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Lehtinen N, Suhonen J, Rice K, Välimäki E, Toriseva M, Routila J, Halme P, Rahi M, Irjala H, Leivo I, Kallajoki M, Nees M, Kuopio T, Ventelä S, Rantala JK. Assessment of targeted therapy opportunities in sinonasal cancers using patient-derived functional tumor models. Transl Oncol 2024; 44:101935. [PMID: 38522153 PMCID: PMC10973676 DOI: 10.1016/j.tranon.2024.101935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/26/2024] [Accepted: 03/07/2024] [Indexed: 03/26/2024] Open
Abstract
Malignant tumors derived from the epithelium lining the nasal cavity region are termed sinonasal cancers, a highly heterogeneous group of rare tumors accounting for 3 - 5 % of all head and neck cancers. Progress with next-generation molecular profiling has improved our understanding of the complexity of sinonasal cancers and resulted in the identification of an increasing number of distinct tumor entities. Despite these significant developments, the treatment of sinonasal cancers has hardly evolved since the 1980s, and an advanced sinonasal cancer presents a poor prognosis as targeted therapies are usually not available. To gain insights into potential targeted therapeutic opportunities, we performed a multiomics profiling of patient-derived functional tumor models to identify molecular characteristics associated with pharmacological responses in the different subtypes of sinonasal cancer. METHODS Patient-derived ex vivo tumor models representing four distinct sinonasal cancer subtypes: sinonasal intestinal-type adenocarcinoma, sinonasal neuroendocrine carcinoma, sinonasal undifferentiated carcinoma and SMARCB1 deficient sinonasal carcinoma were included in the analyses. Results of functional drug screens of 160 anti-cancer therapies were integrated with gene panel sequencing and histological analyses of the tumor tissues and the ex vivo cell cultures to establish associations between drug sensitivity and molecular characteristics including driver mutations. RESULTS The different sinonasal cancer subtypes display considerable differential drug sensitivity. Underlying the drug sensitivity profiles, each subtype was associated with unique molecular features. The therapeutic vulnerabilities correlating with specific genomic background were extended and validated with in silico analyses of cancer cell lines representing different human cancers and with reported case studies of sinonasal cancers treated with targeted therapies. CONCLUSION The results demonstrate the importance of understanding the differential biology and the molecular features associated with the different subtypes of sinonasal cancers. Patient-derived ex vivo tumor models can be a powerful tool for investigating these rare cancers and prioritizing targeted therapeutic strategies for future clinical development and personalized medicine.
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Affiliation(s)
| | | | | | | | - Mervi Toriseva
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; FICAN West Cancer Centre, Turku, Finland
| | - Johannes Routila
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku and Turku University Hospital, Turku, Finland
| | - Perttu Halme
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku and Turku University Hospital, Turku, Finland
| | - Melissa Rahi
- Department of Neurosurgery, Neurocenter, Turku University Hospital, Turku, Finland; Clinical Neurosciences, University of Turku, Turku, Finland
| | - Heikki Irjala
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku and Turku University Hospital, Turku, Finland
| | - Ilmo Leivo
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; Department of Pathology, University of Turku and Turku University Hospital, Turku, Finland
| | - Markku Kallajoki
- Department of Pathology, University of Turku and Turku University Hospital, Turku, Finland
| | - Matthias Nees
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; FICAN West Cancer Centre, Turku, Finland; Department of Biochemistry and Molecular Biology, Medical University of Lublin, Lublin, Poland
| | - Teijo Kuopio
- Department of Biological and Environmental Science, University of Jyväskylä, Jyväskylä, Finland; Wellbeing Services County of Central Finland, Jyväskylä, Finland
| | - Sami Ventelä
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; FICAN West Cancer Centre, Turku, Finland; Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku and Turku University Hospital, Turku, Finland
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Routila E, Mahran R, Salminen S, Irjala H, Haapio E, Kytö E, Ventelä S, Petterson K, Routila J, Gidwani K, Leivo J. Identification of stemness-related glycosylation changes in head and neck squamous cell carcinoma. BMC Cancer 2024; 24:443. [PMID: 38600440 PMCID: PMC11005150 DOI: 10.1186/s12885-024-12161-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/21/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Altered glycosylation is a hallmark of cancer associated with therapy resistance and tumor behavior. In this study, we investigated the glycosylation profile of stemness-related proteins OCT4, CIP2A, MET, and LIMA1 in HNSCC tumors. METHODS Tumor, adjacent normal tissue, and blood samples of 25 patients were collected together with clinical details. After tissue processing, lectin-based glycovariant screens were performed. RESULTS Strong correlation between glycosylation profiles of all four stemness-related proteins was observed in tumor tissue, whereas glycosylation in tumor tissue, adjacent normal tissue, and serum was differential. CONCLUSIONS A mannose- and galactose-rich glycosylation niche associated with stemness-related proteins was identified.
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Affiliation(s)
- E Routila
- Department of Life Technologies, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland.
- InFLAMES Research Flagship, University of Turku, 20014, Turku, Finland.
- FICAN West Cancer Centre, Turku, Finland.
| | - R Mahran
- Department of Life Technologies, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland
- FICAN West Cancer Centre, Turku, Finland
- Department of Chemistry, University of Turku, Henrikinkatu 2, 20500, Turku, Finland
| | - S Salminen
- Department of Life Technologies, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland
- FICAN West Cancer Centre, Turku, Finland
| | - H Irjala
- Department for Otorhinolaryngology- Head and Neck surgery, University of Turku and Turku University Hospital, Savitehtaankatu 5, 20520, Turku, Finland
| | - E Haapio
- Department for Otorhinolaryngology- Head and Neck surgery, University of Turku and Turku University Hospital, Savitehtaankatu 5, 20520, Turku, Finland
| | - E Kytö
- Department for Otorhinolaryngology- Head and Neck surgery, University of Turku and Turku University Hospital, Savitehtaankatu 5, 20520, Turku, Finland
| | - S Ventelä
- FICAN West Cancer Centre, Turku, Finland
- Department for Otorhinolaryngology- Head and Neck surgery, University of Turku and Turku University Hospital, Savitehtaankatu 5, 20520, Turku, Finland
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Tykistökatu 6, 20520, Turku, Finland
| | - K Petterson
- Department of Life Technologies, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland
| | - J Routila
- FICAN West Cancer Centre, Turku, Finland
- Department for Otorhinolaryngology- Head and Neck surgery, University of Turku and Turku University Hospital, Savitehtaankatu 5, 20520, Turku, Finland
| | - K Gidwani
- Department of Life Technologies, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland
| | - J Leivo
- Department of Life Technologies, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland
- InFLAMES Research Flagship, University of Turku, 20014, Turku, Finland
- FICAN West Cancer Centre, Turku, Finland
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Tuominen S, Nissi L, Kukkula A, Routila J, Huusko T, Leivo I, Minn H, Irjala H, Löyttyniemi E, Ventelä S, Sundvall M, Grönroos TJ. TSPO is a potential independent prognostic factor associated with cellular respiration and p16 in head and neck squamous cell carcinoma. Front Oncol 2023; 13:1298333. [PMID: 38162485 PMCID: PMC10755888 DOI: 10.3389/fonc.2023.1298333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024] Open
Abstract
Background Treatment resistance and relapse are common problems in head and neck squamous cell carcinoma (HNSCC). Except for p16, no clinically accepted prognostic biomarkers are available for HNSCC. New biomarkers predictive of recurrence and survival are crucial for optimal treatment planning and patient outcome. High translocator protein (TSPO) levels have been associated with poor survival in cancer, but the role of TSPO has not been extensively evaluated in HNSCC. Materials and methods TSPO expression was determined in a large population-based tissue microarray cohort including 611 patients with HNSCC and evaluated for survival in several clinicopathological subgroups. A TCGA HNSCC cohort was used to further analyze the role of TSPO in HNSCC. Results TSPO expression was downregulated in more aggressive tumors. Low TSPO expression associated with worse 5-year survival and was an independent prognostic factor for disease-specific survival. Subgroup analyses showed that low TSPO expression associated with worse survival particularly in p16-positive oropharyngeal cancer. In silico analyses supported the prognostic role of TSPO. Cellular respiration had the highest significance in pathway analyses for genes expressed positively with TSPO. Conclusion Decreased TSPO expression associates with poor prognosis in HNSCC. TSPO is a prognostic biomarker in HNSCC to potentially guide treatment stratification especially in p16-positive oropharyngeal cancer.
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Affiliation(s)
- Sanni Tuominen
- Preclinical Imaging Laboratory, Turku PET Centre, University of Turku, Turku, Finland
- Cancer Research Unit, Institute of Biomedicine, University of Turku, Turku, Finland
- FICAN West Cancer Research Laboratory, Turku University Hospital and University of Turku, Turku, Finland
- Medicity Research Laboratory, Faculty of Medicine, University of Turku, Turku, Finland
| | - Linda Nissi
- Department of Clinical Oncology, Turku University Hospital and University of Turku, Turku, Finland
| | - Antti Kukkula
- Cancer Research Unit, Institute of Biomedicine, University of Turku, Turku, Finland
- FICAN West Cancer Research Laboratory, Turku University Hospital and University of Turku, Turku, Finland
| | - Johannes Routila
- Department of Otorhinolaryngology – Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Teemu Huusko
- Department of Otorhinolaryngology – Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Ilmo Leivo
- Department of Pathology, Turku University Hospital and University of Turku, Turku, Finland
| | - Heikki Minn
- Department of Clinical Oncology, Turku University Hospital and University of Turku, Turku, Finland
| | - Heikki Irjala
- Department of Otorhinolaryngology – Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Eliisa Löyttyniemi
- Department of Biostatistics, Turku University Hospital and University of Turku, Turku, Finland
| | - Sami Ventelä
- Department of Otorhinolaryngology – Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Maria Sundvall
- Cancer Research Unit, Institute of Biomedicine, University of Turku, Turku, Finland
- FICAN West Cancer Research Laboratory, Turku University Hospital and University of Turku, Turku, Finland
- Department of Clinical Oncology, Turku University Hospital and University of Turku, Turku, Finland
| | - Tove J. Grönroos
- Preclinical Imaging Laboratory, Turku PET Centre, University of Turku, Turku, Finland
- Medicity Research Laboratory, Faculty of Medicine, University of Turku, Turku, Finland
- Department of Clinical Oncology, Turku University Hospital and University of Turku, Turku, Finland
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Hyytiäinen A, Korelin K, Toriseva M, Wilkman T, Kainulainen S, Mesimäki K, Routila J, Ventelä S, Irjala H, Nees M, Al-Samadi A, Salo T. The effect of matrices on the gene expression profile of patient-derived head and neck carcinoma cells for in vitro therapy testing. Cancer Cell Int 2023; 23:147. [PMID: 37488620 PMCID: PMC10367262 DOI: 10.1186/s12935-023-02982-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/29/2023] [Indexed: 07/26/2023] Open
Abstract
OBJECTIVE Head and neck squamous cell carcinoma (HNSCC) is a highly aggressive tumor with a 5-year mortality rate of ~ 50%. New in vitro methods are needed for testing patients' cancer cell response to anti-cancer treatments. We aimed to investigate how the gene expression of fresh carcinoma tissue samples and freshly digested single cancer cells change after short-term cell culturing on plastic, Matrigel or Myogel. Additionally, we studied the effect of these changes on the cancer cells' response to anti-cancer treatments. MATERIALS/METHODS Fresh tissue samples from HNSCC patients were obtained perioperatively and single cells were enzymatically isolated and cultured on either plastic, Matrigel or Myogel. We treated the cultured cells with cisplatin, cetuximab, and irradiation; and performed cell viability measurement. RNA was isolated from fresh tissue samples, freshly isolated single cells and cultured cells, and RNA sequencing transcriptome profiling and gene set enrichment analysis were performed. RESULTS Cancer cells obtained from fresh tissue samples changed their gene expression regardless of the culturing conditions, which may be due to the enzymatic digestion of the tissue. Myogel was more effective than Matrigel at supporting the upregulation of pathways related to cancer cell proliferation and invasion. The impacts of anti-cancer treatments varied between culturing conditions. CONCLUSIONS Our study showed the challenge of in vitro cancer drug testing using enzymatic cell digestion. The upregulation of many targeted pathways in the cultured cells may partially explain the common clinical failure of the targeted cancer drugs that pass the in vitro testing.
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Affiliation(s)
- Aini Hyytiäinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
- Translational Immunology Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Katja Korelin
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
- Translational Immunology Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Mervi Toriseva
- Institute of Biomedicine, University of Turku, Turku, 20520, Finland
- FICAN West Cancer Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Tommy Wilkman
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland
| | - Satu Kainulainen
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland
| | - Karri Mesimäki
- Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland
| | - Johannes Routila
- FICAN West Cancer Centre, University of Turku and Turku University Hospital, Turku, Finland
- Department of Otorhinolaryngology - Head and Neck surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Sami Ventelä
- FICAN West Cancer Centre, University of Turku and Turku University Hospital, Turku, Finland
- Department of Otorhinolaryngology - Head and Neck surgery, Turku University Hospital and University of Turku, Turku, Finland
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland
| | - Heikki Irjala
- Department of Otorhinolaryngology - Head and Neck surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Matthias Nees
- Institute of Biomedicine, University of Turku, Turku, 20520, Finland
- FICAN West Cancer Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Ahmed Al-Samadi
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
- Translational Immunology Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Institute of Dentistry, School of Medicine, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Tuula Salo
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.
- Translational Immunology Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland.
- Medical Research Center, Oulu University Hospital, Oulu, Finland.
- Department of Pathology, Helsinki University Hospital (HUS), Helsinki, Finland.
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Knubb JC, Kaislavuo JM, Jegoroff HS, Piitulainen JM, Routila J. Comparison of three common tonsil surgery techniques: cold steel with hot hemostasis, monopolar and bipolar diathermy. Eur Arch Otorhinolaryngol 2023; 280:2975-2984. [PMID: 36813861 PMCID: PMC10175435 DOI: 10.1007/s00405-023-07892-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 02/14/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE To analyze the risk of postoperative hemorrhage in tonsil surgery with different surgical methods, instruments, indications, and age groups. Monopolar diathermy compared to bipolar diathermy was of particular interest. METHODS The data from tonsil surgery patients were retrospectively collected between 2012 and 2018 in the Hospital District of Southwest Finland. The surgical method, instruments, indication, sex and age and their association with a postoperative hemorrhage were analyzed. RESULTS A total of 4434 patients were included. The postoperative hemorrhage rate for tonsillectomy was 6.3% and for tonsillotomy 2.2%. The most frequently used surgical instruments were monopolar diathermy (58.4%) cold steel with hot hemostasis (25.1%) and bipolar diathermy (6.4%) with the overall postoperative hemorrhage rates 6.1%, 5.9% and 8.1%, respectively. In tonsillectomy patients, the risk for a secondary hemorrhage was higher with bipolar diathermy compared to both monopolar diathermy (p = 0.039) and the cold steel with hot hemostasis technique (p = 0.029). However, between the monopolar and the cold steel with hot hemostasis groups, the difference was statistically non-significant (p = 0.646). Patients aged > 15 years had 2.6 times higher risk for postoperative hemorrhage. The risk of a secondary hemorrhage increased with tonsillitis as the indication, primary hemorrhage, tonsillectomy or tonsillotomy without adenoidectomy, and male sex in patients aged ≤ 15 years. CONCLUSION Bipolar diathermy increased the risk for secondary bleedings compared to both monopolar diathermy and the cold steel with hot hemostasis technique in tonsillectomy patients. Monopolar diathermy did not significantly differ from the cold steel with hot hemostasis group regarding the bleeding rates.
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Affiliation(s)
- Jenny Christina Knubb
- Otorhinolaryngology, Faculty of Medicine, University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland.
- Department of Otorhinolaryngology, Satakunta Hospital District, Satasairaala Central Hospital, Pori, Finland.
| | - Jasmin Maria Kaislavuo
- Otorhinolaryngology, Faculty of Medicine, University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - Henri Sebastian Jegoroff
- Otorhinolaryngology, Faculty of Medicine, University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - Jaakko Matias Piitulainen
- Otorhinolaryngology, Faculty of Medicine, University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland
- Division of Surgery and Cancer Diseases, Department of Otorhinolaryngology, Head and Neck Surgery, Turku University Hospital, Turku, Finland
| | - Johannes Routila
- Otorhinolaryngology, Faculty of Medicine, University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland
- Division of Surgery and Cancer Diseases, Department of Otorhinolaryngology, Head and Neck Surgery, Turku University Hospital, Turku, Finland
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Denissoff A, Huusko T, Ventelä S, Niemelä S, Routila J. Exposure to alcohol and overall survival in head and neck cancer: A regional cohort study. Head Neck 2022; 44:2109-2117. [PMID: 35713171 PMCID: PMC9545212 DOI: 10.1002/hed.27125] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/24/2022] [Accepted: 06/01/2022] [Indexed: 12/02/2022] Open
Abstract
Background There is a paucity of knowledge regarding the association of alcohol use with overall survival (OS) of patients with head and neck squamous cell carcinoma (HNSCC). Methods All 1033 patients treated for new HNSCC in Southwest Finland regional referral center of Turku University Hospital in 2005–2015. Cox regression analysis was used. Tumor TNM classification, age at baseline and tobacco smoking status were assessed as potential confounders. Results A history of severe harmful alcohol use with major somatic complications (HR: 1.41; 95%CI: 1.06–1.87; p = 0.017) as well as current use of at least 10 units per week (HR: 1.44, 95%CI: 1.16–1.78; p = 0.001) were associated with OS. Conclusions Alcohol consumption of 10–20 units/week, often regarded as moderate use, was found to increase risk of mortality independent of other prognostic variables. Systematic screening of risk level alcohol use and prognostic evaluation of alcohol brief intervention strategies is highly recommended.
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Affiliation(s)
- Alexander Denissoff
- Department of Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland.,Addiction Psychiatry Unit, Department of Psychiatry, Turku University Hospital, Turku, Finland
| | - Teemu Huusko
- Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku, Turku, Finland.,Department for Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Turku, Finland
| | - Sami Ventelä
- Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku, Turku, Finland.,Department for Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Turku, Finland
| | - Solja Niemelä
- Department of Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland.,Addiction Psychiatry Unit, Department of Psychiatry, Turku University Hospital, Turku, Finland
| | - Johannes Routila
- Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku, Turku, Finland.,Department for Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Turku, Finland
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Routila J, Qiao X, Weltner J, Rantala JK, Carpén T, Hagström J, Mäkitie A, Leivo I, Ruuskanen M, Söderlund J, Rintala M, Hietanen S, Irjala H, Minn H, Westermarck J, Ventelä S. Cisplatin overcomes radiotherapy resistance in OCT4-expressing head and neck squamous cell carcinoma. Oral Oncol 2022; 127:105772. [PMID: 35245886 DOI: 10.1016/j.oraloncology.2022.105772] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/11/2022] [Accepted: 02/12/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Cisplatin is combined with radiotherapy for advanced head and neck squamous cell carcinoma (HNSCC). While providing a beneficial effect on survival, it also causes side effects and thus is an important target when considering treatment de-escalation. Currently, there are no biomarkers to predict its patient-selective therapeutic utility. In this study, we examined the role of the stem cell factor OCT4 as a potential biomarker to help clinicians stratify HNSCC patients between radiotherapy and chemoradiotherapy. MATERIALS AND METHODS OCT4 immunohistochemical staining of a population-validated tissue microarray (PV-TMA) (n = 166) representative of a standard HNSCC patients was carried out, and 5-year survival was analyzed. The results were validated using ex vivo drug sensitivity analysis of HNSCC tumor samples, and further cross-validated in independent oropharyngeal (n = 118), nasopharyngeal (n = 170), and vulvar carcinoma (n = 95) clinical datasets. In vitro, genetically modified, patient-derived HNSCC cells were used. RESULTS OCT4 expression in HNSCC tumors was associated with radioresistance. However, combination therapy with cisplatin was found to overcome thisradioresistance in OCT4-expressing HNSCC tumors. The results were validated by using several independent patient cohorts. Furthermore, CRISPRa-based OCT4 overexpression in the HNSCC cell line resulted in apoptosis resistance, and cisplatin was found to downregulate OCT4 protein expression in vitro. Ex vivo drug sensitivity analysis of HNSCC tumors confirmed the association between OCT4 expression and cisplatin sensitivity. CONCLUSION This study introduces OCT4 immunohistochemistry as a simple and cost-effective diagnostic approach for clinical practice to identify HNSCC patients benefitting from radiosensitization by cisplatin using either full or reduced dosing.
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Affiliation(s)
- Johannes Routila
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20521 Turku, Finland
| | - Xi Qiao
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland
| | - Jere Weltner
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, SE-14186 Stockholm, Sweden and Division of Obstetrics and Gynecology, Karolinska Universitetssjukhuset, SE-14186 Stockholm, Sweden
| | - Juha K Rantala
- MISVIK Biology Ltd, Karjakatu 35 B, 20520 Turku, Finland
| | - Timo Carpén
- Department for Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, P.O.Box 263, FI-00029 HUS Helsinki, Finland
| | - Jaana Hagström
- Department of Oral Pathology and Radiology, University of Turku, Turku, Finland
| | - Antti Mäkitie
- Department for Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, P.O.Box 263, FI-00029 HUS Helsinki, Finland
| | - Ilmo Leivo
- Department of Oral Pathology and Radiology, University of Turku, Turku, Finland; Institute of Biomedicine, Pathology, University of Turku, Kiinamyllynkatu 10 D, 20520 Turku, Finland
| | - Miia Ruuskanen
- Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20521 Turku, Finland
| | - Jenni Söderlund
- Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland
| | - Marjut Rintala
- Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland
| | - Sakari Hietanen
- Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland; FICAN West Cancer Centre, Turku, Finland
| | - Heikki Irjala
- Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20521 Turku, Finland
| | - Heikki Minn
- FICAN West Cancer Centre, Turku, Finland; Department of Oncology and Radiotherapy, University of Turku and Turku University Hospital, Turku, Finland
| | - Jukka Westermarck
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; Biomedical Institute, University of Turku, Kiinamyllynkatu 10, 20520 Turku, Finland; FICAN West Cancer Centre, Turku, Finland
| | - Sami Ventelä
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20521 Turku, Finland; FICAN West Cancer Centre, Turku, Finland.
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Routila J, Suvila K, Grénman R, Leivo I, Westermarck J, Ventelä S. Cancer cell line microarray as a novel screening method for identification of radioresistance biomarkers in head and neck squamous cell carcinoma. BMC Cancer 2021; 21:868. [PMID: 34320941 PMCID: PMC8320194 DOI: 10.1186/s12885-021-08618-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 07/15/2021] [Indexed: 11/23/2022] Open
Abstract
Background Currently, no clinically useful biomarkers for radioresistance are available in head and neck squamous cell carcinoma (HNSCC). This study assesses the usefulness of Cell Line Microarray (CMA) method to enhance immunohistochemical screening of potential immunohistochemical biomarkers for radioresistance in HNSCC cell lines. Methods Twenty-nine HNSCC cell lines were cultured, cell pellets formalin-fixed, paraffin-embedded, and arrayed. Radioresistance features of the cell lines were combined to immunohistochemical stains for p53, NDFIP1, EGFR, stem cell marker Oct4, and PP2A inhibitor CIP2A. Results Expression of p53, EGFR or CIP2A did not indicate intrinsic radioresistance in vitro. Stem cell marker Oct4 nuclear positivity and NDFIP1 nuclear positivity was correlated with increased intrinsic radioresistance. Conclusion The usefulness of CMA in analysis of HNSCC cell lines and discovery of biomarkers is demonstrated. CMA is very well adapted to both testing of antibodies in a large panel of cell lines as well as correlating staining results with other cell line characteristics. In addition, CMA-based antibody screening proved an efficient and relatively simple method to identify potential radioresistance biomarkers in HNSCC. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08618-6.
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Affiliation(s)
- Johannes Routila
- Turku Bioscience Centre, University of Turku and Åbo Akademi university, Turku, Finland.,Department for Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland.,Department for Otorhinolaryngology, Satakunta Central Hospital, Pori, Finland
| | - Karri Suvila
- Turku Bioscience Centre, University of Turku and Åbo Akademi university, Turku, Finland
| | - Reidar Grénman
- Department for Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - Ilmo Leivo
- Institute of Biomedicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland
| | - Jukka Westermarck
- Turku Bioscience Centre, University of Turku and Åbo Akademi university, Turku, Finland.,Institute of Biomedicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland
| | - Sami Ventelä
- Turku Bioscience Centre, University of Turku and Åbo Akademi university, Turku, Finland. .,Department for Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland. .,Institute of Biomedicine, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland.
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Routila J, Herhi E, Korpi J, Pulkkinen J, Koivunen P, Rekola J. Tracheobronchial stents in patients with malignant airway disease: Finnish tertiary care experience. Interact Cardiovasc Thorac Surg 2021; 33:557-563. [PMID: 34021347 DOI: 10.1093/icvts/ivab147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 04/12/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Tracheobronchial stenting has an established role in the palliation of malignant central airway obstruction (CAO). The purpose of this study is to describe the experience with self-expanding metal airway stents in 2 tertiary referral centres, covering a third of the population of Finland. PATIENTS AND METHODS Patients referred to and treated with airway stenting for malignant CAO using self-expanding metal-stents were identified from electronic patient records, and data were collected using a structured Endoscopic Lower Airway Management instrument. Statistical analysis to reveal factors affecting patient benefit and survival was carried out. RESULTS A total of 101 patients (mean age 65.8) and 116 procedures were identified. Procedure-related mortality was rare (3/101 patients) and complications infrequent. The median survival was 2.3 months [95% confidence interval (CI): 1.4-3.1). Stent benefit was not significantly affected by clinical characteristics. Survival was impacted by the use of adjunct procedures [hazard ratio (HR) 0.36, 95% CI: 0.23-0.58, P < 0.001), procedural urgency (HR 0.40; 95% CI: 0.23-0.71, P = 0.002) and post-treatment chemoradiotherapy (HR 0.29, 95% CI: 0.15-0.56, P < 0.001). CONCLUSIONS The beneficial impact observed supports the further use of tracheobronchial stenting in malignant CAO. The use of self-expanding metal stents is encouraged.
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Affiliation(s)
- Johannes Routila
- Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital, Turku, Finland.,Department of Otorhinolaryngology-Head and Neck Surgery, University of Turku, Turku, Finland
| | - Eino Herhi
- Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital, Turku, Finland
| | - Jarkko Korpi
- Department of Otorhinolaryngology-Head and Neck Surgery, Oulu University Hospital, Oulu, Finland
| | - Jaakko Pulkkinen
- Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital, Turku, Finland.,Department of Otorhinolaryngology-Head and Neck Surgery, University of Turku, Turku, Finland
| | - Petri Koivunen
- Department of Otorhinolaryngology-Head and Neck Surgery, Oulu University Hospital, Oulu, Finland
| | - Jami Rekola
- Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital, Turku, Finland.,Department of Otorhinolaryngology-Head and Neck Surgery, University of Turku, Turku, Finland
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10
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Routila J, Leivo I, Minn H, Westermarck J, Ventelä S. Evaluation of prognostic biomarkers in a population-validated Finnish HNSCC patient cohort. Eur Arch Otorhinolaryngol 2021; 278:4575-4585. [PMID: 33582846 PMCID: PMC8486716 DOI: 10.1007/s00405-021-06650-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 01/27/2021] [Indexed: 12/31/2022]
Abstract
Introduction Prognostic biomarkers and novel therapeutic approaches have been slow to emerge in the treatment of head and neck squamous cell carcinoma (HNSCC). In this study, an HNSCC patient cohort is created and performance of putative prognostic biomarkers investigated in a population-validated setting. The overall goal is to develop a novel way to combine biomarker analyses with population-level clinical data on HNSCC patients and thus to improve the carryover of biomarkers into clinical practice. Materials and methods To avoid selection biases in retrospective study design, all HNSCC patients were identified and corresponding clinical data were collected from the Southwest Finland geographical area. A particular emphasis was laid on avoiding potential biases in sample selection for immunohistochemical staining analyses. Staining results were evaluated for potential prognostic resolution. Results After comprehensive evaluation, the patient cohort was found to be representative of the background population in terms of clinical characteristics such as patient age and TNM stage distribution. A negligible drop-out of 1.3% (6/476) was observed during the first follow-up year. By immunohistochemical analysis, the role of previously implicated HNSCC biomarkers (p53, EGFR, p16, CIP2A, Oct4, MET, and NDFIP1) was investigated. Discussion Our exceptionally representative patient material supports the use of population validation to improve the applicability of results to real-life situations. The failure of the putative prognostic biomarkers emphasizes the need for controlling bias in retrospective studies, especially in the heterogenous tumor environment of HNSCC. The resolution of simple prognostic examination is unlikely to be sufficient to identify biomarkers for clinical practice of HNSCC. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-021-06650-7.
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Affiliation(s)
- J Routila
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland.,Department for Otorhinolaryngology, Head and Neck Surgery, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - I Leivo
- Biomedical Institute, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland
| | - H Minn
- FICAN West Cancer Centre, Turku, Finland.,Department of Oncology and Radiotherapy, University of Turku and Turku University Hospital, Turku, Finland
| | - J Westermarck
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland.,Biomedical Institute, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland.,FICAN West Cancer Centre, Turku, Finland
| | - Sami Ventelä
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland. .,Department for Otorhinolaryngology, Head and Neck Surgery, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20521, Turku, Finland. .,FICAN West Cancer Centre, Turku, Finland.
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Khan M, Khaznadar SS, Routila J, Ventelä S, Schmid E, Gebhart B, Becker ET, Roider HG, Perala M, Schmitz AA, Krahn T, von Ahsen O. Hepatocyte Growth Factor Receptor overexpression predicts reduced survival but its targeting is not effective in unselected HNSCC patients. Head Neck 2020; 42:625-635. [PMID: 31919967 DOI: 10.1002/hed.26049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 10/24/2019] [Accepted: 12/03/2019] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND MET has emerged as target in head and neck squamous cell carcinoma (HNSCC). However, clinical data on MET inhibition in HNSCC are limited. METHODS HNSCC biopsies and cell lines were tested for MET activity. The response of cell lines to BAY-853474 was tested in proliferation assays. The prognostic value of MET expression was also analyzed. RESULTS HNSCC cell lines do not respond to MET inhibition. MET-dependent gastric cancer cell lines have much higher levels of MET expression and phosphorylation than HNSCC cell lines. Clinical samples of HNSCC contain much less MET than responsive models. CONCLUSIONS No clinical response to MET inhibitors in monotherapy may be expected in unselected cases of HNSCC. Only selected patients with MET amplifications should be treated with MET inhibitors. Patients with increased MET immunoreactivity have shorter overall survival. MET might be useful as marker for the detection of patients with more aggressive types of HNSCC.
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Affiliation(s)
- Martin Khan
- Charité, Berlin, Augustenburger Platz 1, Berlin, Germany
| | - Sami S Khaznadar
- Bayer AG, Research & Development, Pharmaceuticals, Berlin, Germany
| | - Johannes Routila
- Centre for Biotechnology, University of Turku and Åbo Akademi University, Turku, Finland.,Department for Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Turku, Finland
| | - Sami Ventelä
- Centre for Biotechnology, University of Turku and Åbo Akademi University, Turku, Finland.,Department for Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Turku, Finland
| | - Elke Schmid
- Bayer AG, Research & Development, Pharmaceuticals, Berlin, Germany
| | | | - Eva T Becker
- Charité, Berlin, Augustenburger Platz 1, Berlin, Germany
| | - Helge G Roider
- Bayer AG, Research & Development, Pharmaceuticals, Berlin, Germany
| | - Merja Perala
- Auria Biobank, Kiinamyllynkatu 8, Turku, Finland
| | - Arndt A Schmitz
- Bayer AG, Research & Development, Pharmaceuticals, Berlin, Germany
| | - Thomas Krahn
- Bayer AG, Research & Development, Pharmaceuticals, Berlin, Germany
| | - Oliver von Ahsen
- Bayer AG, Research & Development, Pharmaceuticals, Berlin, Germany
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12
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Routila J, Bilgen T, Saramäki O, Grénman R, Visakorpi T, Westermarck J, Ventelä S. Copy number increase of oncoprotein CIP2A is associated with poor patient survival in human head and neck squamous cell carcinoma. J Oral Pathol Med 2015; 45:329-37. [PMID: 26436875 DOI: 10.1111/jop.12372] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND CIP2A, an inhibitor of PP2A tumour suppressor function, is a widely overexpressed biomarker of aggressive disease and poor therapy response in multiple human cancer types. METHODS CIP2A and DPPA4 copy number alterations and expression were analysed by fluorescence in situ hybridisation (FISH) and immunohistochemistry (IHC) in different cell lines and a tissue microarray of 52 HNSCC patients. Results were correlated with patient survival and other clinicopathological data. RESULTS CIP2A and DPPA4 copy number increase occurred at a relatively high frequency in human HNSCC patient samples. CIP2A but not DPPA4 FISH status was significantly associated with patient survival. CIP2A detection by combining IHC with FISH yielded superior resolution in the prognostication of HNSCC. CONCLUSIONS CIP2A copy number increase is associated with poor patient survival in human HNSCC. We suggest that the reliability and prognostic value of CIP2A detection can be improved by performing FISH analysis to CIP2A IHC positive tumours.
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Affiliation(s)
- Johannes Routila
- Centre for Biotechnology, University of Turku and Åbo Akademi University, Turku, Finland
| | - Türker Bilgen
- Prostate Cancer Research Center, Institute of Biosciences and Medical Technology-BioMediTech, University of Tampere, Tampere, Finland.,Research and Application Centre for Scientific and Technological Investigations (NABILTEM), Namik Kemal University, Tekirdag, Turkey
| | - Outi Saramäki
- Prostate Cancer Research Center, Institute of Biosciences and Medical Technology-BioMediTech, University of Tampere, Tampere, Finland.,Fimlab Laboratories, Tampere University Hospital, Tampere, Finland
| | - Reidar Grénman
- Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Turku, Finland
| | - Tapio Visakorpi
- Prostate Cancer Research Center, Institute of Biosciences and Medical Technology-BioMediTech, University of Tampere, Tampere, Finland.,Fimlab Laboratories, Tampere University Hospital, Tampere, Finland
| | - Jukka Westermarck
- Centre for Biotechnology, University of Turku and Åbo Akademi University, Turku, Finland.,Department of Pathology, University of Turku, Turku, Finland
| | - Sami Ventelä
- Centre for Biotechnology, University of Turku and Åbo Akademi University, Turku, Finland.,Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Turku, Finland
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Routila J, Mäkelä JA, Luukkaa H, Leivo I, Irjala H, Westermarck J, Mäkitie A, Ventelä S. Potential role for inhibition of protein phosphatase 2A tumor suppressor in salivary gland malignancies. Genes Chromosomes Cancer 2015; 55:69-81. [DOI: 10.1002/gcc.22312] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 09/06/2015] [Accepted: 09/07/2015] [Indexed: 12/14/2022] Open
Affiliation(s)
- Johannes Routila
- The Centre for Biotechnology; University of Turku and Åbo Akademi University; Tykistökatu BioCity Turku FI-20521 Finland
| | - Juho-Antti Mäkelä
- Department of Physiology; University of Turku; Kiinamyllynkatu 10 Turku FI-20520 Finland
| | - Heikki Luukkaa
- Department of Otorhinolaryngology-Head and Neck Surgery; Turku University Hospital; Kiinamyllynkatu 4-8 Turku FI-20521 Finland
| | - Ilmo Leivo
- Department of Pathology; University of Turku; Kiinamyllynkatu 10 Turku FI-20520 Finland
| | - Heikki Irjala
- Department of Otorhinolaryngology-Head and Neck Surgery; Turku University Hospital; Kiinamyllynkatu 4-8 Turku FI-20521 Finland
| | - Jukka Westermarck
- The Centre for Biotechnology; University of Turku and Åbo Akademi University; Tykistökatu BioCity Turku FI-20521 Finland
- Department of Pathology; University of Turku; Kiinamyllynkatu 10 Turku FI-20520 Finland
| | - Antti Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery; Helsinki University Central Hospital and University of Helsinki; HUCH Helsinki FI-00029 Finland
| | - Sami Ventelä
- The Centre for Biotechnology; University of Turku and Åbo Akademi University; Tykistökatu BioCity Turku FI-20521 Finland
- Department of Otorhinolaryngology-Head and Neck Surgery; Turku University Hospital; Kiinamyllynkatu 4-8 Turku FI-20521 Finland
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