathology, Division of Basic Medicine, Tangshan Vocational and Technical CollegeTangshan, P. R. China
| | - Feng-Yan Han
- Department of Pathology, Tangshan Union HospitalTangshan, P. R. China
| | - Yu-Man Sun
- Department of Pathology, Tangshan Union HospitalTangshan, P. R. China
| | - Ling Zhang
- Department of Pathology, Tangshan Union HospitalTangshan, P. R. China
| | - Hong-Xia Liu
- Department of Pathology, Tangshan Union HospitalTangshan, P. R. China
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Mistry R, Walker A, Walker N, Ofo E. Royal Society of Medicine Surgical Innovation Day Adrian Tanner Prize Winner 2019: Multidisciplinary care and surgical innovation for the benefit of the patient with head and neck cancer of unknown primary. JRSM Open 2020; 11:2054270420921066. [PMID: 32685179 PMCID: PMC7346693 DOI: 10.1177/2054270420921066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Head and neck carcinoma of unknown primary accounts for approximately 1–5% of all head and neck cancers and presents a genuine diagnostic and therapeutic dilemma. Despite advanced investigations, the primary tumour location remains unknown in up to 40% of these cases. Transoral robotic surgery presents a viable diagnostic and therapeutic option in these patients. This surgical innovation alongside advances in the understanding of head and neck cancer biology means that a multidisciplinary approach in the management of these complex patients is of utmost importance to ensure optimal therapeutic outcomes.
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Affiliation(s)
- Rakesh Mistry
- Department of ENT Surgery, St George's University Hospitals NHS Foundation Trust, London SW17 0QT, UK
| | - Abigail Walker
- Department of ENT Surgery, St George's University Hospitals NHS Foundation Trust, London SW17 0QT, UK
| | - Nathan Walker
- Department of ENT Surgery, St George's University Hospitals NHS Foundation Trust, London SW17 0QT, UK
| | - Enyinnaya Ofo
- Department of ENT Surgery, St George's University Hospitals NHS Foundation Trust, London SW17 0QT, UK
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Mistry R, Walker A, Kim D, Ofo E. Transoral robotic surgery for the benefit of patients with head and neck cancer of unknown primary: our experience at St George's University Hospital, London. Ann R Coll Surg Engl 2020; 102:442-450. [PMID: 32347742 PMCID: PMC7388938 DOI: 10.1308/rcsann.2020.0071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Head and neck carcinoma of unknown primary represents 1-5% of all head and neck cancers and presents a diagnostic and therapeutic dilemma. In approximately 40% of cases, a primary tumour location remains unknown despite investigation. With advancements in our understanding of the role of high-risk human papilloma virus in head and neck cancer, transoral robotic surgery presents an option for diagnosis and therapy. MATERIALS AND METHODS This is a retrospective case series from a single centre. Case notes were reviewed for 28 patients who had transoral robotic surgery for head and neck carcinoma of unknown primary between May 2015 and July 2019. RESULTS Transoral robotic surgery identified an oropharyngeal primary tumour in 19 of 28 (67.8%) patients. All oropharyngeal primaries were p16 positive. The base of tongue identification rate was 63.2%. Median length of inpatient stay postoperatively was 1.0 day. Normal oral intake resumed within 48 hours in 96% (27/28) of patients. Three patients (10.3%) suffered minor postoperative bleeds that were all managed conservatively. DISCUSSION The base of tongue primary identification rate (63.2%) in this series is consistent with that previously reported (43-63%; 95% confidence interval). Primary tumour identification rate if a patient is p16 positive is 86.3% (19/22), with 100% of these being oropharyngeal. We suggest future investigation into p16 status as a means of stratifying patients with head and neck carcinoma of unknown primary for transoral robotic surgery. CONCLUSION Transoral robotic base of tongue mucosectomy (or lingual tonsillectomy) is a promising technique that offers a high yield of positive identification for the primary tumour. It is well tolerated with minimal associated morbidity. Our findings are comparable with those in the current literature.
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Affiliation(s)
- R Mistry
- St George’s University Hospitals NHS Foundation Trust, Tooting, London, UK
| | - A Walker
- St George’s University Hospitals NHS Foundation Trust, Tooting, London, UK
| | - D Kim
- St George’s University Hospitals NHS Foundation Trust, Tooting, London, UK
| | - E Ofo
- St George’s University Hospitals NHS Foundation Trust, Tooting, London, UK
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Association Among Glucocorticoid Receptor Sensitivity, Fatigue, and Inflammation in Patients With Head and Neck Cancer. Psychosom Med 2020; 82:508-516. [PMID: 32515926 PMCID: PMC7905992 DOI: 10.1097/psy.0000000000000816] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Fatigued cancer patients often have high peripheral inflammation; however, the biological mechanisms of this association remain unclear. We examined whether decreased sensitivity of immune cells to the anti-inflammatory effects of glucocorticoids may contribute to inflammation and fatigue in head and neck cancer (HNC) patients during treatment. METHODS HNC patients without distant metastasis and with curative intent (n = 77) were studied 1 week before intensity-modulated radiotherapy (IMRT) and 1 month after IMRT. At each time point, fatigue was measured by the Multidimensional Fatigue Inventory-20 along with plasma inflammation markers and glucocorticoid receptor (GR) sensitivity as determined by in vitro dexamethasone suppression of lipopolysaccharide-induced interleukin 6. Linear regression models were used. RESULTS In contrast to our hypothesis, GR sensitivity increased during treatment; however, increased fatigue was associated with a lesser increase in GR sensitivity from baseline to 1 month after IMRT (unstandardized estimate = 4.07, p = .02). This effect was more prominent in human papillomavirus-unrelated HNCs (unstandardized estimate = 8.22, p = .002). Lower increases in GR sensitivity were also associated with increased inflammation at 1 month after IMRT as represented by C-reactive protein, interleukin 6, and tumor necrosis factor α. Addition of inflammation markers to models of GR sensitivity predicting fatigue indicated that these inflammation markers were stronger predictors of fatigue than GR sensitivity. CONCLUSIONS Lower increases in GR sensitivity during HNC treatment were significantly predictive of increased fatigue and inflammation markers. Inflammation markers in turn predicted fatigue above and beyond levels of GR sensitivity. Our findings indicate that HNC patients with cancer-related fatigue may exhibit a decreased capacity for glucocorticoids to regulate inflammatory processes, as evidenced by a lower increase in GR sensitivity. Larger studies are necessary to verify the findings.
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28
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Coyne GO'S, Wang L, Zlott J, Juwara L, Covey JM, Beumer JH, Cristea MC, Newman EM, Koehler S, Nieva JJ, Garcia AA, Gandara DR, Miller B, Khin S, Miller SB, Steinberg SM, Rubinstein L, Parchment RE, Kinders RJ, Piekarz RL, Kummar S, Chen AP, Doroshow JH. Intravenous 5-fluoro-2'-deoxycytidine administered with tetrahydrouridine increases the proportion of p16-expressing circulating tumor cells in patients with advanced solid tumors. Cancer Chemother Pharmacol 2020; 85:979-993. [PMID: 32314030 PMCID: PMC7188725 DOI: 10.1007/s00280-020-04073-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 04/06/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Following promising responses to the DNA methyltransferase (DNMT) inhibitor 5-fluoro-2'-deoxycytidine (FdCyd) combined with tetrahydrouridine (THU) in phase 1 testing, we initiated a non-randomized phase 2 study to assess response to this combination in patients with advanced solid tumor types for which tumor suppressor gene methylation is potentially prognostic. To obtain pharmacodynamic evidence for DNMT inhibition by FdCyd, we developed a novel method for detecting expression of tumor suppressor protein p16/INK4A in circulating tumor cells (CTCs). METHODS Patients in histology-specific strata (breast, head and neck [H&N], or non-small cell lung cancers [NSCLC] or urothelial transitional cell carcinoma) were administered FdCyd (100 mg/m2) and THU (350 mg/m2) intravenously 5 days/week for 2 weeks, in 28-day cycles, and progression-free survival (PFS) rate and objective response rate (ORR) were evaluated. Blood specimens were collected for CTC analysis. RESULTS Ninety-three eligible patients were enrolled (29 breast, 21 H&N, 25 NSCLC, and 18 urothelial). There were three partial responses. All strata were terminated early due to insufficient responses (H&N, NSCLC) or slow accrual (breast, urothelial). However, the preliminary 4-month PFS rate (42%) in the urothelial stratum exceeded the predefined goal-though the ORR (5.6%) did not. An increase in the proportion of p16-expressing cytokeratin-positive CTCs was detected in 69% of patients evaluable for clinical and CTC response, but was not significantly associated with clinical response. CONCLUSION Further study of FdCyd + THU is potentially warranted in urothelial carcinoma but not NSCLC or breast or H&N cancer. Increase in the proportion of p16-expressing cytokeratin-positive CTCs is a pharmacodynamic marker of FdCyd target engagement.
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Affiliation(s)
- Geraldine O 'Sullivan Coyne
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, 31 Center Drive, Bldg. 31 Room 3A-44, Bethesda, MD, 20892, USA
| | - Lihua Wang
- Clinical Pharmacodynamic Biomarkers Program, Applied/Developmental Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Jennifer Zlott
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, 31 Center Drive, Bldg. 31 Room 3A-44, Bethesda, MD, 20892, USA
| | - Lamin Juwara
- Clinical Monitoring Research Program, Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Joseph M Covey
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, 31 Center Drive, Bldg. 31 Room 3A-44, Bethesda, MD, 20892, USA
| | - Jan H Beumer
- Department of Pharmaceutical Sciences, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA
| | - Mihaela C Cristea
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA, USA
| | - Edward M Newman
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA, USA
| | | | - Jorge J Nieva
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Agustin A Garcia
- University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
- Louisiana State University, New Orleans, LA, 70112, USA
| | - David R Gandara
- University of California Davis Cancer Center, Sacramento, CA, USA
| | - Brandon Miller
- Clinical Pharmacodynamic Biomarkers Program, Applied/Developmental Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Sonny Khin
- Clinical Pharmacodynamic Biomarkers Program, Applied/Developmental Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Sarah B Miller
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, 31 Center Drive, Bldg. 31 Room 3A-44, Bethesda, MD, 20892, USA
| | - Seth M Steinberg
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Larry Rubinstein
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, 31 Center Drive, Bldg. 31 Room 3A-44, Bethesda, MD, 20892, USA
| | - Ralph E Parchment
- Clinical Pharmacodynamic Biomarkers Program, Applied/Developmental Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Robert J Kinders
- Clinical Pharmacodynamic Biomarkers Program, Applied/Developmental Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Richard L Piekarz
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, 31 Center Drive, Bldg. 31 Room 3A-44, Bethesda, MD, 20892, USA
| | - Shivaani Kummar
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, 31 Center Drive, Bldg. 31 Room 3A-44, Bethesda, MD, 20892, USA
| | - Alice P Chen
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, 31 Center Drive, Bldg. 31 Room 3A-44, Bethesda, MD, 20892, USA
| | - James H Doroshow
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, 31 Center Drive, Bldg. 31 Room 3A-44, Bethesda, MD, 20892, USA.
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.
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Molkentine JM, Molkentine DP, Bridges KA, Xie T, Yang L, Sheth A, Heffernan TP, Clump DA, Faust AZ, Ferris RL, Myers JN, Frederick MJ, Mason KA, Meyn RE, Pickering CR, Skinner HD. Targeting DNA damage response in head and neck cancers through abrogation of cell cycle checkpoints. Int J Radiat Biol 2020; 97:1121-1128. [PMID: 32073931 DOI: 10.1080/09553002.2020.1730014] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE Head and neck cancers (HNSCC) are routinely treated with radiotherapy; however, normal tissue toxicity remains a concern. Therefore, it is important to validate treatment modalities combining molecularly targeted agents with radiotherapy to improve the therapeutic ratio. The aim of this study was to assess the ability of the PARP inhibitor niraparib (MK-4827) alone, or in combination with cell cycle checkpoint abrogating drugs targeting Chk1 (MK-8776) or Wee1 (MK-1775), to radiosensitize HNSCCs in the context of HPV status. MATERIALS AND METHODS PARP1, PARP2, Chk1 or Wee1 shRNA constructs were analyzed from an in vivo shRNA screen of HNSCC xenografts comparing radiosensitization differences between HPV(+) and HPV(-) tumors. Radiosensitization by niraparib alone or in combination with MK-8776 or MK-1775 was assessed by clonogenic survival in HPV(-) and HPV(+) cells; and the role of p16 in determining response was explored. Relative expressions of DNA repair genes were compared by PCR array in HPV(+) and HPV(-) cells, and following siRNA-mediated knockdown of TRIP12 in HPV(-) cells. RESULTS In vivo shRNA screening showed a modest preferential radiosensitization by Wee1 and PARP2 in HPV(-) and Chk1 in HPV(+) tumor models. Niraparib alone enhanced the radiosensitivity of all HNSCC cell lines tested. However, HPV(-) cells were sensitized to a greater degree, as suggested by the shRNA screen. When combined with MK-8776 or MK-1775, radiosensitization was further enhanced in an HPV dependent manner with HPV(+) cells enhanced by MK-8776 and HPV(-) cells enhanced by MK-1775. A PCR array for DNA repair genes showed PARP and HR proteins BRCA1 and RAD51 were much lower in HPV(+) cells than in HPV(-). Similarly, directly knocking down p16-dependent TRIP12 decreased expression of these same genes. Overexpressing p16 decreased TRIP12 expression and increased radiosensitivity in HPV(-) HN5. However, while PARP inhibition led to significant radiosensitization in the control, it led to no further significant radiosensitization in p16 overexpressing cells. Forced p16 expression in HPV(-) HN5 increased accumulation in G1 and subG1 and limited progression to S phase, thus reducing effectiveness of PARP inhibition. CONCLUSIONS Niraparib effectively radiosensitizes HNSCCs with a greater benefit seen in HPV(-). HPV status also plays a role in response to MK-8776 or MK-1775 when combined with niraparib due to differences in DNA repair mechanisms. This study suggests that using cell cycle abrogators in combination with PARP inhibitors may be a beneficial treatment option in HNSCC, but also emphasizes the importance of HPV status when considering effective treatment strategies.
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Affiliation(s)
- Jessica M Molkentine
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - David P Molkentine
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kathleen A Bridges
- Department of Experimental Radiation Oncology, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Tongxin Xie
- Department of Head and Neck Surgery, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Liangpeng Yang
- Department of Experimental Radiation Oncology, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Aakash Sheth
- Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
| | - Timothy P Heffernan
- Institute for Applied Cancer Science, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - David A Clump
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alma Z Faust
- College of Liberal Arts and Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Robert L Ferris
- Department of Otolaryngology, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jeffrey N Myers
- Department of Head and Neck Surgery, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Mitchell J Frederick
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Kathryn A Mason
- Department of Experimental Radiation Oncology, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Raymond E Meyn
- Department of Experimental Radiation Oncology, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Curtis R Pickering
- Department of Head and Neck Surgery, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Heath D Skinner
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
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30
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Has the time come for de-escalation in the management of oropharyngeal carcinoma? Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2019; 163:293-301. [DOI: 10.5507/bp.2019.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 11/26/2019] [Indexed: 11/23/2022] Open
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31
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Özcan-Wahlbrink M, Schifflers C, Riemer AB. Enhanced Radiation Sensitivity of Human Papillomavirus-Driven Head and Neck Cancer: Focus on Immunological Aspects. Front Immunol 2019; 10:2831. [PMID: 31849993 PMCID: PMC6901628 DOI: 10.3389/fimmu.2019.02831] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 11/18/2019] [Indexed: 12/29/2022] Open
Abstract
Head and neck squamous cell carcinomas (HNSCC), emerging in the mucosa of the upper aerodigestive tract, are associated with either the classical risk factors, tobacco and alcohol consumption, or with infections with high-risk types of the human papillomavirus (HPV). Depending on the involvement of HPV, HNSCC follow different pathways of carcinogenesis and show distinct clinical presentations regarding survival, prognosis and treatment response. For instance, HPV-driven HNSCC exhibit an enhanced radiation response compared to their typically radioresistant HPV-negative counterparts. Although radiosensitivity of HNSCC has been studied by many research groups, the major causes for the difference in radiation responses between HPV-driven and HPV-negative HNSCC are still an open question. In this mini review, we discuss the reported cellular and immunological factors involved in the enhanced radiation response in HPV-driven HNSCC, focusing on the vital role of the immune response in the outcome of HNSCC radiotherapy.
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Affiliation(s)
- Mine Özcan-Wahlbrink
- Immunotherapy and Immunoprevention, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Molecular Vaccine Design, German Center for Infection Research, Partner Site Heidelberg, Heidelberg, Germany
| | - Christoph Schifflers
- Immunotherapy and Immunoprevention, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Molecular Vaccine Design, German Center for Infection Research, Partner Site Heidelberg, Heidelberg, Germany.,Cell Biology Research Unit (URBC)-Namur Research Institute for Life Sciences (NARILIS), University of Namur, Namur, Belgium
| | - Angelika B Riemer
- Immunotherapy and Immunoprevention, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Molecular Vaccine Design, German Center for Infection Research, Partner Site Heidelberg, Heidelberg, Germany
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32
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Patel JJ, Levy DA, Nguyen SA, Knochelmann HM, Day TA. Impact of PD-L1 expression and human papillomavirus status in anti-PD1/PDL1 immunotherapy for head and neck squamous cell carcinoma-Systematic review and meta-analysis. Head Neck 2019; 42:774-786. [PMID: 31762164 DOI: 10.1002/hed.26036] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/30/2019] [Accepted: 11/13/2019] [Indexed: 12/24/2022] Open
Abstract
Programmed cell death-1 (PD-1) pathway inhibition in head and neck squamous cell carcinoma (HNSCC) has demonstrated inconsistent efficacy regarding human papillomavirus (HPV) status and PD-L1 expression. This study compared outcomes in HNSCC in the context of PD-L1 and HPV expression. Outcomes: PD-L1 and HPV expression; overall survival (OS), and tumor response (ORR). 1088 patients received PD-1/L1 inhibitors. Four methodologies were identified in determining PD-L1 expression, most commonly using the Dako PD-L1 IHC 22C3 pharmaDx assay. Using a 1% threshold, ORR was greater for PD-L1 expressers vs non-expressers (18.9%, CI 16.1-21.8 v 8.8% CI 5.3-13.7, P = 0.009), as was OS at 6 months (60.6%, CI 49.2-71.4 v 49.0%, CI 39.1-59.0, P = 0.04) but not at 12 or 18 months. No advantages were identified for HPV expressers. Patients expressing PD-L1 may have a better tumor response and OS. No impact on survival or response was observed based on HPV status.
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Affiliation(s)
- Jaimin J Patel
- Head and Neck Tumor Center, Hollings Cancer Center Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Dylan A Levy
- Head and Neck Tumor Center, Hollings Cancer Center Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.,Frank H. Netter MD School of Medicine, Quinnipiac University, North Haven, Connecticut
| | - Shaun A Nguyen
- Head and Neck Tumor Center, Hollings Cancer Center Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Hannah M Knochelmann
- Department of Microbiology & Immunology, Medical University of South Carolina, Charleston, South Carolina
| | - Terry A Day
- Head and Neck Tumor Center, Hollings Cancer Center Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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Lin Z, Philpott C, Sisson K, Hemmant B. Lacrimal sac primary squamous cell carcinoma with synchronous tonsillar primary squamous cell carcinoma. Orbit 2019; 39:374-378. [PMID: 31722584 DOI: 10.1080/01676830.2019.1691606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A gentleman with recurrent epiphora after two failed endonasal dacryocystorhinostomies was found to have a squamous cell carcinoma of the lacrimal sac at his third operation via an external approach. CT showed contralateral nodal involvement; however, biopsy of the node found it to be histologically distinct from the lacrimal sac lesion. A PET-CT revealed a second primary lesion located at the contralateral palatine tonsil. We discuss the histological features of squamous cell carcinomas and the impact on prognosis. This case highlights the importance of nasoendoscopy prior to lacrimal surgery. There should be a low threshold for lacrimal sac biopsy, and any anatomical or histological inconsistency should prompt further investigation.
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Affiliation(s)
- Zhiheng Lin
- Ophthalmology Department, Colchester Primary Care Centre , Colchester, UK
| | - Carl Philpott
- Head and Neck Department, University of East Anglia , Norwich, UK.,Ophthalmology Department, James Paget University Hospital , Great Yarmouth, UK
| | - Katherine Sisson
- Histopathology Department, Norfolk and Norwich University Hospital , Norwich, UK
| | - Bridget Hemmant
- Head and Neck Department, University of East Anglia , Norwich, UK.,Ophthalmology Department, James Paget University Hospital , Great Yarmouth, UK
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34
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Song Y, Pan Y, Liu J. The relevance between the immune response-related gene module and clinical traits in head and neck squamous cell carcinoma. Cancer Manag Res 2019; 11:7455-7472. [PMID: 31496804 PMCID: PMC6689548 DOI: 10.2147/cmar.s201177] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 07/17/2019] [Indexed: 02/05/2023] Open
Abstract
Purpose Head and neck squamous cell carcinoma (HNSCC) is the sixth most prevalent cancer in the world, accounting for more than 90% of head and neck malignant tumors. However, its molecular mechanism is largely unknown. To help elucidate the potential mechanism of HNSCC tumorigenesis, we investigated the gene interaction patterns associated with tumorigenesis. Methods Weighted gene co-expression network analysis (WGCNA) can help us to predict the intrinsic relationship or correlation between gene expression. Additionally, we further explored the combination of clinical information and module construction. Results Sixteen modules were constructed, among which the key module most closely associated with clinical information was identified. By analyzing the genes in this module, we found that the latter may be related to the immune response, inflammatory response and formation of the tumor microenvironment. Sixteen hub genes were identified-ARHGAP9, SASH3, CORO1A, ITGAL, PPP1R16B, TBC1D10C, IL10RA, ITK, AKNA, PRKCB, TRAF3IP3, GIMAP4, CCR7, P2RY8, GIMAP7, and SP140. We further validated these genes at the transcriptional and translation levels. Conclusion The innovative use of a weighted network to analyze HNSCC samples provides new insights into the molecular mechanism and prognosis of HNSCC. Additionally, the hub genes we identified can be used as biomarkers and therapeutic targets of HNSCC, laying the foundation for the accurate diagnosis and treatment of HNSCC in clinical and research in the future.
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Affiliation(s)
- Yidan Song
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Yihua Pan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Jun Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People's Republic of China
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35
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Hoffmann M, Tribius S. HPV and Oropharyngeal Cancer in the Eighth Edition of the TNM Classification: Pitfalls in Practice. Transl Oncol 2019; 12:1108-1112. [PMID: 31176088 PMCID: PMC6556492 DOI: 10.1016/j.tranon.2019.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 05/13/2019] [Indexed: 11/23/2022] Open
Abstract
This review is a call for mindfulness and precision when applying TNM 8 in oropharyngeal cancers. Implications, intentions, and weaknesses of TNM 8 are addressed in light of our own investigations and the published literature. In TNM 8, the impact of p16INK4A status on the staging of oropharyngeal SCC highlights i) that underlying evidence is scarce, ii) its stage grouping exclusively has prognostic intention, and iii) that a noncritical application of TNM 8 might negatively impact the patients' survival as the perception of TNM 8 as having therapeutic intention may lead to de-escalating treatment regimens in p16INK4A-positive cases, specifically when grouped into stage I despite the presence of neck metastasis. If other parameters from HPV positivity that also have a negative impact on the patient's survival, such as smoking or the presence of comorbidity, are neglected in therapy planning, survival outcomes might even become worse. Future studies applying TNM 8 and further investigating the value of p16INK4A as surrogate marker for active HPV infections will identify whether or not changes in TNM 8 should have therapeutic implications in HPV-associated, only p16INK4A-positive cases or whether this impact additionally holds true for nontonsillar cancers.
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Affiliation(s)
- Markus Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Christian-Albrechts University Kiel, Kiel, Germany.
| | - Silke Tribius
- Hermann-Holthusen-Institute for Radiation Oncology, Asklepios Hospital St. Georg, Hamburg, Germany.
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36
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Palve V, Bagwan J, Krishnan NM, Pareek M, Chandola U, Suresh A, Siddappa G, James BL, Kekatpure V, Kuriakose MA, Panda B. Detection of High-Risk Human Papillomavirus in Oral Cavity Squamous Cell Carcinoma Using Multiple Analytes and Their Role in Patient Survival. J Glob Oncol 2019; 4:1-33. [PMID: 30398949 PMCID: PMC7010445 DOI: 10.1200/jgo.18.00058] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Accurate detection of human papillomavirus (HPV) in oral cavity squamous cell carcinoma (OSCC) is essential to understanding the role of HPV in disease prognosis and management of patients. We used different analytes and methods to understand the true prevalence of HPV in a cohort of patients with OSCC with different molecular backgrounds, and we correlated HPV data with patient survival. METHODS We integrated data from multiple analytes (HPV DNA, HPV RNA, and p16), assays (immunohistochemistry, polymerase chain reaction [PCR], quantitative PCR [qPCR], and digital PCR), and molecular changes (somatic mutations and DNA methylation) from 153 patients with OSCC to correlate p16 expression, HPV DNA, and HPV RNA with HPV incidence and patient survival. RESULTS High prevalence (33% to 58%) of HPV16/18 DNA did not correlate with the presence of transcriptionally active viral genomes (15%) in tumors. Eighteen percent of the tumors were p16 positive and only 6% were both HPV DNA and HPV RNA positive. Most tumors with relatively high copy number HPV DNA and/or HPV RNA, but not with HPV DNA alone (irrespective of copy number), were wild-type for TP53 and CASP8 genes. In our study, p16 protein, HPV DNA, and HPV RNA, either alone or in combination, did not correlate with patient survival. Nine HPV-associated genes stratified the virus-positive from the virus-negative tumor group with high confidence ( P < .008) when HPV DNA copy number and/or HPV RNA were considered to define HPV positivity, and not HPV DNA alone, irrespective of copy number ( P < .2). CONCLUSION In OSCC, the presence of both HPV RNA and p16 is rare. HPV DNA alone is not an accurate measure of HPV positivity and therefore may not be informative. HPV DNA, HPV RNA, and p16 do not correlate with patients' outcome.
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Affiliation(s)
- Vinayak Palve
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Jamir Bagwan
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Neeraja M Krishnan
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Manisha Pareek
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Udita Chandola
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Amritha Suresh
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Gangotri Siddappa
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Bonney L James
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Vikram Kekatpure
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Moni Abraham Kuriakose
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Binay Panda
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
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HPV-driven oropharyngeal squamous cell cancer in Croatia - Demography and survival. PLoS One 2019; 14:e0211577. [PMID: 30707715 PMCID: PMC6358070 DOI: 10.1371/journal.pone.0211577] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 01/16/2019] [Indexed: 02/06/2023] Open
Abstract
Objectives Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide. Main HNSCC risk factors are tobacco, alcohol, and high-risk human papillomavirus (HPV). HPV+ oropharyngeal squamous cell cancer (OPSCC) usually have different etiology, increasing incidence and often show an improved survival when compared to HPV-negative cases. The objective of the current study was to retrospectively examine the influence of HPV on the survival of OPSCC patients in a non-Western population setting. Materials and methods We determined the presence of HPV DNA and/or RNA in 99 formalin-fixed paraffin embedded (FFPE) tissue samples of OPSCC patients treated between 2002 and 2015. Patients were compared based on laboratory, demographic, clinical, life style characteristics and survival. Results HPV RNA was found in 29.3% cases. However, groups based on HPV data (either RNA, DNA or retrospectively collected p16 staining) did not show significant differences. Overall, 5-year survival was 30% with minimal influence of the HPV positivity. Conclusions The HPV influence on survival of OPSCC patients is not identical between populations probably due to other factors overshadowing the HPV effect. This should be taken into account when treatment or policy decisions are made in each particular setting.
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38
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Götz C, Bischof C, Wolff KD, Kolk A. Detection of HPV infection in head and neck cancers: Promise and pitfalls in the last ten years: A meta-analysis. Mol Clin Oncol 2019; 10:17-28. [PMID: 30655973 PMCID: PMC6313947 DOI: 10.3892/mco.2018.1749] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 08/09/2018] [Indexed: 12/16/2022] Open
Abstract
The current controversial discussion on the disease-specific survival of patients with human papillomavirus (HPV)-positive (+) and -negative (-) squamous cell carcinoma (SCC) of the head neck region was the motivation for the present meta-analysis. Different detection methods for HPV are available, though these often lack sensitivity. As a consequence, there may be false interpretation of HPV positivity. A bias concerning HPV status and therefore also survival rates is serving a non-durable relevance in the discussion of tailored therapies. A literature search was performed via the online database PubMed/NCBI, and data extraction and statistical analysis were conducted. A total of 139 studies published between 2004 and 2014 were evaluated in the present meta-analysis. The HPV detection methods, patient characteristics, tumor localizations and stages, as well as (neo-) adjuvant therapies and survival times were analyzed. The average incidence rates of HPV+ patients with oropharyngeal tumors were higher than those of patients with cancers of other regions of the head and neck. Upon evaluating the results of different detection methods no significant differences were identified. We have compared the HPV incidence rates of each detection method, when studies have used more than one. Regarding overall survival, the pooled adjusted hazard ratio (HR) for oropharyngeal SCC was 0.31 [95% confidence interval (CI)=0.27-0.36]. Unfortunately, only 3 equivalent studies were available on nonoropharyngeal tumors, for which the pooled adjusted HR was 1 (95% CI=0.73-1.36). Overall, the evaluation demonstrated that the survival rates reported in numerous studies were not evaluated multifactorially and important confounders were excluded from the statistics. The HPV detection methods used were often not sufficient in representing HPV positivity. In addition, oropharyngeal and oral SCCs were assessed together in the localization. The widely differing number of HPV+ patients in each of the various studies may be explained by insufficient detection methods and by a lack of localization distinction. The considerations of a tailored therapy according to HPV status should be rejected based on the present information. The previously published studies should be read critically and do not represent a basis for therapeutic decisions.
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Affiliation(s)
- Carolin Götz
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
| | - Clara Bischof
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
| | - Andreas Kolk
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
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Göttgens EL, Ostheimer C, Span PN, Bussink J, Hammond EM. HPV, hypoxia and radiation response in head and neck cancer. Br J Radiol 2019; 92:20180047. [PMID: 29493265 PMCID: PMC6435089 DOI: 10.1259/bjr.20180047] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 02/26/2018] [Accepted: 02/26/2018] [Indexed: 12/21/2022] Open
Abstract
Over the last decades, the incidence of human papilloma virus (HPV) positive head and neck squamous-cell carcinoma (HNSCC) has significantly increased. Infection with high-risk HPV types drives tumourigenesis through expression of the oncoproteins E6 and E7. Currently, the primary treatment of HNSCC consists of radiotherapy, often combined with platinum-based chemotherapeutics. One of the common features of HNSCC is the occurrence of tumour hypoxia, which impairs the efficacy of radiotherapy and is a negative prognostic factor. Therefore, it is important to detect and quantify the severity of hypoxia, as well as develop strategies to specifically target hypoxic tumours. HPV-positive tumours are remarkably radiosensitive compared to HPV-negative tumours and consequently the HPV-positive patients have a better prognosis. This provides an opportunity to elucidate mechanisms of radiation sensitivity, which may reveal targets for improved therapy for HPV-negative head and neck cancers. In this review, we will discuss the differences between HPV-positive and HPV-negative head and neck tumours and methods of hypoxia detection and targeting in these disease types. Particular emphasis will be placed on the mechanisms by which HPV infection impacts radiosensitivity.
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Affiliation(s)
- Eva-Leonne Göttgens
- Department of Radiation Oncology, Radiotherapy & OncoImmunology laboratory, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Paul N Span
- Department of Radiation Oncology, Radiotherapy & OncoImmunology laboratory, Radboud University Medical Center, Nijmegen, Netherlands
| | - Jan Bussink
- Department of Radiation Oncology, Radiotherapy & OncoImmunology laboratory, Radboud University Medical Center, Nijmegen, Netherlands
| | - Ester M Hammond
- Department of Oncology, CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, UK
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40
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Costa RL, Boroni M, Soares MA. Distinct co-expression networks using multi-omic data reveal novel interventional targets in HPV-positive and negative head-and-neck squamous cell cancer. Sci Rep 2018; 8:15254. [PMID: 30323202 PMCID: PMC6189122 DOI: 10.1038/s41598-018-33498-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 09/19/2018] [Indexed: 12/25/2022] Open
Abstract
The human papillomavirus (HPV) is present in a significant fraction of head-and-neck squamous cell cancer (HNSCC). The main goal of this study was to identify distinct co-expression patterns between HPV+ and HPV- HNSCC and to provide insights into potential regulatory mechanisms/effects within the analyzed networks. We selected cases deposited in The Cancer Genome Atlas database comprising data of gene expression, methylation profiles and mutational patterns, in addition to clinical information. The intersection among differentially expressed and differentially methylated genes showed the negative correlations between the levels of methylation and expression, suggesting that these genes have their expression levels regulated by methylation alteration patterns in their promoter. Weighted correlation network analysis was used to identify co-expression modules and a systematic approach was applied to refine them and identify key regulatory elements integrating results from the other omics. Three distinct co-expression modules were associated with HPV status and molecular signatures. Validation using independent studies reporting biological experimental data converged for the most significant genes in all modules. This study provides insights into complex genetic and epigenetic particularities in the development and progression of HNSCC according to HPV status, and contribute to unveiling specific genes/pathways as novel therapeutic targets in HNSCC.
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Affiliation(s)
- Raquel L Costa
- Programa de Oncovirologia, Instituto Nacional de Câncer, Rio de Janeiro, Brazil.
- Bioinformatics and Computational Biology Lab, Instituto Nacional de Câncer, Rio de Janeiro, Brazil.
| | - Mariana Boroni
- Bioinformatics and Computational Biology Lab, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
| | - Marcelo A Soares
- Programa de Oncovirologia, Instituto Nacional de Câncer, Rio de Janeiro, Brazil
- Department of Genetics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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41
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Polverini PJ, D'Silva NJ, Lei YL. Precision Therapy of Head and Neck Squamous Cell Carcinoma. J Dent Res 2018; 97:614-621. [PMID: 29649374 DOI: 10.1177/0022034518769645] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Precision medicine is an approach to disease prevention and treatment that takes into account genetic variability and environmental and lifestyle influences that are unique to each patient. It facilitates stratification of patient populations that vary in their susceptibility to disease and response to therapy. Shared databases and the implementation of new technology systems designed to advance the integration of this information will enable health care providers to more accurately predict and customize prevention and treatment strategies for patients. Although precision medicine has had a limited impact in most areas of medicine, it has been shown to be an increasingly successful approach to cancer therapy. Despite early promising results targeting aberrant signaling pathways or inhibitors designed to block tumor-driven processes such as angiogenesis, limited success emphasizes the need to discover new biomarkers and treatment targets that are more reliable in predicting response to therapy and result in better health outcomes. Recent successes in the use of immunity-inducing antibodies have stimulated increased interest in the use of precision immunotherapy of head and neck squamous cell carcinoma. Using next-generation sequencing, the precise profiling of tumor-infiltrating lymphocytes has great promise to identify hypoimmunogenic cancer that would benefit from a rationally designed combinatorial approach. Continued interrogation of tumors will reveal new actionable targets with increasing therapeutic efficacy and fulfill the promise of precision therapy of head and neck cancer.
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Affiliation(s)
- P J Polverini
- 1 Department of Periodontics and Oral Medicine, Division of Oral Medicine, Pathology, and Radiology, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,2 Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA.,3 Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | - N J D'Silva
- 1 Department of Periodontics and Oral Medicine, Division of Oral Medicine, Pathology, and Radiology, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,2 Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA.,3 Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | - Y L Lei
- 1 Department of Periodontics and Oral Medicine, Division of Oral Medicine, Pathology, and Radiology, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,3 Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA.,4 Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, MI, USA
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Chen WS, Bindra RS, Mo A, Hayman T, Husain Z, Contessa JN, Gaffney SG, Townsend JP, Yu JB. CDKN2A Copy Number Loss Is an Independent Prognostic Factor in HPV-Negative Head and Neck Squamous Cell Carcinoma. Front Oncol 2018; 8:95. [PMID: 29670856 PMCID: PMC5893829 DOI: 10.3389/fonc.2018.00095] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 03/19/2018] [Indexed: 01/30/2023] Open
Abstract
Background HPV infection is associated with high p16 expression and good prognosis in head and neck squamous cell carcinomas (HNSCCs). Analysis of CDKN2A, the gene encoding p16, may further elucidate the association between p16 expression and prognosis. We sought to determine whether CDKN2A copy number loss was associated with poor survival in HPV-negative HNSCCs. Methods The Cancer Genome Atlas HNSCC clinical and genomic data were obtained and integrated. Patients <80 years old with a primary tumor in the oral cavity, oropharynx, hypopharynx, or larynx were included. Stratifying by copy number loss status, CDKN2A mRNA and p16 protein expression levels were examined and overall survival (OS) and disease-free survival (DFS) were evaluated. Results 401 patients with HPV-negative HNSCC were identified. 146 patients demonstrated CDKN2A copy number loss. The CDKN2A copy number loss group expressed significantly lower levels of CDKN2A mRNA and p16 protein than did the non-copy number loss group. Median OS for patients with and without CDKN2A copy number loss was 16.5 and 46.6 months, respectively (p = 0.007). Median DFS for both groups was 11.6 and 19.2 months, respectively (p = 0.03). In both univariate and multivariable analyses, stage IV designation, receipt of chemotherapy and CDKN2A copy number loss were predictive of OS. Conclusion CDKN2A copy number loss predicted poor survival independently of other patient and treatment factors and may be a clinically useful prognostic factor.
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Affiliation(s)
| | - Ranjit S Bindra
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, United States.,Yale Cancer Center, Yale School of Medicine, New Haven, CT, United States
| | - Allen Mo
- University of Connecticut School of Medicine, Farmington, CT, United States
| | - Thomas Hayman
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, United States
| | - Zain Husain
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, United States.,Yale Cancer Center, Yale School of Medicine, New Haven, CT, United States
| | - Joseph N Contessa
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, United States.,Yale Cancer Center, Yale School of Medicine, New Haven, CT, United States
| | - Stephen G Gaffney
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, United States
| | - Jeffrey P Townsend
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, United States
| | - James B Yu
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, United States.,Yale Cancer Center, Yale School of Medicine, New Haven, CT, United States.,Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center at Yale, Yale School of Medicine, New Haven, CT, United States
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43
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Proportion of CD4 and CD8 tumor infiltrating lymphocytes predicts survival in persistent/recurrent laryngeal squamous cell carcinoma. Oral Oncol 2017; 77:83-89. [PMID: 29362129 DOI: 10.1016/j.oraloncology.2017.12.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/24/2017] [Accepted: 12/05/2017] [Indexed: 01/10/2023]
Abstract
Tumor infiltrating lymphocytes (TILs) have been shown to be an important prognostic factor in patients with previously untreated head and neck cancer. After organ preservation therapy for laryngeal cancer and subsequent persistence/recurrence, the prognostic value of TILs is unknown. Our goal was to determine if TILs have value as a prognostic biomarker in patients with surgically salvageable persistent/recurrent laryngeal squamous cell carcinoma. Levels of TILs were quantified on tissue microarrays from 183 patients undergoing salvage total laryngectomy for persistent/recurrent laryngeal cancer after radiation or chemoradiation between 1997 and 2014. Demographic and clinical data were abstracted. Immunohistology evaluation included CD4, CD8, PDL-1, p16, CD31, Vimentin, EGFR, and p53. Elevated levels of either CD8 or CD4 positive TILs were associated with improved disease specific survival (CD8: HR 0.46, 95% CI 0.24-0.88, CD4: HR 0.43; 95% CI 0.21-0.89) and disease free survival (CD8: HR 0.53, 95% CI 0.29-0.94, CD4: HR 0.52; 95% CI 0.27-0.99). Levels of CD8 (HR 0.74; 95% CI 0.47-1.17) or CD4 (HR 0.66; 95% CI 0.40-1.08) TILs were not significantly associated with overall survival. In bivariate analysis, patients with elevated CD4 and/or CD8 TILs had significantly improved disease specific survival (HR 0.42; 95% CI 0.21-0.83) and disease free survival (HR 0.45; 95% CI 0.24-0.84) compared to patients with low levels of CD4 and CD8. PDL-1, p16, CD31, Vimentin, EGFR, and p53 were not significant prognostic factors. On multivariate analysis, elevated CD8 TILs were associated with improved disease specific survival (HR 0.35; 95% CI 0.14-0.88, p = .02) and disease free survival (HR 0.41; 95% CI 0.17-0.96, p = .04). CD8, and possibly CD4, positive TILs are associated with favorable disease free and disease specific survival for recurrent/persistent laryngeal cancer.
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Albers AE, Qian X, Kaufmann AM, Coordes A. Meta analysis: HPV and p16 pattern determines survival in patients with HNSCC and identifies potential new biologic subtype. Sci Rep 2017; 7:16715. [PMID: 29196639 PMCID: PMC5711807 DOI: 10.1038/s41598-017-16918-w] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 11/19/2017] [Indexed: 02/07/2023] Open
Abstract
Consistent discrepancies in the p16/HPV-positivity have been observed in head and neck squamous cell carcinoma (HNSCC). It is therefore questionable, if all HPV+ and/or p16+ tested cancers are HPV-driven. Patients down-staged according to the HPV-dependant TNM are at risk for undertreatment and data in clinical trials may be skewed due to false patient inclusion. We performed a meta-analysis to classify clinical outcomes of the distinct subgroups with combined p16 and HPV detection. 25 out of 1677 publications fulfilled the inclusion criteria. The proportion of the subgroups was 35.6% for HPV+/p16+, 50.4% for HPV-/p16-, 6.7% for HPV-/p16+ and 7.3% for HPV+/P16-. The HPV+/p16+ subgroup had a significantly improved 5-year overall-survival (OS) and disease-free-survival in comparison to others both for HNSCC and oropharyngeal cancers. The 5-year OS of the HPV-/p16+ HNSCC was intermediate while HPV+/p16- and HPV-/p16- had the shortest survival outcomes. The clearly distinct survival of HPV-/p16+ cancers may characterize a new relevant HPV-independent subtype yet to be biologically characterized. The possibility also exists that in some HPV+/p16+ cancers HPV is an innocent bystander and p16 is independently positive. Therefore, in perspective, HPV-testing should distinguish between bystander HPV and truly HPV-driven cancers to avoid potential undertreatment in HPV+ but non-HPV-driven HNSCC.
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Affiliation(s)
- Andreas E Albers
- Department of Otorhinolaryngology, Head and Neck Surgery, Berlin Institute of Health, Charite - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin, Germany.
| | - Xu Qian
- Department of Otorhinolaryngology, Head and Neck Surgery, Berlin Institute of Health, Charite - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Andreas M Kaufmann
- Clinic for Gynecology, Charité - Berlin Institute of Health, Charite - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Annekatrin Coordes
- Department of Otorhinolaryngology, Head and Neck Surgery, Berlin Institute of Health, Charite - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin, Germany
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Gribko A, Hahlbrock A, Strieth S, Becker S, Hagemann J, Deichelbohrer M, Hildebrandt A, Habtemichael N, Wünsch D. Disease-relevant signalling-pathways in head and neck cancer: Taspase1's proteolytic activity fine-tunes TFIIA function. Sci Rep 2017; 7:14937. [PMID: 29097782 PMCID: PMC5668323 DOI: 10.1038/s41598-017-14814-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 10/16/2017] [Indexed: 12/23/2022] Open
Abstract
Head and neck cancer (HNC) is the seventh most common malignancy in the world and its prevailing form, the head and neck squamous cell carcinoma (HNSCC), is characterized as aggressive and invasive cancer type. The transcription factor II A (TFIIA), initially described as general regulator of RNA polymerase II-dependent transcription, is part of complex transcriptional networks also controlling mammalian head morphogenesis. Posttranslational cleavage of the TFIIA precursor by the oncologically relevant protease Taspase1 is crucial in this process. In contrast, the relevance of Taspase1-mediated TFIIA cleavage during oncogenesis of HNSCC is not characterized yet. Here, we performed genome-wide expression profiling of HNSCC which revealed significant downregulation of the TFIIA downstream target CDKN2A. To identify potential regulatory mechanisms of TFIIA on cellular level, we characterized nuclear-cytoplasmic transport and Taspase1-mediated cleavage of TFIIA variants. Unexpectedly, we identified an evolutionary conserved nuclear export signal (NES) counteracting nuclear localization and thus, transcriptional activity of TFIIA. Notably, proteolytic processing of TFIIA by Taspase1 was found to mask the NES, thereby promoting nuclear localization and transcriptional activation of TFIIA target genes, such as CDKN2A. Collectively, we here describe a hitherto unknown mechanism how cellular localization and Taspase1 cleavage fine-tunes transcriptional activity of TFIIA in HNSCC.
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Affiliation(s)
- Alena Gribko
- Department of Otorhinolaryngology, Molecular and Cellular Oncology, University Hospital of Mainz, Langenbeckstrasse 1, Mainz, 55101, Germany
| | - Angelina Hahlbrock
- Department of Otorhinolaryngology, Molecular and Cellular Oncology, University Hospital of Mainz, Langenbeckstrasse 1, Mainz, 55101, Germany
| | - Sebastian Strieth
- Department of Otorhinolaryngology, Molecular and Cellular Oncology, University Hospital of Mainz, Langenbeckstrasse 1, Mainz, 55101, Germany
| | - Sven Becker
- Department of Otorhinolaryngology, Molecular and Cellular Oncology, University Hospital of Mainz, Langenbeckstrasse 1, Mainz, 55101, Germany
| | - Jan Hagemann
- Department of Otorhinolaryngology, Molecular and Cellular Oncology, University Hospital of Mainz, Langenbeckstrasse 1, Mainz, 55101, Germany
| | - Max Deichelbohrer
- Department of Otorhinolaryngology, Molecular and Cellular Oncology, University Hospital of Mainz, Langenbeckstrasse 1, Mainz, 55101, Germany
| | - Andreas Hildebrandt
- Scientific Computing and Bioinformatics, Johannes Gutenberg University, Staudingerweg 9, Mainz, 55128, Germany
| | - Negusse Habtemichael
- Department of Otorhinolaryngology, Molecular and Cellular Oncology, University Hospital of Mainz, Langenbeckstrasse 1, Mainz, 55101, Germany
| | - D Wünsch
- Department of Otorhinolaryngology, Molecular and Cellular Oncology, University Hospital of Mainz, Langenbeckstrasse 1, Mainz, 55101, Germany.
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Hosseini SZ, Makvandi M, Samarbafzade A, Timori A, Ranjbar N, Saki N, Nisi N, Shahani T, Varnaseri M, Angali Ahmadi K. Frequency of Human Papillomavirus (HPV) 16 and 18 Detection
in Paraffin- Embedded Laryngeal Carcinoma Tissue. Asian Pac J Cancer Prev 2017; 18:889-893. [PMID: 28545184 PMCID: PMC5494237 DOI: 10.22034/apjcp.2017.18.4.889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background and Objective: Human papilloma virus (HPV) 16 and HPV18 have been detected in head and neck
squamous cell carcinomas (HNSCC) and there is evidence that detection of HPVs would have better prognostic value
than patients with HNSCC negative for HPVs. Thus, this study was conducted to evaluate frequency of HPV 16 and HPV
18 genotypes in patients with laryngeal carcinoma. Materials and methods: Fifty formalin-fixed, paraffin-embedded
(FFPE) tissue blocks of laryngeal cancers were collected. Sections were prepared at 5 μm and DNA was extracted from
each sample and subjected to the polymerase chain reaction (PCR) to detect HPV-16/18 DNA s. Results: All samples
were squamous cell carcinomas (SCCs). Overall 14/50 (28%) were positive for HPVs, 8 (18%) with HPV-16 and 6
(12%) with HPV-18. Additionally, 2 (4%) mixed infections of HPV 16 and 18 genotypes were observed among these
cases. Conclusions: Overall, 28% of HNSCC samples proved positive for HPV16 and HPV18 genotypes, two high-risk
HPV types. It is important to further assess whether such viral infection, could be a risk factor in HNSCC progression.
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Affiliation(s)
- Seyed Zinab Hosseini
- Health Research Institute; Infectious and Tropical Disease Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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FKBP51 Immunohistochemical Expression: A New Prognostic Biomarker for OSCC? Int J Mol Sci 2017; 18:ijms18020443. [PMID: 28218707 PMCID: PMC5343977 DOI: 10.3390/ijms18020443] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 02/03/2017] [Accepted: 02/09/2017] [Indexed: 12/23/2022] Open
Abstract
Up-to-date, several molecular markers of prognosis have been studied in Oral Squamous Cell Carcinoma (OSCC), but none entered in the clinical setting. Therapy of OSCC tumors mainly relies on surgery, radiotherapy and partially on chemotherapy; there is an urgent need for biomarkers able to better stratify OSCC patients’ risk to address targeted therapeutic strategies. The role of immune response in the pathogenesis and biological behavior of OSCC has been investigated by several authors, and promising results have been obtained with immune checkpoint inhibitors. We already investigated the role of the immune modulator FK506-binding protein 51 (FKBP51), a FK506-binding immunophilin, in cutaneous melanoma biology, and its expression in several human solid tumors. In the present study, we aimed to assess the value of FKBP51 expression in OSCC tumor cells as a marker of outcome. We collected clinical data from 72 patients who underwent surgery for Squamous Cell Carcinoma (SCC) of the tongue, floor, lips and palate. FKBP51 expression was assessed by immunohistochemistry on paraffin-embedded tumor tissues. In addition, we evaluated the human papillomavirus (HPV) status of primary tumors by immunohistochemistry, viral subtyping and In Situ Hybridization (ISH) assay. We found that high FKBP51-expressing tumors characterized the OSCCs with the worst prognosis: the high immunohistochemical expression of FKBP51 associated with death occurring within five years from the diagnosis with a sensitivity of 88.46% and a specificity of 91.67%. The estimated positive predictive value of the test was 88.45% and negative predictive value 91.67%. We tested FKBP51 mRNA presence, by RT-PCR assay, in a selected series of OSCC tumors, and we found that mRNA correlated well to the protein expression and to the clinical outcome. Applying the Bayes formula, we estimated an 88% probability of dying within five years from the diagnosis of OSCC patients with a high FKBP51 immunohistochemical (IHC) test result (>51% of FKBP51 positive tumor cells). On the basis of our analysis, we propose tumor tissue expression of FKBP51 protein as a reliable prognostic marker for OSCC tumors.
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Worsham MJ, Chen KM, Datta I, Stephen JK, Chitale D, Gothard A, Divine G. The biological significance of methylome differences in human papilloma virus associated head and neck cancer. Oncol Lett 2016; 12:4949-4956. [PMID: 28101231 PMCID: PMC5228097 DOI: 10.3892/ol.2016.5303] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 08/26/2016] [Indexed: 01/02/2023] Open
Abstract
In recent years, studies have suggested that promoter methylation in human papilloma virus (HPV) positive head and neck squamous cell carcinoma (HNSCC) has a mechanistic role and has the potential to improve patient survival. The present study aimed to replicate key molecular findings from previous analyses of the methylomes of HPV positive and HPV negative HNSCC in an independent cohort, to assess the reliability of differentially methylated markers in HPV-associated tumors. HPV was measured using real-time quantitative PCR and the biological significance of methylation differences was assessed by Ingenuity Pathway Analysis (IPA). Using an identical experimental design of a 450K methylation platform, 7 of the 11 genes were detected to be significantly differentially methylated and all 11 genes were either hypo- or hypermethylated, which was in agreement with the results of a previous study. IPA's enriched networks analysis identified one network with msh homeobox 2 (MSX2) as a central node. Locally dense interactions between genes in networks tend to reflect significant biology; therefore MSX2 was selected as an important gene. Sequestration in the top four canonical pathways was noted for 5-hydroxytryptamine receptor 1E (serotonin signaling), collapsin response mediator protein 1 (semaphorin signaling) and paired like homeodomain 2 (bone morphogenic protein and transforming growth factor-β signaling). Placement of 9 of the 11 genes in highly ranked pathways and bionetworks identified key biological processes to further emphasize differences between HNSCC HPV positive and negative pathogenesis.
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Affiliation(s)
- Maria J Worsham
- Department of Otolaryngology/Head and Neck Research, Henry Ford Hospital, Detroit, MI 48202, USA
| | - Kang Mei Chen
- Department of Otolaryngology/Head and Neck Research, Henry Ford Hospital, Detroit, MI 48202, USA
| | - Indrani Datta
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI 48202, USA
| | - Josena K Stephen
- Department of Otolaryngology/Head and Neck Research, Henry Ford Hospital, Detroit, MI 48202, USA
| | - Dhananjay Chitale
- Department of Pathology, Henry Ford Hospital, Detroit, MI 48202, USA
| | | | - George Divine
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI 48202, USA
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Chow LQM, Haddad R, Gupta S, Mahipal A, Mehra R, Tahara M, Berger R, Eder JP, Burtness B, Lee SH, Keam B, Kang H, Muro K, Weiss J, Geva R, Lin CC, Chung HC, Meister A, Dolled-Filhart M, Pathiraja K, Cheng JD, Seiwert TY. Antitumor Activity of Pembrolizumab in Biomarker-Unselected Patients With Recurrent and/or Metastatic Head and Neck Squamous Cell Carcinoma: Results From the Phase Ib KEYNOTE-012 Expansion Cohort. J Clin Oncol 2016; 34:3838-3845. [PMID: 27646946 PMCID: PMC6804896 DOI: 10.1200/jco.2016.68.1478] [Citation(s) in RCA: 589] [Impact Index Per Article: 73.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose Treatment with pembrolizumab, an anti–programmed death-1 antibody, at 10 mg/kg administered once every 2 weeks, displayed durable antitumor activity in programmed death-ligand 1 (PD-L1) –positive recurrent and/or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) in the KEYNOTE-012 trial. Results from the expansion cohort, in which patients with HNSCC, irrespective of biomarker status, received a fixed dose of pembrolizumab at a less frequent dosing schedule, are reported. Patients and Methods Patients with R/M HNSCC, irrespective of PD-L1 or human papillomavirus status, received pembrolizumab 200 mg intravenously once every 3 weeks. Imaging was performed every 8 weeks. Primary end points were overall response rate (ORR) per central imaging vendor (Response Evaluation Criteria in Solid Tumors v1.1) and safety. Secondary end points included progression-free survival, overall survival, and association of response and PD-L1 expression. Patients who received one or more doses of pembrolizumab were included in analyses. Results Of 132 patients enrolled, median age was 60 years (range, 25 to 84 years), 83% were male, and 57% received two or more lines of therapy for R/M disease. ORR was 18% (95% CI, 12 to 26) by central imaging vendor and 20% (95% CI, 13 to 28) by investigator review. Median duration of response was not reached (range, ≥ 2 to ≥ 11 months). Six-month progression-free survival and overall survival rates were 23% and 59%, respectively. By using tumor and immune cells, a statistically significant increase in ORR was observed for PD-L1–positive versus –negative patients (22% v 4%; P = .021). Treatment-related adverse events of any grade and grade ≥ 3 events occurred in 62% and 9% of patients, respectively. Conclusion Fixed-dose pembrolizumab 200 mg administered once every 3 weeks was well tolerated and yielded a clinically meaningful ORR with evidence of durable responses, which supports further development of this regimen in patients with advanced HNSCC.
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Affiliation(s)
- Laura Q M Chow
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Robert Haddad
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Shilpa Gupta
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Amit Mahipal
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Ranee Mehra
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Makoto Tahara
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Raanan Berger
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Joseph Paul Eder
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Barbara Burtness
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Se-Hoon Lee
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Bhumsuk Keam
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Hyunseok Kang
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Kei Muro
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Jared Weiss
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Ravit Geva
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Chi Lin
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Hyun Cheol Chung
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Amy Meister
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Marisa Dolled-Filhart
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Kumudu Pathiraja
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Jonathan D Cheng
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Tanguy Y Seiwert
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
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Qian G, Hu Z, Xu H, Müller S, Wang D, Zhang H, Kim S, Chen Z, Saba NF, Shin DM, Wang AY, Chen ZG. A novel prediction model for human papillomavirus-associated oropharyngeal squamous cell carcinoma using p16 and subcellular β-catenin expression. J Oral Pathol Med 2016; 45:399-408. [PMID: 26493274 PMCID: PMC4841757 DOI: 10.1111/jop.12378] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND p16 overexpression is a highly sensitive yet moderately specific biomarker for predicting human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC). Nuclear β-catenin translocation has been linked to HPV-positive OPSCC. However, whether the strategy of combining β-catenin with p16 can better predict HPV-associated OPSCC remains unknown. METHODS We evaluated the expression of p16 and β-catenin (nuclear and membrane) by immunohistochemistry staining in 101 OPSCC tissues and HPV status by HPV DNA in situ hybridization. Logistic regression models were used to evaluate single or multiple biomarkers for HPV prediction. The prediction power, sensitivity, and specificity were determined by receiver operating characteristic (ROC) analyses. RESULTS Our data showed that upon univariate analysis, p16 and nuclear β-catenin were positively correlated with HPV status, while membrane β-catenin was inversely correlated with HPV status (P < 0.01). p16 showed the highest HPV predictive power, with area under the curve (AUC) of 0.9074 compared to 0.6762 for nuclear β-catenin and 0.7635 for membrane β-catenin, respectively, indicating differential accuracies for HPV prediction. Multivariable analysis showed that p16 was significantly correlated with HPV, while nuclear and membrane β-catenin showed marginal significance. The three-biomarker model was similarly sensitive (98.9% vs. 100%) but more specific (88.9% vs. 81%) than p16 alone, which also showed a good predictive value for overall (P = 0.0002) survival and disease-free (P = 0.0158) survival. CONCLUSION Our study suggests a novel model of combining p16 and subcellular β-catenin for prediction of HPV-associatred OPSCC, and this finding deserves further validation.
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Affiliation(s)
- Guoqing Qian
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia, 30322, USA
| | - Zhongliang Hu
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia, 30322, USA
- Department of Pathology, Xiangya Hospital; Department of Pathology, Xiangya Medical School; Central South University, Changsha, Hunan, 410078, China
| | - Hong Xu
- Ocean NanoTech, San Diego, California, 92126, USA
| | - Susan Müller
- Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, 30322, USA
| | - Dongsheng Wang
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia, 30322, USA
| | - Hongzheng Zhang
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia, 30322, USA
| | - Sungjin Kim
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, 30322, USA
| | - Zhengjia Chen
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, 30322, USA
| | - Nabil F. Saba
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia, 30322, USA
| | - Dong M. Shin
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia, 30322, USA
| | | | - Zhuo Georgia Chen
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia, 30322, USA
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