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Caponio VCA, Zhurakivska K, Mascitti M, Togni L, Spirito F, Cirillo N, Lo Muzio L, Troiano G. High-risk TP53 mutations predict poor primary treatment response of patients with head and neck squamous cell carcinoma. Oral Dis 2024; 30:2018-2026. [PMID: 37501500 DOI: 10.1111/odi.14698] [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: 12/06/2022] [Revised: 06/06/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVES Head and neck squamous cell carcinoma (HNSCC) poses a diagnostic and therapeutic challenge worldwide and is associated with a poor survival rate. Due to the variability in the efficacy of treatments for HNSCC, new predictive biomarkers of therapy outcomes are needed. Recently, we developed an algorithm that employs the mutational profile of TP53 as an independent prognostic factor in HNSCC. In this study, we investigated its role as a predictive biomarker of treatment outcomes in HNSCC patients. We also tested the usefulness of two classification systems for TP53 mutational landscapes. MATERIALS AND METHODS Clinical and genomic data were retrieved from The Cancer Genome Atlas database. We built a multivariate stepwise backward binary regression model to assess the role of TP53 mutations in predicting therapeutic outcomes. RESULTS Cases harbouring high-risk-of-death mutations reported an odds ratio of 3.301 for stable or progressive disease compared to wild-type cases, while no significant difference in treatment outcomes was found between cases with low-risk-of-death mutations and wild-type TP53. Our analysis found that older patients with a history of alcohol consumption had a higher risk of stable/progressive disease. CONCLUSIONS This study improves current evidence on the role of TP53 mutations in treatment response in HNSCC patients.
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Affiliation(s)
| | - Khrystyna Zhurakivska
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Marco Mascitti
- Department of Clinical Specialist and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Lucrezia Togni
- Department of Clinical Specialist and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Nicola Cirillo
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
- School of Dentistry, University of Jordan, Amman, Jordan
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
- C.I.N.B.O. (Consorzio Interuniversitario Nazionale per la Bio-Oncologia), Chieti, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Mahdavi H. Induction chemotherapy in locally advanced head and neck cancers, is there a best choice? Crit Rev Oncol Hematol 2023; 186:103986. [PMID: 37059273 DOI: 10.1016/j.critrevonc.2023.103986] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/25/2023] [Accepted: 04/11/2023] [Indexed: 04/16/2023] Open
Abstract
Locally advanced stages of squamous cancers of the head and neck (LAHNCs) acquire high propensity for local and systemic relapse. Addition of systemic therapy as an induction (IC) to the standard concurrent chemoradiotherapy (CCRT) has become an approach of many practitioners. This strategy has shown to reduce metastases but did not affect survival in unselected populations. Meanwhile, the induction regimen including docetaxel, cisplatin, 5-FU (TPF) has shown superiority over other combinations, however, a survival advantage was not detected when compared to CCRT alone. This may be attributed to its high toxicity profile, inducing treatment delay, resistance, or variations in tumor sites and responses. Currently, newer systemic therapy combinations are being tested and indicators of benefit are being identified. The focus of this review is on the development of the choice of combination regimen for induction. Subsequently, proposed alternatives and strategies for patient selection will be introduced.
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Affiliation(s)
- Hoda Mahdavi
- Department of Radiation Oncology, School of Medicine, Iran University of Medical Sciences,Tehran, Iran; Department of Radiation Oncology, Firoozgar General Hospital, Beh-Afarin St., Karimkhan-e-Zand Ave., Vali-e-Asr Sq., Tehran, Iran.
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3
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Mitotic Checkpoints and the Role of WEE1 Inhibition in Head and Neck Squamous Cell Carcinoma. Cancer J 2022; 28:381-386. [PMID: 36165727 DOI: 10.1097/ppo.0000000000000613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT The WEE1 kinase family plays a crucial role in cell cycle regulation and DNA damage response pathways in malignant cells. Inhibition of WEE1 effectively overrides G2 cell cycle arrest and results in the accumulation of extensive DNA damage within dividing cells, potentiating mitotic catastrophe and cell death. As such, the development of WEE1 inhibitors as antineoplastic therapeutics has gained increasing interest in recent years. In particular, the role of WEE1 inhibitors for treatment of head and neck squamous cell carcinomas remains an area of active research with both preclinical and clinical studies investigating their use as both single-agent therapy and chemosensitizers when used in tandem with traditional chemotherapy, particularly in the context of TP53-mutant tumors. Here, we review the relevant available preclinical and clinical data on hand investigating the efficacy of WEE1 inhibitors for the treatment of head and neck cancers.
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Song H, Lou C, Ma J, Gong Q, Tian Z, You Y, Ren G, Guo W, Wang Y, He K, Xiao M. Single-Cell Transcriptome Analysis Reveals Changes of Tumor Immune Microenvironment in Oral Squamous Cell Carcinoma After Chemotherapy. Front Cell Dev Biol 2022; 10:914120. [PMID: 35784460 PMCID: PMC9247458 DOI: 10.3389/fcell.2022.914120] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/23/2022] [Indexed: 11/21/2022] Open
Abstract
Induction chemotherapy in oral squamous cell carcinoma is a controversial issue in clinical practice. To investigate the evolution of cancer cells and tumor microenvironment (TME) response to chemotherapy in oral squamous cell carcinoma, single-cell transcriptome analysis was performed in a post-chemotherapy squamous cell carcinoma located in oral cavity. The main cell types were identified based on gene expression patterns determined using dimensionality reduction and unsupervised cell clustering. Non-negative matrix factorization clustering of the gene expression of Cancer-associated fibroblasts (CAFs) and macrophages was performed. Kyoto Encyclopedia of Genes and Genomes pathway analyses and gene set enrichment analysis were performed to explore significant functional pathways. CellPhoneDB and NicheNet were used to detect the intercellular communication between cell types. CAFs were divided into "inflammatory CAFs," "antigen-presenting CAFs" and "myofibroblastic CAFs." Three classic subgroups of tumor-associated macrophages (TAMs) were detected, namely C1Q (+), FCN1 (+) and SPP1(+) TAMs. The inflammatory cytokine expression is elevated, and several molecular pathways, such as PI3K/Akt/mTORC1, TNF-α via NFκB, TGF-β, IL-6/JAK2/STAT3 and CXCL12/CXCR4 axis associated with epithelial-mesenchymal transition were enriched in TME. Also, CD74-MIF/COPA/APP interactions were expressed in TME of oral squamous cell carcinoma after chemotherapy. The results revealed the characteristics of TME in post-chemotherapy oral squamous cell carcinoma at single-cell transcriptome level, providing new insights and clues for further investigation.
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Affiliation(s)
- Hao Song
- Department of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Chao Lou
- Department of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Jie Ma
- Department of Implant Dentistry, Shanghai Xuhui District Dental Center, Shanghai, China
| | - Qiyu Gong
- Shanghai Institute of Immunology, Faculty of Basic Medicine, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhuowei Tian
- Department of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Yuanhe You
- Department of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Guoxin Ren
- Department of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Wei Guo
- Department of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Yanan Wang
- Department of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Kunyan He
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Meng Xiao
- Department of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
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Michikawa C, Torres-Saavedra PA, Silver NL, Harari PM, Kies MS, Rosenthal DI, Le QT, Jordan RC, Duose DY, Mallampati S, Trivedi S, Luthra R, Wistuba II, Osman AA, Lichtarge O, Foote RL, Parvathaneni U, Hayes DN, Pickering CR, Myers JN. Evolutionary Action Score of TP53 Analysis in Pathologically High-Risk Human Papillomavirus-Negative Head and Neck Cancer From a Phase 2 Clinical Trial: NRG Oncology Radiation Therapy Oncology Group 0234. Adv Radiat Oncol 2022; 7:100989. [PMID: 36420184 PMCID: PMC9677209 DOI: 10.1016/j.adro.2022.100989] [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: 12/28/2021] [Accepted: 05/04/2022] [Indexed: 12/15/2022] Open
Abstract
Purpose An evolutionary action scoring algorithm (EAp53) based on phylogenetic sequence variations stratifies patients with head and neck squamous cell carcinoma (HNSCC) bearing TP53 missense mutations as high-risk, associated with poor outcomes, or low-risk, with similar outcomes as TP53 wild-type, and has been validated as a reliable prognostic marker. We performed this study to further validate prior findings demonstrating that EAp53 is a prognostic marker for patients with locally advanced HNSCC and explored its predictive value for treatment outcomes to adjuvant bio-chemoradiotherapy. Methods and Materials Eighty-one resection samples from patients treated surgically for stage III or IV human papillomavirus-negative HNSCC with high-risk pathologic features, who received either radiation therapy + cetuximab + cisplatin (cisplatin) or radiation therapy + cetuximab + docetaxel (docetaxel) as adjuvant treatment in a phase 2 study were subjected to TP53 targeted sequencing and EAp53 scoring to correlate with clinical outcomes. Due to the limited sample size, patients were combined into 2 EAp53 groups: (1) wild-type or low-risk; and (2) high-risk or other. Results At a median follow-up of 9.8 years, there was a significant interaction between EAp53 group and treatment for overall survival (P = .008), disease-free survival (P = .05), and distant metastasis (DM; P = .004). In wild-type or low-risk group, the docetaxel arm showed significantly better overall survival (hazard ratio [HR] 0.11, [0.03-0.36]), disease-free survival (HR 0.24, [0.09-0.61]), and less DM (HR 0.04, [0.01-0.31]) than the cisplatin arm. In high-risk or other group, differences between treatments were not statistically significant. Conclusions The docetaxel arm was associated with better survival than the cisplatin arm for patients with wild-type or low-risk EAp53. These benefits appear to be largely driven by a reduction in DM.
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Affiliation(s)
- Chieko Michikawa
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas,Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Pedro A. Torres-Saavedra
- NRG Oncology Statistics and Data Management Center, American College of Radiology, Philadelphia, Pennsylvania
| | - Natalie L. Silver
- Cleveland Clinic, Head and Neck Institute/Lerner Research Institute, Cleveland, Ohio
| | - Paul M. Harari
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Merrill S. Kies
- Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David I. Rosenthal
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Quynh-Thu Le
- Department of Radiation Oncology, Stanford University Medical Center, Stanford, California
| | - Richard C. Jordan
- NRG Oncology Biospecimen Bank and University of California, San Francisco, San Francisco, California
| | | | | | - Sanchit Trivedi
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Rajyalakshmi Luthra
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Abdullah A. Osman
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Olivier Lichtarge
- Departments of Molecular and Human Genetics, Pharmacology, and Biochemistry and Molecular Biology, Baylor College of Medicine, Houston, Texas
| | - Robert L. Foote
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota
| | - Upendra Parvathaneni
- Radiation Oncology Center, University of Washington Medical Center, Seattle, Washington
| | - D. Neil Hayes
- Division of Medical Oncology, The University of Tennessee Health Science Center, Memphis, Tennessee
| | - Curtis R. Pickering
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jeffrey N. Myers
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas,Corresponding author: Jeffrey N. Myers, MD, PhD
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Karukonda P, Odhiambo D, Mowery YM. Pharmacologic inhibition of ataxia telangiectasia and Rad3-related (ATR) in the treatment of head and neck squamous cell carcinoma. Mol Carcinog 2022; 61:225-238. [PMID: 34964992 PMCID: PMC8799519 DOI: 10.1002/mc.23384] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 02/03/2023]
Abstract
Head and neck squamous cell carcinoma (HNSCC) poses significant treatment challenges, with high recurrence rates for locally advanced disease despite aggressive therapy typically involving a combination of surgery, radiation therapy, and/or chemotherapy. HNSCCs commonly exhibit reduced or absent TP53 function due to genomic alterations or human papillomavirus (HPV) infection, leading to dependence on the S- and G2/M checkpoints for cell cycle regulation. Both of these checkpoints are activated by Ataxia Telangiectasia and Rad3-related (ATR), which tends to be overexpressed in HNSCC relative to adjacent normal tissues and represents a potentially promising therapeutic target, particularly in combination with other treatments. ATR is a DNA damage signaling kinase that is activated in response to replication stress and single-stranded DNA breaks, such as those induced by radiation therapy and certain chemotherapies. ATR kinase inhibitors are currently being investigated in several clinical trials as part of the management of locally advanced, recurrent, or metastatic HNSCC, along with other malignancies. In this review article, we summarize the rationale and preclinical data supporting incorporation of ATR inhibition into therapeutic regimens for HNSCC.
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Affiliation(s)
- Pooja Karukonda
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - Diana Odhiambo
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - Yvonne M. Mowery
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA,Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, NC, USA
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Raj S, Vachher N, Aden D, Srivastava A, Nath D. Co-expression of P53 and Ki67 in premalignant and malignant oral/oropharyngeal biopsies in Bundelkhand Region, India. ARCHIVES OF MEDICINE AND HEALTH SCIENCES 2022. [DOI: 10.4103/amhs.amhs_155_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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8
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Cheng Y, Li S, Gao L, Zhi K, Ren W. The Molecular Basis and Therapeutic Aspects of Cisplatin Resistance in Oral Squamous Cell Carcinoma. Front Oncol 2021; 11:761379. [PMID: 34746001 PMCID: PMC8569522 DOI: 10.3389/fonc.2021.761379] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/04/2021] [Indexed: 02/06/2023] Open
Abstract
Oral squamous cell carcinoma (OSCC) is a kind of malignant tumors with low survival rate and prone to have early metastasis and recurrence. Cisplatin is an alkylating agent which induces DNA damage through the formation of cisplatin-DNA adducts, leading to cell cycle arrest and apoptosis. In the management of advanced OSCC, cisplatin-based chemotherapy or chemoradiotherapy has been considered as the first-line treatment. Unfortunately, only a portion of OSCC patients can benefit from cisplatin treatment, both inherent resistance and acquired resistance greatly limit the efficacy of cisplatin and even cause treatment failure. Herein, this review outline the underlying mechanisms of cisplatin resistance in OSCC from the aspects of DNA damage and repair, epigenetic regulation, transport processes, programmed cell death and tumor microenvironment. In addition, this review summarizes the strategies applicable to overcome cisplatin resistance, which can provide new ideas to improve the clinical therapeutic outcome of OSCC.
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Affiliation(s)
- Yali Cheng
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.,School of Stomatology of Qingdao University, Qingdao, China
| | - Shaoming Li
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.,School of Stomatology of Qingdao University, Qingdao, China
| | - Ling Gao
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.,Key Lab of Oral Clinical Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Keqian Zhi
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.,Key Lab of Oral Clinical Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Wenhao Ren
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
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9
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Osawa Y, Aoyama KI, Hosomichi K, Uchibori M, Tajima A, Kimura M, Ota Y. Somatic mutations in oral squamous cell carcinomas in 98 Japanese patients and their clinical implications. Cancer Treat Res Commun 2021; 29:100456. [PMID: 34563788 DOI: 10.1016/j.ctarc.2021.100456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The somatic mutational profile of oral squamous cell carcinoma (OSCC) among Japanese patients has been less investigated, partly because of the rarity of the tumor. Moreover, previous studies have either used formalin-fixed paraffin-embedded samples or lacked paired normal tissues. We aimed to determine somatic mutations in the exomes of 76 genes, including 50 driver genes of solid cancers and NOTCH-related genes, some of which are previously reported as frequently mutated in head and neck squamous cell carcinoma or OSCC. MATERIALS AND METHODS We used fresh-frozen tumor/normal-paired samples from 98 treatment-naïve Japanese patients with OSCC and analyzed their correlations with clinicopathological characteristics and survival. RESULTS We identified 136 exonic mutations, including 78 non-synonymous mutations, 13 synonymous mutations, 22 nonsense mutations, 2 non-frameshift deletions, 11 frameshift deletion, and 5 each of splice-site and frameshift insertions. The most frequently mutated genes were TP53 (36.7%), FAT1 (9.2%), NOTCH1 (8.2%), CDKN2A (7.1%), ZFHX4 (5.1%), CASP8 (4.1%), EP300 (4.1%), and KMT2D (4.1%). We followed up 90 of the 98 patients for 3 years. Among them, TP53 mutation was associated with significantly shorter 3-year disease-free survival. Most of the identified TP53 mutations occurred in the DNA-binding domain and were functionally deleterious. DISCUSSION Our findings and the mutation spectra can contribute to the development of a therapeutic strategy for Japanese patients with OSCC.
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Affiliation(s)
- Yuko Osawa
- Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine,143 Shimokasuya, Isehara, Kanagawa, Japan
| | - Ken-Ichi Aoyama
- Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine,143 Shimokasuya, Isehara, Kanagawa, Japan
| | - Kazuyoshi Hosomichi
- The Institute of Medical Sciences, Tokai University, 143 Shimokasuya, Isehara, Kanagawa, Japan
| | - Masahiro Uchibori
- Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine,143 Shimokasuya, Isehara, Kanagawa, Japan
| | - Atsushi Tajima
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, Japan
| | - Minoru Kimura
- The Institute of Medical Sciences, Tokai University, 143 Shimokasuya, Isehara, Kanagawa, Japan
| | - Yoshihide Ota
- Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine,143 Shimokasuya, Isehara, Kanagawa, Japan.
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The oncogenicity of tumor-derived mutant p53 is enhanced by the recruitment of PLK3. Nat Commun 2021; 12:704. [PMID: 33514736 PMCID: PMC7846773 DOI: 10.1038/s41467-021-20928-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 12/21/2020] [Indexed: 01/10/2023] Open
Abstract
p53 mutations with single amino acid changes in cancer often lead to dominant oncogenic changes. Here, we have developed a mouse model of gain-of-function (GOF) p53-driven lung cancer utilizing conditionally active LSL p53-R172H and LSL K-Ras-G12D knock-in alleles that can be activated by Cre in lung club cells. Mutation of the p53 transactivation domain (TAD) (p53-L25Q/W26S/R172H) eliminating significant transactivation activity resulted in loss of tumorigenicity, demonstrating that transactivation mediated by or dependent on TAD is required for oncogenicity by GOF p53. GOF p53 TAD mutations significantly reduce phosphorylation of nearby p53 serine 20 (S20), which is a target for PLK3 phosphorylation. Knocking out PLK3 attenuated S20 phosphorylation along with transactivation and oncogenicity by GOF p53, indicating that GOF p53 exploits PLK3 to trigger its transactivation capability and exert oncogenic functions. Our data show a mechanistic involvement of PLK3 in mutant p53 pathway of oncogenesis. The mechanisms of how gain-of-function (GOF) mutant p53 drives carcinogenesis are unclear. Here, the authors show that a GOF mutant p53 requires its transactivation capability to induce mouse lung tumors and this is dependent on PLK3 phosphorylation of GOF mutant p53.
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Devaraja K, Aggarwal S, Verma SS, Gupta SC. Clinico-pathological peculiarities of human papilloma virus driven head and neck squamous cell carcinoma: A comprehensive update. Life Sci 2020; 245:117383. [PMID: 32007572 DOI: 10.1016/j.lfs.2020.117383] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/17/2020] [Accepted: 01/28/2020] [Indexed: 01/11/2023]
Abstract
AIMS The current article provides a detailed account of the current understanding of molecular and clinico-pathological aspects of Human papilloma virus (HPV) driven head and neck squamous cell carcinoma (HNSCC). MATERIALS AND METHODS The literature review included most of the landmark trials and clinical studies related to the HPV driven HNSCC. KEY FINDINGS HPV positive HNSCC differ distinctly from HPV negative tobacco-related HNSCC, especially in oropharyngeal region. Therefore, the American joint committee on cancer`s latest manual for classification and staging of cancer suggests a separate staging system for HPV positive oropharyngeal cancers. Despite the younger patients being affected and the high propensity for cervical metastasis, the HPV positive oropharyngeal cancers respond much better to the treatment. The association with wild type TP53 and low EGFR expression confers the favorable prognosis in HPV driven HNSCC. Since the association is not universal, we suggest checking for p53 and EGFR expression status before considering de-intensification of therapy. In addition, the presence of matted lymph nodes and five or more nodes could mean relatively poorer prognosis, and are not suitable for de-intensification of therapy. The same is also true probably with higher T stage and co-existing tobacco use. The methods for the detection of p16, HPV DNA, HPV E6/E7 mRNA, anti-E6/E7 antibodies, in tissue, in serum and in saliva of patients, along with their clinical implications are also discussed. SIGNIFICANCE This article provides latest developments on the HPV driven HNSCC. 'Diagnosis of transcriptionally active HPV infection,' 'Modalities for surveillance,' 'Implication of de-escalation of therapy' are some of the critical issues that could serve the medical, the research as well as the patient communities.
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Affiliation(s)
- K Devaraja
- Department of Otorhinolaryngology and Head and Neck surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576104, India.
| | - Sadhna Aggarwal
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Sumit Singh Verma
- Department of Biochemistry, Institute of Science, Banaras Hindu University, Varanasi, 221 005, India
| | - Subash Chandra Gupta
- Department of Biochemistry, Institute of Science, Banaras Hindu University, Varanasi, 221 005, India.
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12
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Siegelmann-Danieli N, Ben-Izhack O, Hanlon A, Ridge JA, Stein ME, Khandelwal V, Langer CJ. P53 Alteration in Oral Tongue Cancer is Not Significantly Associated with Age at Diagnosis or Tobacco Exposure. TUMORI JOURNAL 2019; 91:346-50. [PMID: 16277102 DOI: 10.1177/030089160509100412] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aims and background The tumor suppressor gene P53 is mutated in almost half of head and neck cancers. The current work assessed the prognostic significance of P53 alteration in patients with squamous cell carcinoma of the oral tongue treated with a curative intent, its association with age at diagnosis (using 45 years as a cut point), and risk exposure as defined by tobacco and/or alcohol consumption. Methods P53 alteration was determined immunohistochemically in 45 patients with tongue cancer treated with a curative intent. Results P53 alteration occurred in 20 of 45 tumors (44%) and was more common among younger patients (58% versus 36% for younger versus older patients, respectively) and those lacking tobacco/alcohol exposure (53% versus 40% for “no-risk” and “risk” groups, respectively), but the differences were not statistically significant. With a median follow-up of 56 months, 5-year progression-free survival rates were 48% and 66% in patients with and without P53 detection, respectively (P = 0.22). Conclusions Despite a trend of a younger age at diagnosis in P53-altered tumors, results did not reach statistically significant differences. A trend of a worse clinical outcome with P53 alteration was noted.
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13
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From VA Larynx to the future of chemoselection: Defining the role of induction chemotherapy in larynx cancer. Oral Oncol 2018; 86:200-205. [DOI: 10.1016/j.oraloncology.2018.09.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 09/11/2018] [Accepted: 09/18/2018] [Indexed: 01/18/2023]
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Huang LY, Wang X, Cui XF, Li H, Zhao J, Wu CC, Min L, Zhou Z, Wan L, Wang YP, Zhang C, Gao WQ, Sun Y, Han ZG. IRTKS is correlated with progression and survival time of patients with gastric cancer. Gut 2018. [PMID: 28647685 DOI: 10.1136/gutjnl-2016-313478] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVES IRTKS functions as a novel regulator of tumour suppressor p53; however, the role of IRTKS in pathogenesis of gastric cancer is unclear. DESIGN We used immunohistochemistry to detect IRTKS levels in 527 human gastric cancer specimens. We generated both IRTKS-deficient and p53-deficient mice to observe survival time of these mice and to isolate mouse embryonic fibroblasts (MEFs) for evaluating in vivo tumorigenicity. Co-immunoprecipitation was used to study the interaction among p53, MDM2 and IRTKS, as well as the ubiquitination of p53. RESULTS IRTKS was significantly overexpressed in human gastric cancer, which was conversely associated with wild-type p53 expression. Among patients with wild-type p53 (n=206), those with high IRTKS expression (n=141) had a shorter survival time than those with low IRTKS (n=65) (p=0.0153). Heterozygous p53+/- mice with IRTKS deficiency exhibited significantly delayed tumorigenesis and an extended tumour-free survival time. p53+/- MEFs without IRTKS exhibited attenuated in vivo tumorigenicity. IRTKS depletion upregulated p53 and its target genes, such as BAX and p21. Intriguingly, IRTKS overexpression promoted p53 ubiquitination and degradation in MEFs and gastric cancer cells. Under DNA damage conditions, IRTKS was phosphorylated at Ser331 by the activated Chk2 kinase and then dissociated from p53, along with the p53-specific E3 ubiquitin ligase MDM2, resulting in attenuated p53 ubiquitination and degradation. CONCLUSION IRTKS overexpression is negatively correlated with progression and overall survival time of patients with gastric cancer with wild-type p53 through promotion of p53 degradation via the ubiquitin/proteasome pathway.
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Affiliation(s)
- Li-Yu Huang
- Key Laboratory of Systems Biomedicine (Ministry of Education) and Shanghai-MOST Key Laboratory for Disease and Health Genomics, Chinese National Human Genome Center at Shanghai, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China.,Key Laboratory of Systems Biomedicine (Ministry of Education) and Collaborative Innovation Center of Systems Biomedicine, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xuefei Wang
- Department of General Surgery, Zhongshan Hospital, General Surgery Research Institute, Fudan University, Shanghai, China
| | - Xiao-Fang Cui
- Key Laboratory of Systems Biomedicine (Ministry of Education) and Collaborative Innovation Center of Systems Biomedicine, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - He Li
- Department of General Surgery, Zhongshan Hospital, General Surgery Research Institute, Fudan University, Shanghai, China
| | - Junjie Zhao
- Department of General Surgery, Zhongshan Hospital, General Surgery Research Institute, Fudan University, Shanghai, China
| | - Chong-Chao Wu
- Key Laboratory of Systems Biomedicine (Ministry of Education) and Collaborative Innovation Center of Systems Biomedicine, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lingqiang Min
- Department of General Surgery, Zhongshan Hospital, General Surgery Research Institute, Fudan University, Shanghai, China
| | - Zhicheng Zhou
- State Key Laboratory of Oncogenes and Related Genes, School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Lixin Wan
- Department of Molecular Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Yu-Ping Wang
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China
| | - Chao Zhang
- Institute for Computational Biomedicine, Weill Cornell Medical College of Cornell University, New York, USA.,Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medical College of Cornell University, New York, USA
| | - Wei-Qiang Gao
- State Key Laboratory of Oncogenes and Related Genes, School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Yihong Sun
- Department of General Surgery, Zhongshan Hospital, General Surgery Research Institute, Fudan University, Shanghai, China
| | - Ze-Guang Han
- Key Laboratory of Systems Biomedicine (Ministry of Education) and Shanghai-MOST Key Laboratory for Disease and Health Genomics, Chinese National Human Genome Center at Shanghai, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China.,Key Laboratory of Systems Biomedicine (Ministry of Education) and Collaborative Innovation Center of Systems Biomedicine, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
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15
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Lee JK, Lee KH, Kim SA, Kweon SS, Cho SH, Shim HJ, Bae WK, Chung IJ, Chung WK, Yoon TM, Lim SC, Lee DH. p16 as a prognostic factor for the response to induction chemotherapy in advanced hypopharyngeal squamous cell carcinoma. Oncol Lett 2018. [PMID: 29731856 DOI: 10.3892/ol.2018.8138.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The present study was conducted to investigate the prognostic significance of p16 (also known as cyclin-dependent kinase inhibitor 2A) in the treatment of induction chemoradiotherapy for advanced hypopharyngeal squamous cell carcinoma (HPSCC). Patients who were treated with at least two cycles of induction chemotherapy followed by concurrent chemoradiotherapy for locally advanced HPSCC were reviewed in the study. The staining results were analyzed to examine the association between the chemotherapy response and the survival outcome. A total of 45 patients were enrolled for the present study; the majority had received induction chemotherapy with docetaxel, cisplatin, and 5-FU. Following induction chemotherapy, 17 patients (37.8%) exhibited a complete response and 28 patients (62.2%) exhibited a partial response. There were 11 patients (24.4%) with p16-positive immunohistochemical stains and 30 patients (66.7%) with p53-positive immunohistochemical stains. There was no significant difference in chemotherapy response, overall survival, or progression-free survival time between groups with p16-positive and p16-negative stains. Low p53 expression and chemotherapy response were not associated with each other. High p16 expression did not correlate with low p53 expression. In this study, p16 was not determined to predict the chemotherapy response for HPSCC. High p16 expression did not correlate with survival incidence for patients with HPSCC.
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Affiliation(s)
- Joon Kyoo Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Kyung-Hwa Lee
- Department of Pathology, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Sun-Ae Kim
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Sun Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Sang-Hee Cho
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Hyun-Jeong Shim
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Woo-Kyun Bae
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Ik-Joo Chung
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Woong-Ki Chung
- Department of Radiation Oncology, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Tae Mi Yoon
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Sang Chul Lim
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Dong Hoon Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
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16
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Fallai C, Bolner A, Signor M, Gava A, Franchin G, Ponticelli P, Taino R, Rossi F, Ardizzoia A, Oggionni M, Crispino S, Olmi P. Long-Term Results of Conventional Radiotherapy versus Accelerated Hyperfractionated Radiotherapy versus Concomitant Radiotherapy and Chemotherapy in Locoregionally Advanced Carcinoma of the Oropharynx. TUMORI JOURNAL 2018; 92:41-54. [PMID: 16683383 DOI: 10.1177/030089160609200108] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS AND BACKGROUND To compare conventional fractionation (CF) radiation therapy (RT), arm A, versus a split-course accelerated hyperfractionated schedule (S-AHF), arm B, versus CFRT plus concomitant chemotherapy (CT), arm C, in terms of five-year survival and toxicity for squamous cell tumors of the oropharynx. METHODS AND STUDY DESIGN Between January 1993 and June 1998, 192 previously untreated patients with stage III and IV oropharyngeal carcinoma (excluding T1N1 and T2N1) were enrolled in a multicenter randomized phase III trial (ORO 93-01). In arms A and C, 66 to 70 Gy in 33 to 35 fractions was administered five days a week for six and a half to seven weeks. In arm B, the dose delivered was 64 to 67.2 Gy in two fractions of 1.6 Gy every day, five days a week, with a planned two-week split at 38.4 Gy. In arm C the CT regimen consisted of three cycles of carboplatin and 5-fluorouracil (CBDCA 75 mg/m2 on days 1 to 4 and 5-FU 1000 mg/m2 i.v. on days 1 to 4 every 28 days). RESULTS No statistically significant difference was found in five-year overall survival (P = 0.39): 21% for arm A, 21% for arm B, and 40% for arm C. Similarly, there was no statistically significant difference in terms of five-year relapse-free survival: 15% for arm A, 17% for arm B, and 36% for arm C. There was a slight trend towards better five-year locoregional control (P = 0.07) for the combined arm: patients without locoregional relapse were 48% in arm C, 21% in arm A and 18% in arm B. Locoregional control was significantly better when arm C was compared with arms A and B combined (P = 0.02; arm A+B 20%; arm C 48%). Distant metastases were fairly balanced in the three arms (A: 14; B: 9; C: 11), with a tendency towards more frequent isolated distant metastasis development in arm C (8 of 11 [72%] versus 7 of 23 [30%] in arms A+B). Five-year second-tumor-free survival was 85%. The 13 second tumors were equally distributed and were mainly correlated with tobacco and alcohol consumption (five lung, two esophagus, two oral cavity, one larynx, one pancreas, one hepatocarcinoma, one myeloma). Arm C showed slightly more G3+ late side effects involving subcutaneous tissues and mucosa, although significant late sequelae were relatively uncommon and the mucosal side effects were mostly transient. The occurrence of persistent G3 xerostomia was comparable in the three treatment arms. CONCLUSIONS The results obtained with the combination of CT and RT compared with RT alone did not reach statistical significance, but combined treatment almost doubled the five-year overall survival, relapse-free survival and locoregional control rate. Patients with advanced squamous cell carcinomas of the oropharynx who are medically suitable for the combined approach should be treated with a combination of radiotherapy and chemotherapy. The occurrence of second tumors is relatively common in these patients and may contribute substantially to the causes of death.
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MESH Headings
- Aged
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/analysis
- Carboplatin/administration & dosage
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/radiotherapy
- Chemotherapy, Adjuvant/adverse effects
- Dose Fractionation, Radiation
- Female
- Fluorouracil/administration & dosage
- Humans
- Male
- Middle Aged
- Neoplasm Staging
- Neoplasms, Second Primary/drug therapy
- Neoplasms, Second Primary/radiotherapy
- Oropharyngeal Neoplasms/drug therapy
- Oropharyngeal Neoplasms/pathology
- Oropharyngeal Neoplasms/radiotherapy
- Radiotherapy, Adjuvant/adverse effects
- Radiotherapy, Adjuvant/methods
- Risk Factors
- Salvage Therapy
- Survival Analysis
- Time Factors
- Treatment Failure
- Treatment Outcome
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Affiliation(s)
- Carlo Fallai
- Radioterapia 2, Istituto Nazionale Tumori, Milan, Italy.
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17
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Lee JK, Lee KH, Kim SA, Kweon SS, Cho SH, Shim HJ, Bae WK, Chung IJ, Chung WK, Yoon TM, Lim SC, Lee DH. p16 as a prognostic factor for the response to induction chemotherapy in advanced hypopharyngeal squamous cell carcinoma. Oncol Lett 2018; 15:6571-6577. [PMID: 29731856 DOI: 10.3892/ol.2018.8138] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 06/02/2017] [Indexed: 01/09/2023] Open
Abstract
The present study was conducted to investigate the prognostic significance of p16 (also known as cyclin-dependent kinase inhibitor 2A) in the treatment of induction chemoradiotherapy for advanced hypopharyngeal squamous cell carcinoma (HPSCC). Patients who were treated with at least two cycles of induction chemotherapy followed by concurrent chemoradiotherapy for locally advanced HPSCC were reviewed in the study. The staining results were analyzed to examine the association between the chemotherapy response and the survival outcome. A total of 45 patients were enrolled for the present study; the majority had received induction chemotherapy with docetaxel, cisplatin, and 5-FU. Following induction chemotherapy, 17 patients (37.8%) exhibited a complete response and 28 patients (62.2%) exhibited a partial response. There were 11 patients (24.4%) with p16-positive immunohistochemical stains and 30 patients (66.7%) with p53-positive immunohistochemical stains. There was no significant difference in chemotherapy response, overall survival, or progression-free survival time between groups with p16-positive and p16-negative stains. Low p53 expression and chemotherapy response were not associated with each other. High p16 expression did not correlate with low p53 expression. In this study, p16 was not determined to predict the chemotherapy response for HPSCC. High p16 expression did not correlate with survival incidence for patients with HPSCC.
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Affiliation(s)
- Joon Kyoo Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Kyung-Hwa Lee
- Department of Pathology, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Sun-Ae Kim
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Sun Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Sang-Hee Cho
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Hyun-Jeong Shim
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Woo-Kyun Bae
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Ik-Joo Chung
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Woong-Ki Chung
- Department of Radiation Oncology, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Tae Mi Yoon
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Sang Chul Lim
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
| | - Dong Hoon Lee
- Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam 519-809, Republic of Korea
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18
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Tunca B, Erisen L, Coskun H, Cecener G, Ozuysal S, Egeli U. P53 Gene Mutations in Surgical Margins and Primary Tumor Tissues of Patients with Squamous Cell Carcinoma of the Head and Neck. TUMORI JOURNAL 2018; 93:182-8. [PMID: 17557566 DOI: 10.1177/030089160709300212] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and Background The frequency of p53 mutations in primary tumors, the effect of the mutations on some clinical and pathological features of head and neck squamous cell carcinoma, and the impact of p53 mutations in the surgical margins on local recurrence were determined. Material and Methods We investigated the presence of p53 mutations in primary tumor samples and in the surgical margins of 34 patients with head and neck cancer using single strand conformational polymorphism and sequencing analysis. Results The p53 mutations (codons 175addAT, 175delGC, 206G→A, and 248delC) were found in the primary tumor samples of 15 of 34 patients (44.12%) and in the surgical margins of 5 of the 15 tumors (33.33%) with p53 mutations. Conclusions We found no statistically significant association between the presence of p53 mutations in the primary tumor, the clinical and pathological features, or outcome of head and neck squamous cell carcinoma in this study. Furthermore, the presence of p53 mutations in the surgical margins may not increase the risk of local-regional recurrence, but probably increases the risk of developing distant metastases or second primary tumors.
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Affiliation(s)
- Berrin Tunca
- Department of Medical Biology, School of Medicine, Uludag University, Bursa, Turkey.
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19
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Current understanding of the tumor microenvironment of laryngeal dysplasia and progression to invasive cancer. Curr Opin Otolaryngol Head Neck Surg 2016; 24:121-7. [PMID: 26963671 DOI: 10.1097/moo.0000000000000245] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW This review examines the historical tumor progression genetic model of laryngeal carcinomas, from dysplasia to invasive carcinoma and the role of infiltrating immune and inflammatory cells as contributors to this process. RECENT FINDINGS Classically, the genetic model of carcinogenesis describes overexpression of oncogenes and/or silencing of tumor suppressor genes which, when combined with exposure to environmental carcinogens over the course of time, results in damage to cellular DNA. Increasing evidence indicates that innate and adaptive immune mediators also play an important role in tumor progression of laryngeal carcinomas. Cellular mediators of immune suppression are often over represented in the tumor microenvironment and these cells release cytokines, which perpetuate immune suppression allowing for tumor immune evasion. SUMMARY Future therapies targeting laryngeal malignancies should focus on a combined approach which targets both genetic variations and immune mediators.
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20
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Murnyák B, Hortobágyi T. Immunohistochemical correlates of TP53 somatic mutations in cancer. Oncotarget 2016; 7:64910-64920. [PMID: 27626311 PMCID: PMC5323125 DOI: 10.18632/oncotarget.11912] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 09/01/2016] [Indexed: 12/20/2022] Open
Abstract
Despite controversy on the correlation between p53 accumulation and TP53 mutational status, immunohistochemical (IHC) detection of overexpressed protein has long been used as a surrogate method for mutation analysis. The aim of our study was to characterise the IHC expression features of TP53 somatic mutations and define their occurrence in human cancers. A large-scale database analysis was conducted in the IARC TP53 Database (R17); 7878 mutations with IHC features were retrieved representing 60 distinct tumour sites. The majority of the alterations were immunopositive (p <0.001). Sex was known for 4897 mutations showing a female dominance (57.2%) and females carrying negative mutations were significantly younger. TP53 mutations were divided into three IHC groups according to mutation frequency and IHC positivity. Each group had female dominance. Among the IHC groups, significant correlations were observed with age at diagnosis in breast, bladder, liver, haematopoietic system and head & neck cancers. An increased likelihood of false negative IHC associated with rare nonsense mutations was observed in certain tumour sites. Our study demonstrates that p53 immunopositivity largely correlates with TP53 mutational status but expression is absent in certain mutation types.Besides, describing the complex IHC expression of TP53 somatic mutations, our results reveal some caveats for the diagnostic practice.
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Affiliation(s)
- Balázs Murnyák
- Division of Neuropathology, Institute of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Tibor Hortobágyi
- Division of Neuropathology, Institute of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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21
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Scheel A, Bellile E, McHugh JB, Walline HM, Prince ME, Urba S, Wolf GT, Eisbruch A, Worden F, Carey TE, Bradford C. Classification of TP53 mutations and HPV predict survival in advanced larynx cancer. Laryngoscope 2016; 126:E292-9. [PMID: 27345657 PMCID: PMC5002993 DOI: 10.1002/lary.25915] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 12/28/2015] [Accepted: 01/19/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS Assess tumor suppressor p53 (TP53) functional mutations in the context of other biomarkers in advanced larynx cancer. STUDY DESIGN Prospective analysis of pretreatment tumor TP53, human papillomavirus (HPV), Bcl-xL, and cyclin D1 status in stage III and IV larynx cancer patients in a clinical trial. METHODS TP53 exons 4 through 9 from 58 tumors were sequenced. Mutations were grouped using three classifications based on their expected function. Each functional group was analyzed for response to induction chemotherapy, time to surgery, survival, HPV status, p16INK4a, Bcl-xl, and cyclin D1 expression. RESULTS TP53 mutations were found in 22 of 58 (37.9%) patients with advanced larynx cancer, including missense mutations in 13 of 58 (22.4%) patients, nonsense mutations in four of 58 (6.9%), and deletions in five of 58 (8.6%). High-risk HPV was found in 20 of 52 (38.5%) tumors. A classification based on Evolutionary Action score of p53 (EAp53) distinguished missense mutations with high risk for decreased survival from low-risk mutations (P = 0.0315). A model including this TP53 classification, HPV status, cyclin D1, and Bcl-xL staining significantly predicts survival (P = 0.0017). CONCLUSION EAp53 functional classification of TP53 mutants and biomarkers predict survival in advanced larynx cancer. LEVEL OF EVIDENCE NA. Laryngoscope, 126:E292-E299, 2016.
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Affiliation(s)
- Adam Scheel
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, U.S.A
| | - Emily Bellile
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, U.S.A
| | - Jonathan B McHugh
- Department of Pathology, University of Michigan Health System, Ann Arbor, Michigan, U.S.A
| | - Heather M Walline
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, U.S.A
| | - Mark E Prince
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, U.S.A
| | - Susan Urba
- Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, U.S.A
| | - Gregory T Wolf
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, U.S.A
| | - Avraham Eisbruch
- Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, Michigan, U.S.A
| | - Francis Worden
- Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, U.S.A
| | - Thomas E Carey
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, U.S.A
| | - Carol Bradford
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, U.S.A
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22
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Gupta S, Khan H, Kushwaha VS, Husain N, Negi M, Ghatak A, Bhatt M. Impact of EGFR and p53 expressions on survival and quality of life in locally advanced oral squamous cell carcinoma patients treated with chemoradiation. Cancer Biol Ther 2016; 16:1269-80. [PMID: 26177827 DOI: 10.1080/15384047.2015.1070985] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
EGFR and p53 are molecular markers which play important role in tumor progression and development. The objective of this study was to assess the association between EGFR and p53 expression and survival, and to determine whether EGFR and p53 expression levels were associated with differences quality of life in OSCC patients undergoing chemoradiation. A total of 120 OSCC patients aged 20-67 y and stage III/IV were recruited. Treatment response was assessed according to W.H.O. (1979). EGFR and p53 expression in tumor tissue was estimated by immunohistochemical (IHC) method and quantified as percentage positive nuclei. Molecular marker expressions of both EGFR and p53 were found significantly (P < 0.01 or P < 0.001) associated with overall response, survivals and quality of life. Neither EGFR nor p53 expression was associated with hematologic or non-hematologic toxicity. EGFR and p53 molecular marker expressions may have significant association with survival and QOL in OSCC patients undergoing chemoradiation.
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Affiliation(s)
- Seema Gupta
- a Department of Radiotherapy ; King George's Medical University ; Lucknow , UP , India
| | - Huma Khan
- a Department of Radiotherapy ; King George's Medical University ; Lucknow , UP , India
| | | | - Nuzhat Husain
- b Department of Pathology ; RMLIMS ; Lucknow , UP , India
| | - Mps Negi
- c Clinical and Experimental Medicine Division; CSIR-Central Drug Research Institute ; Lucknow , UP , India
| | - Ashim Ghatak
- c Clinical and Experimental Medicine Division; CSIR-Central Drug Research Institute ; Lucknow , UP , India
| | - Mlb Bhatt
- a Department of Radiotherapy ; King George's Medical University ; Lucknow , UP , India
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23
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Takenobu M, Osaki M, Fujiwara K, Fukuhara T, Kitano H, Kugoh H, Okada F. PITX1 is a novel predictor of the response to chemotherapy in head and neck squamous cell carcinoma. Mol Clin Oncol 2016; 5:89-94. [PMID: 27330773 DOI: 10.3892/mco.2016.880] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 02/19/2016] [Indexed: 12/24/2022] Open
Abstract
The pituitary homeobox 1 (PITX1) protein is essential for developmental processes in humans. Previously, PITX1 was identified as a possible tumor suppressor gene in various types of human carcinoma. However, the association between PITX1 and human head and neck squamous cell carcinoma (HNSCC) remains to be elucidated. Immunohistochemical analysis was performed to examine the expression levels of PITX1 in 47 cases of HNSCC, and in 4 control cases. The expression of p53 was also examined in these cases. The labeling indices (LIs) were calculated, and the correlations between clinical factors (chemosensitivity, prognosis and the degree of differentiation) and the LIs were assessed. The PITX1 LI in HNSCC was 27.4±14.5%, which was significantly lower compared with the LIs of the control samples: 76.9±6.97% (P<0.05). Additionally, the PITX1 LIs were 39.9±6.2, 26.9±16.9 and 24.2±11.8% in the complete response (CR), partial response (PR), stable disease or progressive disease (SD/PD) groups, respectively. The PITX1 LI in the CR group revealed the highest result between the all groups, and it was significantly greater compared with that in the SD/PD group (P<0.01). The p53 LIs were 24.5±19.9, 25.7±16.9 and 19.8±13.8 in the CR, PR and SD/PD groups, respectively (P>0.05). Neither the PITX1 nor the p53 LIs were a statistically significant indicator of the prognosis. PITX1 is a candidate tumor suppressor gene and a possible predictive biomarker of chemosensitivity of human HNSCC.
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Affiliation(s)
- Masao Takenobu
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8503, Japan; Division of Pathological Biochemistry, Department of Biomedical Sciences, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8503, Japan
| | - Mitsuhiko Osaki
- Division of Pathological Biochemistry, Department of Biomedical Sciences, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8503, Japan; Chromosome Engineering Research Center, Tottori University, Yonago, Tottori 683-8503, Japan
| | - Kazunori Fujiwara
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8503, Japan
| | - Takahiro Fukuhara
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8503, Japan
| | - Hiroya Kitano
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8503, Japan
| | - Hiroyuki Kugoh
- Chromosome Engineering Research Center, Tottori University, Yonago, Tottori 683-8503, Japan; Division of Molecular Genetics and Biofunction, Graduate School of Medical Science; Tottori University, Yonago, Tottori 683-8503, Japan
| | - Futoshi Okada
- Division of Pathological Biochemistry, Department of Biomedical Sciences, Faculty of Medicine, Tottori University, Yonago, Tottori 683-8503, Japan; Chromosome Engineering Research Center, Tottori University, Yonago, Tottori 683-8503, Japan
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Marta GN, William WN, Feher O, Carvalho AL, Kowalski LP. Induction chemotherapy for oral cavity cancer patients: Current status and future perspectives. Oral Oncol 2015; 51:1069-75. [DOI: 10.1016/j.oraloncology.2015.10.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 10/05/2015] [Accepted: 10/13/2015] [Indexed: 12/26/2022]
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Biomarkers predicting chemotherapy response in head and neck squamous cell carcinoma: a review. The Journal of Laryngology & Otology 2015; 129:1046-52. [PMID: 26429303 DOI: 10.1017/s0022215115002479] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Biomarkers are increasingly being used in many cancers to select patients for oncological treatment paradigms based on their inherent genetic properties. However, in head and neck cancers, there are no personalised therapies available outside the context of a clinical trial. A number of studies suggest there are intrinsic tumour properties of head and neck cancers that affect their response to chemotherapeutic agents. This paper aimed to review their evidence base. METHOD A narrative review was conducted following a search of the PubMed database. RESULTS AND CONCLUSION The review identified a number of biomarkers predicting response to chemotherapy in head and neck cancers. The paper discusses these in detail, and explores where future research could be directed in order to deliver personalised therapies for patients with head and neck cancers.
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Osman AA, Monroe MM, Ortega Alves MV, Patel AA, Katsonis P, Fitzgerald AL, Neskey DM, Frederick MJ, Woo SH, Caulin C, Hsu TK, McDonald TO, Kimmel M, Meyn RE, Lichtarge O, Myers JN. Wee-1 kinase inhibition overcomes cisplatin resistance associated with high-risk TP53 mutations in head and neck cancer through mitotic arrest followed by senescence. Mol Cancer Ther 2014; 14:608-19. [PMID: 25504633 DOI: 10.1158/1535-7163.mct-14-0735-t] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Although cisplatin has played a role in "standard-of-care" multimodality therapy for patients with advanced squamous cell carcinoma of the head and neck (HNSCC), the rate of treatment failure remains particularly high for patients receiving cisplatin whose tumors have mutations in the TP53 gene. We found that cisplatin treatment of HNSCC cells with mutant TP53 leads to arrest of cells in the G2 phase of the cell cycle, leading us to hypothesize that the wee-1 kinase inhibitor MK-1775 would abrogate the cisplatin-induced G2 block and thereby sensitize isogenic HNSCC cells with mutant TP53 or lacking p53 expression to cisplatin. We tested this hypothesis using clonogenic survival assays, flow cytometry, and in vivo tumor growth delay experiments with an orthotopic nude mouse model of oral tongue cancer. We also used a novel TP53 mutation classification scheme to identify which TP53 mutations are associated with limited tumor responses to cisplatin treatment. Clonogenic survival analyses indicate that nanomolar concentration of MK-1775 sensitizes HNSCC cells with high-risk mutant p53 to cisplatin. Consistent with its ability to chemosensitize, MK-1775 abrogated the cisplatin-induced G2 block in p53-defective cells leading to mitotic arrest associated with a senescence-like phenotype. Furthermore, MK-1775 enhanced the efficacy of cisplatin in vivo in tumors harboring TP53 mutations. These results indicate that HNSCC cells expressing high-risk p53 mutations are significantly sensitized to cisplatin therapy by the selective wee-1 kinase inhibitor, supporting the clinical evaluation of MK-1775 in combination with cisplatin for the treatment of patients with TP53 mutant HNSCC.
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Affiliation(s)
- Abdullah A Osman
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Marcus M Monroe
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah
| | | | - Ameeta A Patel
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Panagiotis Katsonis
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Alison L Fitzgerald
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David M Neskey
- Department of Otolaryngology Head and Neck Surgery, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina
| | - Mitchell J Frederick
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sang Hyeok Woo
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Carlos Caulin
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Teng-Kuei Hsu
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | | | - Marek Kimmel
- Department of Statistics, Rice University, Houston, Texas
| | - Raymond E Meyn
- Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Olivier Lichtarge
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Jeffrey N Myers
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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Kim MJ, Ki MS, Kim K, Shim HJ, Hwang JE, Bae WK, Chung IJ, Lee DH, Lee JK, Yoon TM, Lim SC, Chung WK, Jeong JU, Lim HS, Choi YD, Cho SH. Different protein expression associated with chemotherapy response in oropharyngeal cancer according to HPV status. BMC Cancer 2014; 14:824. [PMID: 25380690 PMCID: PMC4232654 DOI: 10.1186/1471-2407-14-824] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 10/24/2014] [Indexed: 01/17/2023] Open
Abstract
BACKGOUND Oropharyngeal cancer (OPC) associated with human papilloma virus (HPV OPC) shows better treatment outcomes than non-HPV OPC. We investigated the expression of p53, β-tubulin, bcl-2 and ERCC 1, which are well-known biomarkers to predict the chemotherapy response, according to HPV status in OPC patients. METHODS Patients who treated with at least 2 cycles of induction chemotherapy followed by concurrent chemoradiotherapy for locally advanced oropharyngeal cancer were reviewed. HPV PCR and immunohistochemical stain was done in paraffin embedded tumor tissue and evaluated the relation with the chemotherapy response and survival outcomes according to HPV status. RESULTS Seventy-four patients were enrolled for this study and all patients received induction chemotherapy with docetaxel, 5-FU and cisplatin. After induction chemotherapy, complete response (CR) was shown in 22 patients (30%) and partial response (PR) in 46 patients (62%). HPV + was detected in 21 patients (28%), while 35 patients (47%) showed p16+ expression by IHC analysis. p16 positive patients showed better overall response, PFS and OS than p16 negative patients. p53 and class III beta-tubulin expression were significantly higher in HPV- and p16- than HPV + and p16+ patients. Conversely, bcl-2 expression was greater in HPV + or p16+ than HPV- or p16- patients. ERCC1 expression did not differ significantly according to HPV status. In multivariate analyses, early T stage (p = 0.036) and good PS (PS 0) (p = 0.029) showed a better 3Y-PFS rate, and low p53 expression (p = 0.012) and complete response after induction chemotherapy (p = 0.026) were highly associated with 3Y-OS rate. Low expression of p53 and p16 positive patients showed significantly prolonged OS than others (p = 0.010). CONCLUSION P53, class III beta-tubulin and bcl-2 were differently expressed in OPC according to HPV status and present study suggested the underlying mechanism of better response to chemotherapy in case of HPV OPC than non-HPV OPC. Among these biomarkers, p53 is the strongest prognostic marker in OPC and p53 in addition to p16 support the rationale to study of de-escalation strategy for OPC.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Sang-Hee Cho
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, 322 Seoyangro, Hwasun, Jeollanamdo 519-763, Republic of Korea.
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Siroy AE, Boland GM, Milton DR, Roszik J, Frankian S, Malke J, Haydu L, Prieto VG, Tetzlaff M, Ivan D, Wang WL, Torres-Cabala C, Curry J, Roy-Chowdhuri S, Broaddus R, Rashid A, Stewart J, Gershenwald JE, Amaria RN, Patel SP, Papadopoulos NE, Bedikian A, Hwu WJ, Hwu P, Diab A, Woodman SE, Aldape KD, Luthra R, Patel KP, Shaw KR, Mills GB, Mendelsohn J, Meric-Bernstam F, Kim KB, Routbort MJ, Lazar AJ, Davies MA. Beyond BRAF(V600): clinical mutation panel testing by next-generation sequencing in advanced melanoma. J Invest Dermatol 2014; 135:508-515. [PMID: 25148578 PMCID: PMC4289407 DOI: 10.1038/jid.2014.366] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 07/24/2014] [Accepted: 08/05/2014] [Indexed: 01/15/2023]
Abstract
The management of melanoma has evolved due to improved understanding of its molecular drivers. To augment the current understanding of the prevalence, patterns, and associations of mutations in this disease, the results of clinical testing of 699 advanced melanoma patients using a pan-cancer next generation sequencing (NGS) panel of hotspot regions in 46 genes were reviewed. Mutations were identified in 43 of the 46 genes on the panel. The most common mutations were BRAFV600 (36%), NRAS (21%), TP53 (16%), BRAFNon-V600 (6%), and KIT (4%). Approximately one-third of melanomas had >1 mutation detected, and the number of mutations per tumor was associated with melanoma subtype. Concurrent TP53 mutations were the most frequent event in tumors with BRAFV600 and NRAS mutations. Melanomas with BRAFNon-V600 mutations frequently harbored concurrent NRAS mutations (18%), which were rare in tumors with BRAFV600 mutations (1.6%). The prevalence of BRAFV600 and KIT mutations were significantly associated with melanoma subtypes, and BRAFV600 and TP53 mutations were significantly associated with cutaneous primary tumor location. Multiple potential therapeutic targets were identified in metastatic unknown primary and cutaneous melanomas that lacked BRAFV600 and NRAS mutations. These results enrich our understanding of the patterns and clinical associations of oncogenic mutations in melanoma.
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Affiliation(s)
- Alan E Siroy
- Department of Pathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Genevieve M Boland
- Department of Surgical Oncology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Denái R Milton
- Department of Biostatistics, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Jason Roszik
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Silva Frankian
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Jared Malke
- Department of Surgical Oncology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Lauren Haydu
- Department of Surgical Oncology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Victor G Prieto
- Department of Pathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA; Department of Dermatology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Michael Tetzlaff
- Department of Pathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Doina Ivan
- Department of Pathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA; Department of Dermatology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Wei-Lien Wang
- Department of Pathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Carlos Torres-Cabala
- Department of Pathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA; Department of Dermatology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Jonathan Curry
- Department of Pathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Sinchita Roy-Chowdhuri
- Department of Pathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Russell Broaddus
- Department of Pathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Asif Rashid
- Department of Pathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - John Stewart
- Department of Pathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Jeffrey E Gershenwald
- Department of Surgical Oncology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA; Department of Cancer Biology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Rodabe N Amaria
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Sapna P Patel
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Nicholas E Papadopoulos
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Agop Bedikian
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Wen-Jen Hwu
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Patrick Hwu
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Adi Diab
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Scott E Woodman
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA; Department of Systems Biology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Kenneth D Aldape
- Department of Pathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Rajyalakshmi Luthra
- Department of Hematopathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Keyur P Patel
- Department of Hematopathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Kenna R Shaw
- Department of Systems Biology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Gordon B Mills
- Department of Systems Biology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - John Mendelsohn
- Department of Experimental Therapeutics, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Funda Meric-Bernstam
- Department of Surgical Oncology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA; Department of Investigational Cancer Therapeutics, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Kevin B Kim
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Mark J Routbort
- Department of Hematopathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Alexander J Lazar
- Department of Pathology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA; Department of Dermatology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Michael A Davies
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA; Department of Systems Biology, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA.
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Mountzios G, Rampias T, Psyrri A. The mutational spectrum of squamous-cell carcinoma of the head and neck: targetable genetic events and clinical impact. Ann Oncol 2014; 25:1889-1900. [PMID: 24718888 DOI: 10.1093/annonc/mdu143] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Squamous-cell cancer of the head and neck (SCCHN) represents a heterogeneous disease entity, with various etiological factors implicated in the genesis of distinct molecular subsets of tumors, which exhibit different biological and clinical behavior. Treatment of SCCHN is expected to change in the next decade as targeted therapies continue to make strides. Recently, next-generation sequencing studies conducted on ∼190 SCCHN specimens shed light into the molecular pathogenesis of the disease. These studies discovered mutations in genes involved in the differentiation program of squamous epithelium and the Notch/p63 axis (such as NOTCH1, TP63 and FBXW7), and validated genetic alterations derived from previous studies (such as mutations in TP53, CDKN2A, PIK3CA, CCND1 and HRAS) as driver genetic events in SCCHN neoplastic transformation. More recently, comprehensive data from The Cancer Genome Atlas (TCGA) project on 306 SCCHN specimens provided further insight into SCCHN inherent molecular complexity, identifying novel significantly mutated genes, including FAT1, MLL2, TGFRBR2, HLA-A, NFE2l2 and CASP8. In this article, we provide an overview of the mutational spectrum of SCCHN, with emphasis on the clinical implementation of this knowledge. We also discuss the potential integration of new data within the framework of precision cancer medicine.
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Affiliation(s)
- G Mountzios
- Department of Medical Oncology, University of Athens School of Medicine, Athens, Greece
| | - T Rampias
- Department of Surgery, Section of Otolaryngology, Yale University School of Medicine, New Haven,USA
| | - A Psyrri
- Second Department of Internal Medicine, Section of Medical Oncology, Attikon University Hospital, Athens, Greece; Department of Medicine, Yale Cancer Center, Yale University School of Medicine, New Haven,USA.
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p27 and BCL2 expression predicts response to chemotherapy in head and neck squamous cell carcinomas. Oral Oncol 2014; 50:128-34. [DOI: 10.1016/j.oraloncology.2013.10.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 10/06/2013] [Accepted: 10/26/2013] [Indexed: 11/17/2022]
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31
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Bossi P, Locati LD, Licitra L. Biological agents in head and neck cancer. Expert Rev Anticancer Ther 2014; 7:1643-50. [DOI: 10.1586/14737140.7.11.1643] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Takahashi Y, Bell D, Agarwal G, Roberts D, Xie TX, El-Naggar A, Myers JN, Hanna EY. Comprehensive assessment of prognostic markers for sinonasal squamous cell carcinoma. Head Neck 2013; 36:1094-102. [PMID: 23836481 DOI: 10.1002/hed.23423] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 06/11/2013] [Accepted: 06/19/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known about the molecular signature of the rare tumor sinonasal squamous cell carcinoma (SNSCC). The purpose of this study was to comprehensively assess various molecular biomarkers in SNSCC. METHODS We chose 13 markers for this study, which have been known as prognostic markers in head and neck squamous cell carcinoma. Expression of these markers was examined by either in situ hybridization or immunohistochemical methods on tissue microarrays made from 70 SNSCC specimens and 28 matched-pair normal tissues from patients who underwent surgical resection at our institution. Expression data were correlated with patient clinicopathologic parameters and survival. RESULTS Of the 13 markers, only epidermal growth factor receptor (EGFR) protein expression was associated with significantly shorter disease-free survival (DFS; p = .01307). EGFR expression was also associated with shorter overall survival (OS), but the difference was not statistically significant. CONCLUSION Targeted inhibition of tumor EGFR expression may be a new approach to treating SNSCC.
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Affiliation(s)
- Yoko Takahashi
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Seethalakshmi C. Early Detection of Oral Squamous Cell Carcinoma (OSCC) - Role of Genetics: A Literature Review. J Clin Diagn Res 2013; 7:1824-6. [PMID: 24086928 DOI: 10.7860/jcdr/2013/5552.3281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 03/28/2013] [Indexed: 11/24/2022]
Affiliation(s)
- C Seethalakshmi
- Senior Lecturer, (Oral Medicine and Radiology) Chettinad Dental College and Research Institute , Kelambakkam, Chennai, Tamil Nadu, India
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34
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Das K, Tan P. Molecular cytogenetics: recent developments and applications in cancer. Clin Genet 2013; 84:315-25. [DOI: 10.1111/cge.12229] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 07/02/2013] [Accepted: 07/02/2013] [Indexed: 12/13/2022]
Affiliation(s)
- K Das
- Cancer and Stem Cell Biology; Duke-NUS Graduate Medical School; Singapore Singapore
| | - P Tan
- Cancer and Stem Cell Biology; Duke-NUS Graduate Medical School; Singapore Singapore
- Cancer Science Institute of Singapore, Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
- Genome Institute of Singapore; Singapore Singapore
- Cellular and Molecular Research; National Cancer Centre of Singapore; Singapore Singapore
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35
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Habl G, Potthoff K, Haefner MF, Abdollahi A, Hassel JC, Boller E, Indorf M, Debus J. Differentiation of irradiation and cetuximab induced skin reactions in patients with locally advanced head and neck cancer undergoing radioimmunotherapy: the HICARE protocol (head and neck cancer: immunochemo and radiotherapy with erbitux) - a multicenter phase IV trial. BMC Cancer 2013; 13:345. [PMID: 23855804 PMCID: PMC3751099 DOI: 10.1186/1471-2407-13-345] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Accepted: 07/10/2013] [Indexed: 11/23/2022] Open
Abstract
Background In order to improve the clinical outcome of patients with locally advanced squamous cell carcinoma of the head and neck (LASCCHN) not being capable to receive platinum-based chemoradiation, radiotherapy can be intensified by addition of cetuximab, a monoclonal antibody that blocks the epidermal growth factor receptor (EGFR). The radioimmunotherapy with cetuximab is a feasible treatment option showing a favourable toxicity profile. The most frequent side effect of radiotherapy is radiation dermatitis, the most common side effect of treatment with cetuximab is acneiform rash. Incidence and severity of these frequent, often overlapping and sometimes limiting skin reactions, however, are not well explored. A clinical and molecular differentiation between radiogenic skin reactions and skin reactions caused by cetuximab which may correlate with outcome, have never been described before. Methods/design The HICARE study is a national, multicenter, prospective phase IV study exploring the different types of skin reactions that occur in patients with LASCCHN undergoing radioimmun(chemo)therapy with the EGFR inhibitor cetuximab. 500 patients with LASCCHN will be enrolled in 40 participating sites in Germany. Primary endpoint is the rate of radiation dermatitis NCI CTCAE grade 3 and 4 (v. 4.02). Radioimmunotherapy will be applied according to SmPC, i.e. cetuximab will be administered as loading dose and then weekly during the radiotherapy. Irradiation will be applied as intensity-modulated radiation therapy (IMRT) or 3D-dimensional radiation therapy. Discussion The HICARE trial is expected to be one of the largest trials ever conducted in head and neck cancer patients. The goal of the HICARE trial is to differentiate skin reactions caused by radiation from those caused by the monoclonal antibody cetuximab, to evaluate the incidence and severity of these skin reactions and to correlate them with outcome parameters. Besides, the translational research program will help to identify and confirm novel peripheral blood based molecular predictors and surrogates for treatment response and resistance. Trial registration Clinical Trial Identifier, NCT01553032 (clinicaltrials.gov) EudraCT number: 2010-019748-38
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Affiliation(s)
- G Habl
- Department of Radiation Oncology, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, Heidelberg, 69120, Germany.
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36
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Gadhikar MA, Sciuto MR, Alves MVO, Pickering CR, Osman AA, Neskey DM, Zhao M, Fitzgerald AL, Myers JN, Frederick MJ. Chk1/2 inhibition overcomes the cisplatin resistance of head and neck cancer cells secondary to the loss of functional p53. Mol Cancer Ther 2013; 12:1860-73. [PMID: 23839309 DOI: 10.1158/1535-7163.mct-13-0157] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Despite the use of multimodality therapy using cisplatin to treat patients with advanced stage squamous cell carcinoma of the head and neck (HNSCC), there is an unacceptably high rate of treatment failure. TP53 is the most commonly mutated gene in HNSCC, and the impact of p53 mutation on response to cisplatin treatment is poorly understood. Here, we show unambiguously that wild-type TP53 (wtp53) is associated with sensitivity of HNSCC cells to cisplatin treatment, whereas mutation or loss of TP53 is associated with cisplatin resistance. We also show that senescence is the major cellular response to cisplatin in wtp53 HNSCC cells and that cisplatin resistance in p53-null or -mutant TP53 cells is due to their lack of senescence. Given the dependence on checkpoint kinase (Chk)1/2 kinases to mediate the DNA damage response in p53-deficient cells, there is potential to exploit this to therapeutic advantage through targeted inhibition of the Chk1/2 kinases. Treatment of p53-deficient HNSCC cells with the Chk inhibitor AZD7762 sensitizes them to cisplatin through induction of mitotic cell death. This is the first report showing the ability of a Chk kinase inhibitor to sensitize TP53-deficient HNSCC to cisplatin in a synthetic lethal manner, which has significance given the frequency of TP53 mutations in this disease and because cisplatin has become part of standard therapy for aggressive HNSCC tumors. These preclinical data provide evidence that a personalized approach to the treatment of HNSCC based on Chk inhibition in p53-mutant tumors may be feasible.
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Affiliation(s)
- Mayur A Gadhikar
- Corresponding Authors: Mitchell J. Frederick, Department of Head & Neck Surgery, University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1445, Houston, TX 77030.
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Tan M, Myers JN, Agrawal N. Oral cavity and oropharyngeal squamous cell carcinoma genomics. Otolaryngol Clin North Am 2013; 46:545-66. [PMID: 23910469 DOI: 10.1016/j.otc.2013.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Recent technological advances now permit the study of the entire cancer genome, which can elucidate complex pathway interactions that are not apparent at the level of single genes. In this review, the authors describe innovations that have allowed for whole-exome/genome analysis of genetic and epigenetic alterations and of changes in gene expression. Studies using next-generation sequencing, array comparative genomic hybridization, methylation arrays, and gene expression profiling are reviewed, with a particular focus on findings from recent whole-exome sequencing projects. A discussion of the implications of these data on treatment and future goals for cancer genomics is included.
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Affiliation(s)
- Marietta Tan
- Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, USA
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Abstract
PURPOSE OF REVIEW The p53 tumor suppressor is a master regulator of antitumor defenses through its control of growth arrest, senescence and apoptosis. In recent years, p53 regulation was found to extend to a variety of biological processes including autophagy, fertility, metabolism and immune responses. Here, we focus on the role of p53 in the immune system. We explore the relationship between p53 and the innate immune response with particular emphasis on the Toll-like receptor (TLR) pathway and implications for cancer therapy. RECENT FINDINGS Numerous studies have shown that the immune system, especially innate immunity, has a critical role in tumor development. It appears that p53 can influence innate immune responses as part of its tumor suppressor activities and recent work suggests that the complete set of innate immune TLR genes are responsive to chromosomal stress and the transcriptional network regulated by p53. Activation of p53 by common antitumor agents results in p53 dependent regulation of expression of most TLR genes in human primary and cancer cell lines, resulting in modulation of TLR downstream responses to cognate ligands. In addition several tumor-associated p53 mutants can also affect TLR gene expression. These observations together with the discovery of other immune-related p53 target genes provide new insights into the relationship between p53 and immunity and suggest approaches that might be useful in cancer therapies. SUMMARY The tumor suppressor p53 can modulate innate immune gene responses in response to factors that can activate p53. This is expected to provide new opportunities in cancer diagnosis and in chemotherapeutic strategies that employ specific TLR agonists or antagonists that target the TLR pathway.
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Zhong LP, Zhu DW, William WN, Liu Y, Ma J, Yang CZ, Yang X, Wang LZ, Li J, Myers JN, Lee JJ, Zhang CP, Zhang ZY. Elevated cyclin D1 expression is predictive for a benefit from TPF induction chemotherapy in oral squamous cell carcinoma patients with advanced nodal disease. Mol Cancer Ther 2013; 12:1112-21. [PMID: 23515614 DOI: 10.1158/1535-7163.mct-12-1013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Induction chemotherapy is likely to be effective for biologically distinct subgroups of patients with cancer with biomarker detection. To investigate the prognostic and predictive values of cyclin D1 expression in patients with oral squamous cell carcinoma (OSCC) who were treated in a prospective, randomized, phase III trial evaluating standard treatment with surgery and postoperative radiotherapy preceded or not by induction docetaxel, cisplatin, and 5-fluorouracil (TPF), immunohistochemical staining for cyclin D1 was conducted in pretreatment biopsy specimens of 232 out of 256 clinical stage III/IVA OSCC patients randomized to the clinical trial. Cyclin D1 index was estimated as the proportion of tumor cells with cyclin D1 nuclear staining. A low cyclin D1 expression predicted significantly better overall survival (OS; P = 0.001), disease-free survival (P = 0.005), locoregional recurrence-free survival (P = 0.003), and distant metastasis-free survival (DMFS; P = 0.002) compared with high cyclin D1 expression. Cyclin D1 expression levels were not predictive of benefit from induction TPF in the population overall. However, patients with nodal stage cN2 whose tumors had high cyclin D1 expression treated with TPF had significantly greater OS (P = 0.025) and DMFS (P = 0.025) when compared with high cyclin D1 cN2 patients treated with surgery upfront. Patients with low cyclin D1 level or patients with cN0 or cN1 disease did not benefit from induction chemotherapy. This study indicates that cN2 OSCC patients with high cyclin D1 expression can benefit from the addition of TPF induction chemotherapy to standard treatment. Cyclin D1 expression could be used as a biomarker in further validation studies to select cN2 patients that could benefit from induction therapy.
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Affiliation(s)
- Lai-Ping Zhong
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Ma J, Liu Y, Yang X, Zhang CP, Zhang ZY, Zhong LP. Induction chemotherapy in patients with resectable head and neck squamous cell carcinoma: a meta-analysis. World J Surg Oncol 2013; 11:67. [PMID: 23497185 PMCID: PMC3601969 DOI: 10.1186/1477-7819-11-67] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 02/23/2013] [Indexed: 01/22/2023] Open
Abstract
Background Induction chemotherapy has been investigated as a possible strategy to shrink or downstage locally advanced head and neck cancers, providing opportunity to remove the lesions completely after induction chemotherapy, especially in the patients with resectable advanced disease. The aim of this study was to investigate the definitive effect of induction chemotherapy in patients with resectable head and neck squamous cell carcinoma. Methods A meta-analysis of randomized trials (1965–2011) was performed on the impact of induction chemotherapy on survival, disease control, and toxicity in this population of patients. Kaplan-Meier curves were read by Engauge-Digitizer. Data combining was performed using RevMan. Results Fourteen trials (2099 patients) were involved in this analysis. There was no significant difference on overall survival, disease free survival, or locoregional recurrence between the patients treated with and without induction chemotherapy (P >0.05). However, the patients treated with induction chemotherapy had a lower rate of distant metastasis by 8% (95% confidence interval 1%–16%, P = 0.02) than those treated without induction chemotherapy. In patients with laryngeal cancer, comparing to radical surgery, the larynx could be preserved in responders to induction chemotherapy without survival decease (P >0.05). Induction chemotherapy-associated death was 0%–5%. Conclusions Based on the results above, there is a significant benefit of induction chemotherapy on decreasing distant metastasis in patients with resectable head and neck squamous cell carcinoma. In patients with laryngeal cancer, induction chemotherapy provides larynx preservation in responders to induction chemotherapy.
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Affiliation(s)
- Jie Ma
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, No,639 Zhizaoju Rd, Shanghai, 200011, China
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Zhong LP, Zhang CP, Ren GX, Guo W, William WN, Sun J, Zhu HG, Tu WY, Li J, Cai YL, Wang LZ, Fan XD, Wang ZH, Hu YJ, Ji T, Yang WJ, Ye WM, Li J, He Y, Wang YA, Xu LQ, Wang BS, Kies MS, Lee JJ, Myers JN, Zhang ZY. Randomized phase III trial of induction chemotherapy with docetaxel, cisplatin, and fluorouracil followed by surgery versus up-front surgery in locally advanced resectable oral squamous cell carcinoma. J Clin Oncol 2013; 31:744-51. [PMID: 23129742 PMCID: PMC5569675 DOI: 10.1200/jco.2012.43.8820] [Citation(s) in RCA: 219] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate induction chemotherapy with docetaxel, cisplatin, and fluorouracil (TPF) followed by surgery and postoperative radiotherapy versus up-front surgery and postoperative radiotherapy in patients with locally advanced resectable oral squamous cell carcinoma (OSCC). PATIENTS AND METHODS A prospective open-label phase III trial was conducted. Eligibility criteria included untreated stage III or IVA locally advanced resectable OSCC. Patients received two cycles of TPF induction chemotherapy (docetaxel 75 mg/m(2) on day 1, cisplatin 75 mg/m(2) on day 1, and fluorouracil 750 mg/m(2) on days 1 to 5) followed by radical surgery and postoperative radiotherapy (54 to 66 Gy) versus up-front radical surgery and postoperative radiotherapy. The primary end point was overall survival (OS). Secondary end points included local control and safety. RESULTS Of the 256 patients enrolled onto this trial, 222 completed the full treatment protocol. There were no unexpected toxicities, and induction chemotherapy did not increase perioperative morbidity. The clinical response rate to induction chemotherapy was 80.6%. After a median follow-up of 30 months, there was no significant difference in OS (hazard ratio [HR], 0.977; 95% CI, 0.634 to 1.507; P = .918) or disease-free survival (HR, 0.974; 95% CI, 0.654 to 1.45; P = .897) between patients treated with and without TPF induction. Patients in the induction chemotherapy arm with a clinical response or favorable pathologic response (≤ 10% viable tumor cells) had superior OS and locoregional and distant control. CONCLUSION Our study failed to demonstrate that TPF induction chemotherapy improves survival compared with up-front surgery in patients with resectable stage III or IVA OSCC.
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Affiliation(s)
- Lai-ping Zhong
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Chen-ping Zhang
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Guo-xin Ren
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Wei Guo
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - William N. William
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jian Sun
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Han-guang Zhu
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Wen-yong Tu
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jiang Li
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Yi-li Cai
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Li-zhen Wang
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Xin-dong Fan
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Zhong-he Wang
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Yong-jie Hu
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tong Ji
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Wen-jun Yang
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Wei-min Ye
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jun Li
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Yue He
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Yan-an Wang
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Li-qun Xu
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Bo-song Wang
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Merrill S. Kies
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J. Jack Lee
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jeffrey N. Myers
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Zhi-yuan Zhang
- Lai-ping Zhong, Chen-ping Zhang, Guo-xin Ren, Wei Guo, Jian Sun, Han-guang Zhu, Wen-yong Tu, Jiang Li, Yi-li Cai, Li-zhen Wang, Zhong-he Wang, Yong-jie Hu, Tong Ji, Wen-jun Yang, Wei-min Ye, Jun Li, Yue He, Yan-an Wang, Li-qun Xu, and Zhi-yuan Zhang, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Xin-dong Fan, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Bo-song Wang, Shanghai Jiao Tong University School of Medicine, Shanghai, China; and William N. William Jr, Merrill S. Kies, J. Jack Lee, and Jeffrey N. Myers, The University of Texas MD Anderson Cancer Center, Houston, TX
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42
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Tp53 status as guide for the management of ethmoid sinus intestinal-type adenocarcinoma. Oral Oncol 2013; 49:413-9. [PMID: 23369851 DOI: 10.1016/j.oraloncology.2012.12.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 12/24/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Intestinal-type adenocarcinoma (ITAC) of the ethmoid sinus is a rare, occupational-related tumor. Optimal treatment consists of surgery and radiotherapy, while chemotherapy is still investigational. The molecular profile of ITAC is characterized by the occurrence of TP53 mutations associated with genotoxic agents such as wood dust. We investigated the role of p53 functionality in relation to the primary treatment. MATERIALS AND METHODS We retrospectively reviewed 100 medical charts of consecutive patients with a first diagnosis of ITAC treated at our Institute; 74 patients were evaluable for TP53 analysis. Thirty (41%) were treated from 1991 to 2006 with craniofacial resection followed by radiotherapy (Group A), compared with 44 patients (59%) treated from 1996 to 2006 with cisplatin-based induction chemotherapy (PFL) followed by standard treatment (Group B). RESULTS Five-year OS in Group A was 42%, while in Group B it was 70% (p = 0.041); 5-year DFS in Group A was 40%, while in Group B it was 66%, (p = 0.009) (p = 0.061 and 0.003 at Cox multivariable OS and DFS analyses). Analyzing each group according to p53 functional status, only for Group B patients (who received preoperative chemotherapy) both OS and DFS were in favor of functional p53 (p = 0.023 and p = 0.010, respectively). No impact of p53 functional status as a biomarker was observed in Group A. CONCLUSIONS Functional p53 may predict PFL-chemotherapy efficacy, offering a possible increase in survival when induction chemotherapy is given to a selected population. On the other hand, upcoming innovative approaches should be explored in the presence of non-functional p53.
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43
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Loyo M, Li RJ, Bettegowda C, Pickering CR, Frederick MJ, Myers JN, Agrawal N. Lessons learned from next-generation sequencing in head and neck cancer. Head Neck 2012; 35:454-63. [PMID: 22907887 DOI: 10.1002/hed.23100] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2012] [Indexed: 12/30/2022] Open
Abstract
Scientific innovation has enabled whole exome capture and massively parallel sequencing of cancer genomes. In head and neck cancer, next-generation sequencing has granted us further understanding of the mutational spectrum of squamous cell carcinoma. As a result of these new technologies, frequently occurring mutations were identified in NOTCH1, a gene that had not previously been implicated in head and neck cancer. The current review describes the most common mutations in head and neck cancer: TP53, NOTCH1, HRAS, PIK3CA, and CDKN2A. Emphasis is placed on the involved cellular pathways, clinical correlations, and potential therapeutic interventions. Additionally, the implications of human papillomavirus on mutation patterns are discussed.
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Affiliation(s)
- Myriam Loyo
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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44
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Induction chemotherapy decreases the rate of distant metastasis in patients with head and neck squamous cell carcinoma but does not improve survival or locoregional control: a meta-analysis. Oral Oncol 2012; 48:1076-84. [PMID: 22800881 DOI: 10.1016/j.oraloncology.2012.06.014] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Revised: 06/16/2012] [Accepted: 06/19/2012] [Indexed: 10/28/2022]
Abstract
The definitive effect of induction chemotherapy (IC) on locally advanced head and neck squamous cell carcinoma (HNSCC) remains uncertain and although randomized controlled trials are supposed to provide high levels evidence for clinical guidelines, the data thus far has been conflicted. In an effort to elucidate the potential benefit of IC, a meta-analysis of randomized controlled trials (1965-2011) was performed investigating the impact of IC on survival, locoregional control, distant metastasis, and toxicity in HNSCC. Kaplan-Meier curves were read by a digitizing software-Engauge Digitizer. Data combination was performed using the software-RevMan and trial level log hazard ratio (HR) and variance were pooled and presented. Among the 40 eligible trials, 28 trials encompassing 4189 patients receiving locoregional treatment with or without IC were included in the analysis. The cumulative benefit of IC on overall survival and distant metastasis was 6% (HR = 0.94, 95%CI = 0.87-1.01, P = 0.11) and 7% (95%CI = 0-13%, P = 0.05) respectively while for locoregional control a benefit was not observed as seen by the -2% (95%CI = -11% to 8%, P = 0.73) improved control rate. In a subsite analysis specifically for laryngeal preservation, IC did not significantly improve survival (P = 0.47). There was a significant benefit from the cisplatin and 5-fluorouracil (PF) protocols with an increase in overall survival of 13% (HR = 0.87, 95%CI = 0.78-0.97, P = 0.01), and a reduction in the 5-year distant metastasis rate of 11% (95%CI = 0-21%, P = 0.04). The occurrence of grade 3/4 mucositis, leukopenia and emesis was significantly lower in patients receiving IC compared to patients receiving concomitant chemoradiotherapy. In conclusion, there is not a significant benefit of the pooled IC regimens in HNSCC on survival or locoregional control. In contrast, IC does show significant benefit in the reduction of distant metastasis. When protocols using a PF regimen are analyzed independently, a significant improvement in survival and rate of distant metastases is observed while there is not a benefit in locoregional control. The routine use of IC is still debatable. IC could be applied on larynx preservation strategy.
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45
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Shatz M, Menendez D, Resnick MA. The human TLR innate immune gene family is differentially influenced by DNA stress and p53 status in cancer cells. Cancer Res 2012; 72:3948-57. [PMID: 22673234 DOI: 10.1158/0008-5472.can-11-4134] [Citation(s) in RCA: 116] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The transcription factor p53 regulates genes associated with a wide range of functions, including the Toll-like receptor (TLR) set of innate immunity genes, suggesting that p53 also modulates the human immune response. The TLR family comprises membrane glycoproteins that recognize pathogen-associated molecular patterns (PAMP) and mediate innate immune responses, and TLR agonists are being used as adjuvants in cancer treatments. Here, we show that doxorubicin, 5-fluorouracil, and UV and ionizing radiation elicit changes in TLR expression that are cell line- and damage-specific. Specifically, treatment-induced expression changes led to increased downstream cytokine expression in response to ligand stimulation. The effect of DNA stressors on TLR expression was mainly mediated by p53, and several p53 cancer-associated mutants dramatically altered the pattern of TLR gene expression. In all cell lines tested, TLR3 induction was p53-dependent, whereas induction of TLR9, the most stress-responsive family member, was less dependent on status of p53. In addition, each of the 10 members of the innate immune TLR gene family tested was differentially inducible. Our findings therefore show that the matrix of p53 status, chromosome stress, and responsiveness of individual TLRs should be considered in TLR-based cancer therapies.
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Affiliation(s)
- Maria Shatz
- Chromosome Stability Group, Laboratory of Molecular Genetics, National Institute of Environmental Health Sciences (NIEHS), NIH, Research Triangle Park, North Carolina 27709, USA
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46
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Sherman EJ, Fisher SG, Kraus DH, Zelefsky MJ, Seshan VE, Singh B, Shaha AR, Shah JP, Wolf GT, Pfister DG. TALK score: Development and validation of a prognostic model for predicting larynx preservation outcome. Laryngoscope 2012; 122:1043-50. [DOI: 10.1002/lary.23220] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 12/03/2011] [Accepted: 01/03/2012] [Indexed: 01/07/2023]
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47
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Sano D, Xie TX, Ow TJ, Zhao M, Pickering CR, Zhou G, Sandulache VC, Wheeler DA, Gibbs RA, Caulin C, Myers JN. Disruptive TP53 mutation is associated with aggressive disease characteristics in an orthotopic murine model of oral tongue cancer. Clin Cancer Res 2011; 17:6658-70. [PMID: 21903770 DOI: 10.1158/1078-0432.ccr-11-0046] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To characterize tumor growth and metastatic potential in head and neck squamous cell carcinoma (HNSCC) cell lines in an orthotopic murine model of oral tongue cancer and to correlate TP53 mutation status with these findings. EXPERIMENTAL DESIGN Cells from each of 48 HNSCC cell lines were orthotopically injected into the oral tongues of nude mice. Tumor volume, cervical lymph node metastasis, and mouse survival were recorded. Direct sequencing of the TP53 gene and Western blot analysis for the p53 protein after induction with 5-fluorouracil was conducted. Cell lines were categorized as either mutant TP53 or wild-type TP53, and lines with TP53 mutation were further categorized on the basis of type of mutation (disruptive or nondisruptive) and level of p53 protein expression. The behavior of tumors in these different groups was compared. RESULTS These 48 HNSCC cell lines showed a wide range of behavior from highly aggressive and metastatic to no tumor formation. Mice injected with cells harboring disruptive TP53 mutations had faster tumor growth, greater incidence of cervical lymph node metastasis, and shorter survival than mice injected with cells lacking these mutations. CONCLUSIONS HNSCC cell lines display a wide spectrum of behavior in an orthotopic model of oral cancer. Cell lines with disruptive TP53 mutations are more aggressive in this system, corroborating clinical reports that have linked these mutations to poor patient outcome.
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Affiliation(s)
- Daisuke Sano
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
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48
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Wu Y, Posner MR, Schumaker LM, Nikitakis N, Goloubeva O, Tan M, Lu C, Iqbal S, Lorch J, Sarlis NJ, Haddad RI, Cullen KJ. Novel biomarker panel predicts prognosis in human papillomavirus-negative oropharyngeal cancer: an analysis of the TAX 324 trial. Cancer 2011; 118:1811-7. [PMID: 22009819 DOI: 10.1002/cncr.26485] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 07/07/2011] [Accepted: 07/07/2011] [Indexed: 12/18/2022]
Abstract
BACKGROUND New treatment strategies for locally advanced head and neck squamous cell carcinoma combine induction chemotherapy and chemoradiation. Identifying the predictors of outcome in sequentially treated patients is critical for focusing therapeutic research. In this analysis, the authors evaluated human papillomavirus type 16 (HPV-16) status and the expression levels of a defined set of biomarkers to identify predictors of response to this treatment modality. METHODS In total, 114 patients with oropharyngeal cancer (OPC) who were treated on the TAX 324 trial (cisplatin and fluorouracil with or without docetaxel in patients with locally advanced head and neck squamous cell carcinoma) had pretreatment biopsy specimens that were evaluable for HPV-16 DNA and immunohistochemical expression of the following biomarkers: beta-tubulin II (βT-II), glutathione S-transferase (GST-π), p53, and B-cell lymphoma 2 (Bcl-2). Patients were categorized into risk groups based on their HPV status and biomarker expression levels. RESULTS Patients with high-risk OPC were defined by HPV-negative status and either elevated expression of βT-II or levels of at least 2 of the other 3 adverse markers (elevated GST-π, elevated p53, or low Bcl-2). All other HPV-negative patients were categorized as moderate risk. In total, 55 patients were HPV-positive, and 59 patients were HPV-negative, with 34 were categorized as high risk and 25 categorized as moderate risk. The median survival for HPV-positive patients was not reached. The median survival was 44.2 months for moderate-risk patients (95% confidence interval, 20.9 months to not reached) and 12.1 months for high-risk patients (95% confidence interval, 7.5-19.7 months). The 24-month survival rate was 89% for HPV-positive patients, 67% for moderate-risk patients, and 29% for high-risk patients (P < .0001). CONCLUSIONS The molecular data set in this study readily differentiated between 2 distinct groups of patients with locally advanced, HPV-negative OPC. This risk-stratification strategy may serve as a guide for treatment selection.
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Affiliation(s)
- Yin Wu
- Experimental Therapeutics Program, University of Maryland Marlene and Stewart Greenebaum Cancer Center, Baltimore, Maryland 21201, USA
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Donzelli S, Biagioni F, Fausti F, Strano S, Fontemaggi G, Blandino G. Oncogenomic Approaches in Exploring Gain of Function of Mutant p53. Curr Genomics 2011; 9:200-7. [PMID: 19440517 PMCID: PMC2679646 DOI: 10.2174/138920208784340713] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2008] [Revised: 04/09/2008] [Accepted: 04/14/2008] [Indexed: 01/07/2023] Open
Abstract
Cancer is caused by the spatial and temporal accumulation of alterations in the genome of a given cell. This leads to the deregulation of key signalling pathways that play a pivotal role in the control of cell proliferation and cell fate. The p53 tumor suppressor gene is the most frequent target in genetic alterations in human cancers. The primary selective advantage of such mutations is the elimination of cellular wild type p53 activity. In addition, many evidences in vitro and in vivo have demonstrated that at least certain mutant forms of p53 may possess a gain of function, whereby they contribute positively to cancer progression. The fine mapping and deciphering of specific cancer phenotypes is taking advantage of molecular-profiling studies based on genome-wide approaches. Currently, high-throughput methods such as array-based comparative genomic hybridization (CGH array), single nucleotide polymorphism array (SNP array), expression arrays and ChIP-on-chip arrays are available to study mutant p53-associated alterations in human cancers. Here we will mainly focus on the integration of the results raised through oncogenomic platforms that aim to shed light on the molecular mechanisms underlying mutant p53 gain of function activities and to provide useful information on the molecular stratification of tumor patients.
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Affiliation(s)
- Sara Donzelli
- Department of Experimental Oncology, Regina Elena Cancer Institute, 00158-Rome, Italy
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Lingen MW, Pinto A, Mendes RA, Franchini R, Czerninski R, Tilakaratne WM, Partridge M, Peterson DE, Woo SB. Genetics/epigenetics of oral premalignancy: current status and future research. Oral Dis 2011; 17 Suppl 1:7-22. [PMID: 21382136 DOI: 10.1111/j.1601-0825.2011.01789.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Squamous cell carcinoma (SCC) of the oral and oropharyngeal region is the sixth most common malignancy in the world today. Despite numerous advances in treatment, long-term survival from this disease remains poor. Early detection can decrease both morbidity and mortality associated with this neoplasm. However, screening for potentially malignant disease is typically confounded by difficulty in discriminating between reactive/inflammatory lesions vs those lesions that are premalignant in nature. Furthermore, the histologic diagnosis of dysplasia can be subjective and is thus prone to a considerable range of interpretation. Similarly, no definitive, validated criteria exist for predicting which dysplastic lesions are most likely to progress to cancer over time. Given this state of science, the presence of dysplasia can only be used to indicate that an oral lesion may have an increased risk of malignant transformation. Molecular biomarkers capable of identifying the subset of lesions likely to progress to cancer are required to eliminate this clinical diagnostic dilemma. The purpose of this review is to assess the current state of knowledge regarding genetic/epigenetic alterations observed in oral mucosal premalignancy. In addition, recommendations for future research studies directed at defining the predictive capacity of specific biomarkers in this modeling are presented.
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Affiliation(s)
- M W Lingen
- Department of Pathology, The University of Chicago Pritzker School of Medicine, Chicago, IL, USA
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