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Troussier I, Klausner G, Morinière S, Blais E, Jean-Christophe Faivre, Champion A, Geoffrois L, Pflumio C, Babin E, Maingon P, Thariat J. [Advances in the management of cervical lymphadenopathies of unknown primary: advances in diagnostic imaging and surgical modalities and new international staging system]. Bull Cancer 2017; 105:181-192. [PMID: 29275831 DOI: 10.1016/j.bulcan.2017.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/10/2017] [Accepted: 11/15/2017] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Cervical lymphadenopathies of unknown primary represent 3 % of head and neck cancers. Their diagnostic work up has largely changed in recent years. This review provides an update on diagnostic developments and their potential therapeutic impact. MATERIALS AND METHODS This is a systematic review of the literature. RESULTS In recent years, changes in epidemiology-based prognostic factors such as human papilloma virus (HPV) cancers, advances in imaging and minimally invasive surgery have been integrated in the management of cervical lymphadenopathies of unknown primary. In particular, systematic use of PET scanner and increasing practice of robotic or laser surgery have contributed to increasing detection rate of primary cancers. These allow more adapted and personalized treatments. The impact of changes in the eighth TNM staging system is discussed. CONCLUSION The management of cervical lymphadenopathies of unknown primary cancer has changed significantly in the last 10 years. On the other hand, practice changes will have to be assessed.
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Affiliation(s)
- Idriss Troussier
- CHRU Pitié-Salpêtrière, radiothérapie, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - Guillaume Klausner
- Institut Gustave-Roussy, radiothérapie, 114, rue Edouard-Vaillant, 94800 Villejuif, France
| | - Sylvain Morinière
- CHRU de Tours, carcinologie cervicofaciale, 2, boulevard Tonnellé, 37000 Tours, France
| | - Eivind Blais
- Centre Bergonié, radiothérapie, 229, cours de l'Argonne, 33000 Bordeaux, France
| | - Jean-Christophe Faivre
- Institut de cancérologie de Lorraine, oncologie médicale, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - Ambroise Champion
- Hôpitaux universitaires Genève, radiothérapie, rue Gabrielle-Perret-Gentil, 4, 1205 Genève, Suisse
| | - Lionnel Geoffrois
- CHRU de Tours, carcinologie cervicofaciale, 2, boulevard Tonnellé, 37000 Tours, France
| | - Carole Pflumio
- CHRU de Tours, carcinologie cervicofaciale, 2, boulevard Tonnellé, 37000 Tours, France
| | - Emmanuel Babin
- CHRU de Caen, carcinologie cervicofaciale, avenue de la Côte-de-Nacre, 14033 Caen, France
| | - Philippe Maingon
- CHRU Pitié-Salpêtrière, radiothérapie, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - Juliette Thariat
- ARCHADE centre François-Baclesse, radiothérapie, 3, avenue du Général-Harris, 14000 Caen, France.
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102
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Mehrad M, Dupont WD, Plummer WD, Lewis JS. Expression and Significance of Cytokeratin 7, a Squamocolumnar Junction Marker, in Head and Neck Squamous Cell Carcinoma. Head Neck Pathol 2017; 12:448-454. [PMID: 29235037 PMCID: PMC6232215 DOI: 10.1007/s12105-017-0874-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 12/06/2017] [Indexed: 01/03/2023]
Abstract
The favorable features of high-risk human papillomavirus (HPV) in the head and neck are limited to those harboring transcriptionally-active HPV, which occur predominantly in the oropharynx (OP). Factors rendering the OP susceptible to HPV oncogenesis are largely unexplored. The role of cytokeratin 7 (CK7) in predisposition to HPV and cancer in the cervix has been evaluated. However, its significance in the H&N is unknown. CK7 immunohistochemistry was performed on a tissue microarray cohort of OP and non-oropharyngeal (NOP) squamous cell carcinomas (SCC) with known clinical follow-up and HPV E6/7 mRNA status. Expression was graded based on the distribution (1 ≤ 33%, 2 = 33-66%, 3 ≥ 66%) and intensity (1 = weak, 2 = strong) with combined score of ≥ 2 considered positive. Survival analysis was performed. Seventy-four NOPSCCs and 204 OPSCCs were studied. HPV was positive in 2.7% of NOPSCCs and 70.9% of OPSCCs. CK7 was positive in 23.0% of OPSCCs and 14.8% of NOPSCCs (p = 0.2), and in 24.1% of HPV positive versus 17.2% of negative patients (p = 0.2). There was no correlation with age, race, gender, HPV status, histologic type, tumor subsite, treatment, stage, or co-morbidities, and CK7 expression was not significantly associated with overall or disease specific survival. In our series, CK7 is positive in ~ 25% of H&N SCCs, although usually only focally. While CK7 has been suspected to be overexpressed selectively in HPV-related OPSCCs due to their origination from tonsillar crypt epithelium, we did not find any significant difference by anatomic H&N subsite, nor by HPV status, for its expression and found no association with patient survival.
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Affiliation(s)
- Mitra Mehrad
- Vanderbilt University Medical Center, Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, C-3321A Medical Center North, Nashville, TN 37232 USA
| | - William D. Dupont
- Vanderbilt University Medical Center, Biostatistics, Nashville, TN USA
| | - W. Dale Plummer
- Vanderbilt University Medical Center, Biostatistics, Nashville, TN USA
| | - James S. Lewis
- Vanderbilt University Medical Center, Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, C-3321A Medical Center North, Nashville, TN 37232 USA ,Vanderbilt University Medical Center, Otolaryngology, Nashville, TN USA
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103
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Shinomiya H, Shinomiya H, Kubo M, Saito Y, Yoshida M, Ando M, Teshima M, Otsuki N, Kiyota N, Sasaki R, Nibu KI. Prognostic value of ALDH2 polymorphism for patients with oropharyngeal cancer in a Japanese population. PLoS One 2017; 12:e0187992. [PMID: 29206831 PMCID: PMC5716598 DOI: 10.1371/journal.pone.0187992] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 10/30/2017] [Indexed: 01/02/2023] Open
Abstract
Background Half of Japanese possess a polymorphism of aldehyde dehydrogenase 2(ALDH2), while few white individuals possess this mutation. The purpose of this study was to investigate the possibility of ALDH2 polymorphism as a prognostic factor for oropharyngeal cancer (OPC) among Japanese population. Methods We analyzed 82 Japanese patients with OPC treated between 2006 and 2011. The median observation period was 50 months. P16-staining and ALDH2 polymorphisms were investigated. To examine the frequencies of second primary pharyngeal and esophageal cancers (SPPEC),37 Japanese patients with OPC treated at Tokyo University Hospital were included for statistical analysis. Results Statistically significant differences were noted in OS among sex, age, N classification, and p16 (p = 0.045, 0.024, 0.020, 0.007, respectively). In addition, OS and DSS rates of the patients with heterozygous ALDH2 tended to be worse than those of the patients with homozygous ALDH2 (p = 0.21, 0.086, respectively). Of note, OS and DSS of the patients with p16-negative OPC and heterozygous ALDH2 was significant poorer than those of the patients with p16-positive OPC (p = 0.002, 0.006, respectively), while there was no significant difference in OS and DSS between patients with p16-positive OPC and patients with p16-negative OPC and homozygous ALDH2. Conclusions ALDH2 polymorphism might be a promising prognostic factor for Japanese patients with p16-negative OPC.
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Affiliation(s)
- Hirotaka Shinomiya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
- * E-mail: (HS); (KIN)
| | - Hitomi Shinomiya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Mie Kubo
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuki Saito
- Department of Head and Neck Surgery-Otolaryngology, University of Tokyo, Tokyo, Japan
| | - Masafumi Yoshida
- Department of Head and Neck Surgery-Otolaryngology, University of Tokyo, Tokyo, Japan
| | - Mizuo Ando
- Department of Head and Neck Surgery-Otolaryngology, University of Tokyo, Tokyo, Japan
| | - Masanori Teshima
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naoki Otsuki
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naomi Kiyota
- Department of Medical Oncology and Hematology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryohei Sasaki
- Department of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
- * E-mail: (HS); (KIN)
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104
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Nasri E, Wiesen LB, Knapik JA, Fredenburg KM. Eps8 expression is significantly lower in p16 + head and neck squamous cell carcinomas (HNSCCs) compared with p16 - HNSCCs. Hum Pathol 2017; 72:45-51. [PMID: 29107665 DOI: 10.1016/j.humpath.2017.10.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 10/09/2017] [Accepted: 10/18/2017] [Indexed: 11/29/2022]
Abstract
In vitro head and neck cancer studies have demonstrated that epidermal growth factor receptor kinase substrate 8 (Eps8) overexpression contributes to squamous carcinogenesis. Oral squamous cell carcinoma studies have correlated Eps8 expression with metastatic disease and poor prognosis. Head and neck squamous cell carcinoma (HNSCC) studies comparing its expression by anatomic site or in in vivo regional metastases have not been performed. In this study, we compared Eps8 expression in HNSCCs arising in the oral cavity (OCSCC) and oropharynx (OPSCC) along with their corresponding regional lymph node (LN) metastases. We then correlated our findings with clinicopathologic data including tumor-node-metastasis stage, p16 status, age, sex, and smoking and alcohol history. Eps8 immunohistochemistry was performed on 69 archived OCSCCs and OPSCCs, and 24 paired and 4 unpaired LNs. Expression was scored from 0 to 3. Eps8 expression was detected in 49% of combined OCSCC and OPSCC cases. We found that expression correlated with advanced tumor stage (P = .022) and p16 status (P = .032) but not with anatomic site. Notably, p16+ HNSCCs had significantly lower Eps8 expression than p16- HNSCCs. No significant difference was observed between primary HNSCCs and their corresponding metastatic LNs. Neither p16 status nor anatomic site influenced Eps8 expression in regional LN metastases. In conclusion, our data offer in vivo support that, in HNSCCs, Eps8 is involved in tumor invasion but not necessarily the development of regional LN metastasis. The association between low Eps8 expression and p16+ HNSCCs suggests that alternative signaling pathways may be used for their tumorigenesis.
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Affiliation(s)
- Elham Nasri
- University of Florida College of Medicine, Department of Pathology, Immunology, and Laboratory Medicine, Gainesville, FL 32610
| | - Lisa B Wiesen
- University of Florida College of Medicine, Department of Pathology, Immunology, and Laboratory Medicine, Gainesville, FL 32610
| | - Jacquelyn A Knapik
- University of Florida College of Medicine, Department of Pathology, Immunology, and Laboratory Medicine, Gainesville, FL 32610
| | - Kristianna M Fredenburg
- University of Florida College of Medicine, Department of Pathology, Immunology, and Laboratory Medicine, Gainesville, FL 32610.
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105
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Kumar B, Yadav A, Brown NV, Zhao S, Cipolla MJ, Wakely PE, Schmitt AC, Baiocchi RA, Teknos TN, Old M, Kumar P. Nuclear PRMT5, cyclin D1 and IL-6 are associated with poor outcome in oropharyngeal squamous cell carcinoma patients and is inversely associated with p16-status. Oncotarget 2017; 8:14847-14859. [PMID: 28107179 PMCID: PMC5362449 DOI: 10.18632/oncotarget.14682] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 12/27/2016] [Indexed: 12/28/2022] Open
Abstract
Protein arginine methyltransferase-5 (PRMT5) plays an important role in cancer progression by repressing the expression of key tumor suppressor genes via the methylation of transcriptional factors and chromatin-associated proteins. However, very little is known about the expression and biological role of PRMT5 in head and neck cancer. In this study, we examined expression profile of PRMT5 at subcellular levels in oropharyngeal squamous cell carcinoma (OPSCC) and assessed its correlation with disease progression and patient outcome. Our results show that nuclear PRMT5 was associated with poor overall survival (p < 0.012) and these patients had 1.732 times higher hazard of death (95% CI: 1.127–2.661) as compared to patients in whom PRMT5 was not present in the nucleus of the tumors. Nuclear PRMT5 expression was inversely correlated with p16-status (p < 0.001) and was significantly higher in tumor samples from patients who smoked > 10 pack-years (p = 0.013). In addition, nuclear PRMT5 was directly correlated with cyclin D1 (p = 0.0101) and IL-6 expression (p < 0.001). In a subgroup survival analysis, nuclear PRMT5-positive/IL-6-positive group had worst survival, whereas nuclear PRMT5-negative/IL-6-negative group had the best survival. Similarly, patients with p16-negative/nuclear PRMT5-positive tumors had worse survival compared to patients with p16-positive/nuclear PRMT5-negative tumors. Our mechanistic results suggest that IL-6 promotes nuclear translocation of PRMT5. Taken together, our results demonstrate for the first time that nuclear PRMT5 expression is associated with poor clinical outcome in OPSCC patients and IL-6 plays a role in the nuclear translocation of PRMT5.
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Affiliation(s)
- Bhavna Kumar
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA.,The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Arti Yadav
- The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Nicole V Brown
- Center for Biostatistics, The Ohio State University, Columbus, OH 43210, USA
| | - Songzhu Zhao
- Center for Biostatistics, The Ohio State University, Columbus, OH 43210, USA
| | - Michael J Cipolla
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA
| | - Paul E Wakely
- Department of Pathology, The Ohio State University, Columbus, OH 43210, USA
| | - Alessandra C Schmitt
- Department of Pathology, The Ohio State University, Columbus, OH 43210, USA.,Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30303, USA
| | - Robert A Baiocchi
- Department of Internal Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Theodoros N Teknos
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA.,The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210 USA
| | - Matthew Old
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA.,The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Pawan Kumar
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA.,The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210, USA
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106
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Cheah R, Srivastava R, Stafford ND, Beavis AW, Green V, Greenman J. Measuring the response of human head and neck squamous cell carcinoma to irradiation in a microfluidic model allowing customized therapy. Int J Oncol 2017; 51:1227-1238. [PMID: 28902347 DOI: 10.3892/ijo.2017.4118] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 07/31/2017] [Indexed: 11/06/2022] Open
Abstract
Radiotherapy is the standard treatment for head and neck squamous cell carcinoma (HNSCC), however, radioresistance remains a major clinical problem despite significant improvements in treatment protocols. Therapeutic outcome could potentially be improved if a patient's tumour response to irradiation could be predicted ex vivo before clinical application. The present study employed a bespoke microfluidic device to maintain HNSCC tissue whilst subjecting it to external beam irradiation and measured the responses using a panel of cell death and proliferation markers. HNSCC biopsies from five newly-presenting patients [2 lymph node (LN); 3 primary tumour (PT)] were divided into parallel microfluidic devices and replicates of each tumour were subjected to single-dose irradiation (0, 5, 10, 15 and 20 Gy). Lactate dehydrogenase (LDH) release was measured and tissue sections were stained for cytokeratin (CK), cleaved-CK18 (cCK18), phosphorylated-H2AX (γH2AX) and Ki‑67 by immunohistochemistry. In addition, fragmented DNA was detected using terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL). Compared with non‑irradiated controls, higher irradiation doses resulted in elevated CK18-labelling index in two lymph nodes [15 Gy; 34.8% on LN1 and 31.7% on LN2 (p=0.006)] and a single laryngeal primary tumour (20 Gy; 31.5%; p=0.014). Significantly higher levels of DNA fragmentation were also detected in both lymph node samples and one primary tumour but at varying doses of irradiation, i.e., LN1 (20 Gy; 27.6%; p=0.047), LN2 (15 Gy; 15.3%; p=0.038) and PT3 (10 Gy; 35.2%; p=0.01). The γH2AX expression was raised but not significantly in the majority of samples. The percentage of Ki‑67 positive nuclei reduced dose-dependently following irradiation. In contrast no significant difference in LDH release was observed between irradiated groups and controls. There is clear inter- and intra-patient variability in response to irradiation when measuring a variety of parameters, which offers the potential for the approach to provide clinically valuable information.
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Affiliation(s)
- Ramsah Cheah
- Hull York Medical School, University of Hull, Hull, HU6 7RX, UK
| | | | | | - Andrew W Beavis
- Radiation Physics, Hull and East Yorkshire Hospitals NHS Trust, Faculty of Science and Engineering, University of Hull, Hull, HU6 7RX, UK
| | - Victoria Green
- School of Life Sciences, University of Hull, Hull, HU6 7RX, UK
| | - John Greenman
- School of Life Sciences, University of Hull, Hull, HU6 7RX, UK
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107
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Chen RY, Lin YC, Chen SW, Lin TY, Hsieh TC, Yen KY, Liang JA, Yang SN, Wang YC, Chen YH, Chiang SF, Kao CH. Immunohistochemical biomarkers and volumetric parameters for predicting radiotherapy-based outcomes in patients with p16-negative pharyngeal cancer. Oncotarget 2017; 8:72342-72351. [PMID: 29069791 PMCID: PMC5641134 DOI: 10.18632/oncotarget.20374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Accepted: 08/07/2017] [Indexed: 11/25/2022] Open
Abstract
Background This study determined the prognostic effects of immunohistochemical biomarkers and volumetric parameters predicting radiotherapy-based treatment in patients with p16-negative squamous cell carcinoma of the oropharynx or hypopharynx. Results VEGF immunoreactivity > 2 and GLUT1 overexpression were prognostic factors for lower cause-specific survival. Moreover, both factors were associated with lower disease-free survival. The predictors of lower primary relapse-free survival were VEGF immunoreactivity > 2 and CT-based gross tumor volume > 16 mL. Materials and Methods Immunohistochemical biomarkers in pretreatment biopsy specimens from 60 patients with p16-negative cancer were analyzed using tissue microarrays. Computed tomography (CT)-based and biological tumor volumes were retrieved through fluorodeoxyglucose positron emission tomography-CT. Correlations of cause-specific, disease-free, and primary relapse-free survival with volumetric parameters and the immunohistochemical biomarker score were investigated. Conclusions For patients with p16-negative pharyngeal cancer receiving radiotherapy, treatment outcomes can be stratified by VEGF and GLUT1 expression and CT-based gross tumor volume.
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Affiliation(s)
- Rui-Yun Chen
- Department of Pathology, China Medical University Hospital, Taichung, Taiwan
| | - Ying-Chun Lin
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,The Ph.D. Program for Cancer Biology and Drug Discovery, China Medical University and Academia Sinica, Taichung, Taiwan
| | - Shang-Wen Chen
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, China Medical University, Taichung, Taiwan.,School of Medicine, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Tze-Yi Lin
- Department of Pathology, China Medical University Hospital, Taichung, Taiwan
| | - Te-Chun Hsieh
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.,Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Kuo-Yang Yen
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.,Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Ji-An Liang
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Shih-Neng Yang
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Yao-Ching Wang
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Ya-Huey Chen
- Graduate Institute of Cancer Biology, China Medical University, Taichung, Taiwan.,Center for Molecular Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Shu-Fen Chiang
- Cancer Center, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
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108
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Hobbs AJ, Brockton NT, Matthews TW, Chandarana SP, Bose P, Guggisberg K, Fick GH, Dort JC. Primary treatment for oropharyngeal squamous cell carcinoma in Alberta, Canada: A population-based study. Head Neck 2017; 39:2187-2199. [DOI: 10.1002/hed.24889] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 04/19/2017] [Accepted: 06/15/2017] [Indexed: 01/21/2023] Open
Affiliation(s)
- Amy J. Hobbs
- Department of Community Health Sciences; Cumming School of Medicine, University of Calgary; Calgary Alberta Canada
- The Ohlson Research Initiative; Arnie Charbonneau Cancer Institute, University of Calgary; Calgary Alberta Canada
| | - Nigel T. Brockton
- Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services; Calgary Alberta Canada
- The Ohlson Research Initiative; Arnie Charbonneau Cancer Institute, University of Calgary; Calgary Alberta Canada
| | - T. Wayne Matthews
- Department of Surgery; Section of Otolaryngology, Cumming School of Medicine, University of Calgary; Calgary Alberta Canada
- The Ohlson Research Initiative; Arnie Charbonneau Cancer Institute, University of Calgary; Calgary Alberta Canada
| | - Shamir P. Chandarana
- Department of Surgery; Section of Otolaryngology, Cumming School of Medicine, University of Calgary; Calgary Alberta Canada
- The Ohlson Research Initiative; Arnie Charbonneau Cancer Institute, University of Calgary; Calgary Alberta Canada
| | - Pinaki Bose
- Department of Surgery; Section of Otolaryngology, Cumming School of Medicine, University of Calgary; Calgary Alberta Canada
- The Ohlson Research Initiative; Arnie Charbonneau Cancer Institute, University of Calgary; Calgary Alberta Canada
| | - Kelly Guggisberg
- The Ohlson Research Initiative; Arnie Charbonneau Cancer Institute, University of Calgary; Calgary Alberta Canada
- Department of Anatomic Pathology; Calgary Laboratory Services, Rockyview General Hospital; Calgary Alberta Canada
| | - Gordon H. Fick
- Department of Community Health Sciences; Cumming School of Medicine, University of Calgary; Calgary Alberta Canada
| | - Joseph C. Dort
- Department of Community Health Sciences; Cumming School of Medicine, University of Calgary; Calgary Alberta Canada
- Department of Surgery; Section of Otolaryngology, Cumming School of Medicine, University of Calgary; Calgary Alberta Canada
- The Ohlson Research Initiative; Arnie Charbonneau Cancer Institute, University of Calgary; Calgary Alberta Canada
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109
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Rajendra S, Yang T, Xuan W, Sharma P, Pavey D, Lee CS, Le S, Collins J, Wang B. Active human papillomavirus involvement in Barrett's dysplasia and oesophageal adenocarcinoma is characterized by wild-type p53 and aberrations of the retinoblastoma protein pathway. Int J Cancer 2017; 141:2037-2049. [PMID: 28722212 DOI: 10.1002/ijc.30896] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 06/14/2017] [Accepted: 07/11/2017] [Indexed: 12/15/2022]
Abstract
We have previously demonstrated that transcriptionally active high-risk HPV (hr-HPV) is strongly incriminated in Barrett's dysplasia (BD) and oesophageal adenocarcinoma (OAC) using mainly fresh frozen tissue. This study aimed to identify biomarkers of active HPV infection in Barrett's metaplasia, (BM)/BD/OAC by immunohistochemical staining (IHC) of formalin-fixed paraffin embedded (FFPE) tissue for aberrations of p53 and the retinoblastoma (pRb) pathway, which are targets for the viral oncoproteins, E6/E7, respectively. Prospectively, BM (n = 81)/BD (n = 72)/OAC (n = 65) FFPE specimens were subjected to IHC staining for pRb, p16INK4A , cyclin D1 , p53 and RNA in-situ hybridization for E6/E7 transcripts. HPV DNA was determined via PCR in fresh frozen specimens. Viral load measurement (real-time PCR) and Next Generation Sequencing of TP53 was performed. Of 218 patients, 56 were HPV DNA positive [HPV16 (n = 42), 18 (n = 13), 6 (n = 1)]. Viral load was low. Transcriptionally active HPV (DNA+ /RNA+ ) was only found in the dysplastic and adenocarcinoma group (n = 21). The majority of HPV DNA+ /RNA+ BD/OAC were characterized by p 16highINK4A (14/21, 66.7%), pRblow (15/21, 71.4%) and p53low (20/21, 95%) and was significantly different to controls [combination of HPV DNA- /RNA- (n = 94) and HPV DNA+ /RNA- cohorts (n = 22)]. p53low had the strongest association with DNA+ /RNA+ oesophageal lesions (OR = 23.5, 95% CI = 2.94-187.8, p = 0.0029). Seventeen HPV DNA+ /RNA+ BD/OAC identified as p53low, were sequenced and all but one exhibited wild-type status. pRblow /p53low provided the best balance of strength of association (OR = 8.0, 95% CI = 2.6-25.0, p = 0.0003) and sensitivity (71.4%)/specificity (71.6%) for DNA+ /RNA+ BD/OAC. Active HPV involvement in BD/OAC is characterized by wild-type p53 and aberrations of the retinoblastoma protein pathway.
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Affiliation(s)
- Shanmugarajah Rajendra
- Gastro-Intestinal Viral Oncology Group, Ingham Institute for Applied Medical Research, Liverpool, Sydney, NSW, Australia.,South Western Sydney Clinical School, University of New South Wales, Kensington, Sydney, NSW, Australia.,Department of Gastroenterology & Hepatology, Bankstown-Lidcombe Hospital, South Western Sydney Local Health Network, Bankstown, Sydney, NSW, Australia
| | - Tao Yang
- Department of Anatomical Pathology, South Western Sydney Area Pathology Service, Liverpool, Sydney, NSW, Australia.,Faculty of Medicine, Discipline of Pathology, School of Medicine, University of Western Sydney, NSW, Australia
| | - Wei Xuan
- South Western Sydney Clinical School, University of New South Wales, Kensington, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Sydney, NSW, Australia
| | - Prateek Sharma
- Division of Gastroenterology and Hepatology, Veterans Affairs Medical Center and University of Kansas City, MO
| | - Darren Pavey
- Gastro-Intestinal Viral Oncology Group, Ingham Institute for Applied Medical Research, Liverpool, Sydney, NSW, Australia.,South Western Sydney Clinical School, University of New South Wales, Kensington, Sydney, NSW, Australia.,Department of Gastroenterology & Hepatology, Bankstown-Lidcombe Hospital, South Western Sydney Local Health Network, Bankstown, Sydney, NSW, Australia
| | - Cheong Soon Lee
- Department of Anatomical Pathology, South Western Sydney Area Pathology Service, Liverpool, Sydney, NSW, Australia.,Faculty of Medicine, Discipline of Pathology, School of Medicine, University of Western Sydney, NSW, Australia
| | - Son Le
- South Western Sydney Clinical School, University of New South Wales, Kensington, Sydney, NSW, Australia.,Department of Gastroenterology & Hepatology, Bankstown-Lidcombe Hospital, South Western Sydney Local Health Network, Bankstown, Sydney, NSW, Australia
| | - Josephine Collins
- South Western Sydney Clinical School, University of New South Wales, Kensington, Sydney, NSW, Australia.,Department of Gastroenterology & Hepatology, Bankstown-Lidcombe Hospital, South Western Sydney Local Health Network, Bankstown, Sydney, NSW, Australia
| | - Bin Wang
- Gastro-Intestinal Viral Oncology Group, Ingham Institute for Applied Medical Research, Liverpool, Sydney, NSW, Australia.,South Western Sydney Clinical School, University of New South Wales, Kensington, Sydney, NSW, Australia
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110
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Cohen ER, Reis IM, Gomez C, Pereira L, Freiser ME, Hoosien G, Franzmann EJ. Immunohistochemistry Analysis of CD44, EGFR, and p16 in Oral Cavity and Oropharyngeal Squamous Cell Carcinoma. Otolaryngol Head Neck Surg 2017; 157:239-251. [PMID: 28397583 DOI: 10.1177/0194599817700371] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 02/28/2017] [Indexed: 12/26/2022]
Abstract
Objectives We analyze the relationship between CD44, epidermal growth factor receptor (EGFR), and p16 expression in oral cavity and oropharyngeal cancers in a diverse population. We also describe whether particular patterns of staining are associated with progression-free survival and overall survival. Study Design Prospective study, single-blind to pathologist and laboratory technologist. Setting Hospital based. Subjects and Methods Immunohistochemistry, comprising gross staining and cellular expression, was performed and interpreted in a blinded fashion on 24 lip/oral cavity and 40 oropharyngeal cancer specimens collected between 2007 and 2012 from participants of a larger study. Information on overall survival and progression-free survival was obtained from medical records. Results Nineteen cases were clinically p16 positive, 16 of which were oropharyngeal. Oral cavity lesions were more likely to exhibit strong CD44 membrane staining ( P = .0002). Strong CD44 membrane and strong EGFR membrane and/or cytoplasmic staining were more common in p16-negative cancers ( P = .006). Peripheral/mixed gross p16 staining pattern was associated with worse survival than the universal staining on univariate and multivariate analyses ( P = .006, P = .030). This held true when combining gross and cellular localization for p16. For CD44, universal gross staining demonstrated poorer overall survival compared with the peripheral/mixed group ( P = .039). CD44 peripheral/mixed group alone and when combined with universal p16 demonstrated the best survival on multivariate analysis ( P = .010). Conclusion In a diverse population, systematic analysis applying p16, CD44, and EGFR gross staining and cellular localization on immunohistochemistry demonstrates distinct patterns that may have prognostic potential exceeding current methods. Larger studies are warranted to investigate these findings further.
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Affiliation(s)
- Erin R Cohen
- 1 Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Isildinha M Reis
- 2 Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
- 3 Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Carmen Gomez
- 4 Department of Pathology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Lutecia Pereira
- 2 Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Monika E Freiser
- 1 Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Gia Hoosien
- 1 Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Elizabeth J Franzmann
- 1 Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
- 2 Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
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111
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Inhestern J, Schmalenberg H, Dietz A, Rotter N, Maschmeyer G, Jungehülsing M, Grosse-Thie C, Kuhnt T, Görner M, Sudhoff H, Wittekindt C, Guntinas-Lichius O. A two-arm multicenter phase II trial of one cycle chemoselection split-dose docetaxel, cisplatin and 5-fluorouracil (TPF) induction chemotherapy before two cycles of split TPF followed by curative surgery combined with postoperative radiotherapy in patients with locally advanced oral and oropharyngeal squamous cell cancer (TISOC-1). Ann Oncol 2017; 28:1917-1922. [DOI: 10.1093/annonc/mdx202] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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112
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Misawa Y, Misawa K, Kawasaki H, Imai A, Mochizuki D, Ishikawa R, Endo S, Mima M, Kanazawa T, Iwashita T, Mineta H. Evaluation of epigenetic inactivation of vascular endothelial growth factor receptors in head and neck squamous cell carcinoma. Tumour Biol 2017; 39:1010428317711657. [PMID: 28718364 DOI: 10.1177/1010428317711657] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to determine the methylation status of the genes encoding the vascular endothelial growth factor receptors and to evaluate the usefulness of VEGFR methylation as a prognostic indicator in head and neck squamous cell carcinoma. VEGFR messenger RNA expression and promoter methylation were examined in a panel of cell lines via quantitative reverse transcription and methylation-specific polymerase chain reaction, respectively. Promoter methylation was compared with clinical characteristics in 128 head and neck squamous cell carcinoma samples. The normalized methylation values for the VEGFR1, VEGFR2 and VEGFR3 promoters tended to be higher in the tumour cell lines than in normal tonsil samples, whereas amounts of VEGFR1, VEGFR2 and VEGFR3 messenger RNA were significantly higher. Methylation of the VEGFR1 promoter (p = 0.003; 66/128 head and neck squamous cell carcinoma samples, 52%) and VEGFR3 promoter (p = 0.043; 53/128 head and neck squamous cell carcinoma samples, 41%) significantly correlated with recurrence, whereas methylation of the VEGFR2 promoter significantly correlated with lymph node metastasis (p = 0.046; 47/128 head and neck squamous cell carcinoma samples, 37%). Concurrent methylation of the VEGFR1 and VEGFR3 promoters significantly correlated with reduced disease-free survival (log-rank test, p = 0.009). In a multivariate logistic regression analysis, methylation of the VEGFR1, VEGFR3 and both the VEGFR1 and VEGFR3 promoters independently predicted recurrence (odds ratios and 95% confidence intervals: 3.19, 1.51-6.75 (p = 0.002); 2.24, 1.06-4.76 (p = 0.035); and 2.56, 1.09-6.05 (p = 0.032), respectively). Methylation of the VEGFR promoters predicts poor prognosis in head and neck squamous cell carcinoma patients.
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Affiliation(s)
- Yuki Misawa
- 1 Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kiyoshi Misawa
- 1 Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hideya Kawasaki
- 2 Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Atsushi Imai
- 1 Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Daiki Mochizuki
- 1 Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Ryuji Ishikawa
- 1 Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Shiori Endo
- 1 Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Masato Mima
- 1 Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takeharu Kanazawa
- 3 Department of Otolaryngology - Head and Neck Surgery, Jichi Medical University, Shimotsuke, Japan
| | - Toshihide Iwashita
- 2 Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hiroyuki Mineta
- 1 Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Misawa K, Mochizuki D, Imai A, Misawa Y, Endo S, Mima M, Kawasaki H, Carey TE, Kanazawa T. Epigenetic silencing of SALL3 is an independent predictor of poor survival in head and neck cancer. Clin Epigenetics 2017; 9:64. [PMID: 28616099 PMCID: PMC5469057 DOI: 10.1186/s13148-017-0363-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 05/31/2017] [Indexed: 01/10/2023] Open
Abstract
Background This study examined Sal-like protein (SALL)3 methylation profiles of head and neck cancer (HNSCC) patients at diagnosis and follow-up and evaluated their prognostic significance and value as a biomarker. SALL3 expression was examined in a panel of cell lines by quantitative reverse transcription polymerase chain reaction (RT-PCR). The methylation status of the SALL3 promoter was examined by quantitative methylation-specific PCR. Results SALL3 promoter methylation was associated with transcriptional inhibition and was correlated with disease recurrence in 64.8% of cases, with an odds ratio of 1.914 (95% confidence interval: 1.157–3.164; P = 0.011) by multivariate Cox proportional hazard regression analysis. SALL3 promoter hypermethylation showed highly discriminatory receiver operator characteristic curve profiles that clearly distinguished HNSCC from adjacent normal mucosal tissue, and was correlated with reduced disease-free survival (DFS) (log-rank test, P = 0.01). Hypermethylation of tumor-related genes was higher among patients with SALL3 methylation than among those without methylation (P < 0.001). Furthermore, SALL3 hypermethylation was associated with expression of TET1, TET2, and DNMT3A genes. Conclusions This study suggests that CpG hypermethylation is a likely mechanism of SALL3 gene inactivation, supporting the hypothesis that the SALL3 gene may play a role in the tumorigenesis of HNSCC and may serve as an important biomarker. Electronic supplementary material The online version of this article (doi:10.1186/s13148-017-0363-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kiyoshi Misawa
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka 431-3192 Japan
| | - Daiki Mochizuki
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka 431-3192 Japan
| | - Atsushi Imai
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka 431-3192 Japan
| | - Yuki Misawa
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka 431-3192 Japan
| | - Shiori Endo
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka 431-3192 Japan
| | - Masato Mima
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka 431-3192 Japan
| | - Hideya Kawasaki
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Thomas E Carey
- Laboratory of Head and Neck Cancer Biology, Department of Otolaryngology/Head and Neck Surgery, University of Michigan, Ann Arbor, MI USA
| | - Takeharu Kanazawa
- Department of Otolaryngology/Head and Neck Surgery, Jichi Medical University, Tochigi, Japan
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114
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Koncar RF, Feldman R, Bahassi EM, Hashemi Sadraei N. Comparative molecular profiling of HPV-induced squamous cell carcinomas. Cancer Med 2017; 6:1673-1685. [PMID: 28556593 PMCID: PMC5504316 DOI: 10.1002/cam4.1108] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 03/29/2017] [Accepted: 04/30/2017] [Indexed: 12/21/2022] Open
Abstract
Approximately 5% of all cancer incidences result from human papillomavirus (HPV) infection. HPV infection most commonly leads to cancers of the anogenital region or oropharynx. It is unknown whether different HPV-mediated cancers collectively share a molecular signature and it is important to determine if there are targetable alterations common to different types of HPV-positive tumors. We analyzed 743 p53 wild-type samples of anal, cervical, oropharyngeal, and vulvar squamous cell carcinomas which underwent multiplatform testing at a commercial molecular profiling service. Expression of 24 proteins was measured by immunohistochemistry (IHC), mutation of 48 genes was determined by next-generation and Sanger sequencing, and copy number alteration for six genes was determined by in situ hybridization. The four cohorts had remarkably similar molecular profiles. No gene had a statistically significant difference in mutation frequency or copy number change between the four different types of squamous cell carcinomas. The only significant differences between cohorts were frequency of ERCC1 and SPARC loss as determined by IHC. In all four cancer types, oncogene mutation and PD-L1 expression was relatively infrequent. The most commonly mutated gene was PIK3CA, with mutations most often affecting the helical domain of the protein and accompanied by concurrent lack of PTEN expression. Loss of MGMT and RRM1 was common among the four cohorts and may be predictive of response to cytotoxic therapies not currently being used to treat these cancer types. The similar molecular profiles of the four cohorts indicate that treatment strategies may be similarly efficacious across HPV-positive cancers.
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Affiliation(s)
- Robert F Koncar
- Department of Internal Medicine, Division of Hematology/Oncology, University of Cincinnati, Cincinnati, Ohio
| | | | - El Mustapha Bahassi
- Department of Internal Medicine, Division of Hematology/Oncology, University of Cincinnati, Cincinnati, Ohio
| | - Nooshin Hashemi Sadraei
- Department of Internal Medicine, Division of Hematology/Oncology, University of Cincinnati, Cincinnati, Ohio
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115
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Biron VL, O'Connell DA, Barber B, Clark JM, Andrews C, Jeffery CC, Côté DWJ, Harris J, Seikaly H. Transoral robotic surgery with radial forearm free flap reconstruction: case control analysis. J Otolaryngol Head Neck Surg 2017; 46:20. [PMID: 28292318 PMCID: PMC5351107 DOI: 10.1186/s40463-017-0196-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 03/07/2017] [Indexed: 11/10/2022] Open
Abstract
Background The resection of large oropharyngeal tumors traditionally involves a lip-splitting mandibulotomy for adequate margin visualization and free flap reconstruction of the surgical defect. Transoral robotic surgery (TORS) has emerged as a technique that can resect large and complex oropharyngeal tumors, avoiding a lip-splitting approach. The aim of this study is to compare the lip-splitting mandibulotomy approach versus TORS for the management of advanced stage oropharyngeal carcinomas. Methods Prospectively collected data from 18 patients with advanced stage oropharyngeal squamous cell carcinoma (OPSCC) who received TORS with radial forearm free flap reconstruction (RFFF) was compared to a matched cohort of 39 patients who received a lip-splitting mandibulotomy and RFFF. Patients were matched for stage, p16 positivity, smoking, age and gender. Length of hospital stay (LOHS), tracheostomy decanulation time, operative time, surgical margin status, and post-operative complications were compared between groups. Results Patients who received TORS with RFFF had a significantly lower mean LOHS, compared to patients who were treated by lip-splitting mandibulotomy and RFFF (14.4 vs 19.7 days, p = 0.03). No significant differences were seen between groups in terms of operative time, tracheostomy decannulation time, margin positivity and post-operative complications. Conclusion TORS with radial forearm free flap reconstruction is a safe, effective and cost-saving alternative to the lip-splitting mandibulotomy approach for the treatment of advanced stage OPSCC.
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Affiliation(s)
- Vincent L Biron
- Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of Alberta, 8440-112 st, 1E4 Walter Mackenzie Centre, Edmonton, AB, T6G 2B7, Canada. .,Alberta Head & Neck Centre for Oncology and Reconstruction, Edmonton, AB, Canada.
| | - Daniel A O'Connell
- Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of Alberta, 8440-112 st, 1E4 Walter Mackenzie Centre, Edmonton, AB, T6G 2B7, Canada.,Alberta Head & Neck Centre for Oncology and Reconstruction, Edmonton, AB, Canada
| | - Brittany Barber
- Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of Alberta, 8440-112 st, 1E4 Walter Mackenzie Centre, Edmonton, AB, T6G 2B7, Canada
| | - Jessica M Clark
- Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of Alberta, 8440-112 st, 1E4 Walter Mackenzie Centre, Edmonton, AB, T6G 2B7, Canada
| | - Colin Andrews
- Faculty of Medicine and Dentistry, Undergraduate Medical Education, Edmonton, AB, Canada
| | - Caroline C Jeffery
- Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of Alberta, 8440-112 st, 1E4 Walter Mackenzie Centre, Edmonton, AB, T6G 2B7, Canada
| | - David W J Côté
- Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of Alberta, 8440-112 st, 1E4 Walter Mackenzie Centre, Edmonton, AB, T6G 2B7, Canada
| | - Jeffrey Harris
- Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of Alberta, 8440-112 st, 1E4 Walter Mackenzie Centre, Edmonton, AB, T6G 2B7, Canada.,Alberta Head & Neck Centre for Oncology and Reconstruction, Edmonton, AB, Canada
| | - Hadi Seikaly
- Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of Alberta, 8440-112 st, 1E4 Walter Mackenzie Centre, Edmonton, AB, T6G 2B7, Canada.,Alberta Head & Neck Centre for Oncology and Reconstruction, Edmonton, AB, Canada
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116
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Treatment outcomes in veterans with HPV-positive head and neck cancer. Am J Otolaryngol 2017; 38:188-192. [PMID: 28342482 DOI: 10.1016/j.amjoto.2017.01.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 01/16/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Head and neck squamous cell carcinoma (HNSCC) caused by the human papilloma virus (HPV) has an improved prognosis relative to HPV-negative tumors. Patients with HPV-positive disease may benefit from different treatment modalities in order to optimize survival and quality of life. We sought to investigate HPV-positive HNSCC within the military veteran population, and analyze the role of treatment modality in outcomes of patients with HPV-positive and HPV-negative tumors. METHODS Patients diagnosed with HNSCC between January 1, 2010 and December 31, 2014 at one regional veterans health center were retrospectively examined. Pathologic specimens underwent testing for HPV subtype and p16 expression. Demographic and clinical factors, including treatment modality, were analyzed for their impact on the primary outcome of overall survival. RESULTS There were 209 patients with primary tumor sites including larynx (25.4%), oral tongue (19.6%), oral cavity (13.4%), oropharynx (17.2%), tonsil (17.2%), unknown primary (2.9%), nasopharynx (1.9%), and multiple sites (2.4%). Patients had HPV-positive (n=82, 39.2%), HPV-negative (n=89, 42.6%) or unknown HPV status (n=38, 18.2%). Primary treatment modalities were chemoradiation (n=124, 59.3%), surgery (n=39, 18.7%), radiation therapy (n=37, 17.7%), or no treatment (n=9, 4.3%). Survival analysis with Cox proportional hazards model demonstrated significant associations with T classification (T4 3.61, P=0.005), N classification (N3 3.52, P=0.0159), M classification (M1 2.8, P=0.0209), and HPV status (HPV-positive 0.43, P=0.0185), but no relation with primary treatment modality (primary surgery vs. primary chemoradiation 1.01, P=0.9718). CONCLUSION HPV-positive HNSCC in the veteran population has a significantly improved prognosis relative to similarly staged patients with HPV-negative disease. This study demonstrates that the primary treatment modality - chemoradiation, radiation therapy, or surgery - does not impact overall survival among veterans with HPV-positive HNSCC.
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117
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Kumar B, Brown NV, Swanson BJ, Schmitt AC, Old M, Ozer E, Agrawal A, Schuller DE, Teknos TN, Kumar P. High expression of myoferlin is associated with poor outcome in oropharyngeal squamous cell carcinoma patients and is inversely associated with HPV-status. Oncotarget 2017; 7:18665-77. [PMID: 26919244 PMCID: PMC4951318 DOI: 10.18632/oncotarget.7625] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 02/11/2016] [Indexed: 11/25/2022] Open
Abstract
Myoferlin (MYOF) is a member of ferlin family of membrane proteins that was originally discovered as a muscle specific protein. Recent studies have shown that myoferlin is also expressed in other cell types including endothelial cells and cancer cells. However, very little is known about the expression and biological role of myoferlin in head and neck cancer. In this study, we examined expression profile of myoferlin in oropharyngeal squamous cell carcinoma (OPSCC) and assessed its correlation with disease progression and patient outcome. In univariate analyses, nuclear MYOF was associated with poor overall survival (p<0.001) and these patients had 5.5 times increased hazard of death (95% Cl 3.4-8.8). Nuclear myoferlin expression was also directly associated with tumor recurrence (p<0.001), perineural invasion (p=0.008), extracapsular spread (p=0.009), higher T-stage (p=0.0015) and distant metastasis (p<0.001). In addition, nuclear MYOF expression was directly associated with IL-6 (p<0.001) and inversely with HPV status (p=0.0014). In a subgroup survival analysis, MYOF nuclear+/IL-6+ group had worst survival (84.6% mortality), whereas MYOF nuclear-/IL-6- had the best survival. Similarly, patients with HPV-negative/MYOF-positive tumors had worse survival compared to HPV-positive/MYOF-negative. Taken together, our results demonstrate for the first time that nuclear myoferlin expression independently predicts poor clinical outcome in OPSCC patients.
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Affiliation(s)
- Bhavna Kumar
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Nicole V Brown
- Center for Biostatistics, The Ohio State University, Columbus, OH 43210, USA
| | - Benjamin J Swanson
- Department of Pathology, The Ohio State University, Columbus, OH 43210, USA
| | - Alessandra C Schmitt
- Department of Pathology, The Ohio State University, Columbus, OH 43210, USA.,Current affiliation: Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30303, USA
| | - Matthew Old
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Enver Ozer
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Amit Agrawal
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - David E Schuller
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Theodoros N Teknos
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Pawan Kumar
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH 43210, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
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118
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Affolter A, Samosny G, Heimes AS, Schneider J, Weichert W, Stenzinger A, Sommer K, Jensen A, Mayer A, Brenner W, Mann WJ, Brieger J. Multikinase inhibitors sorafenib and sunitinib as radiosensitizers in head and neck cancer cell lines. Head Neck 2017; 39:623-632. [DOI: 10.1002/hed.24557] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 05/27/2016] [Accepted: 06/24/2016] [Indexed: 12/16/2022] Open
Affiliation(s)
- Annette Affolter
- Department of Otorhinolaryngology, Head and Neck Surgery; University Medical Center of the Johannes Gutenberg University; Mainz Germany
- Institute of Pathology; University Medical Center of the Johannes Gutenberg University; Mainz Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, Experimental Head and Neck Oncology; Heidelberg University Hospital; Heidelberg Germany
| | - Gerson Samosny
- Department of Otorhinolaryngology, Head and Neck Surgery; University Medical Center of the Johannes Gutenberg University; Mainz Germany
| | - Anne-Sophie Heimes
- Department of Otorhinolaryngology, Head and Neck Surgery; University Medical Center of the Johannes Gutenberg University; Mainz Germany
| | - Johanna Schneider
- Department of Otorhinolaryngology, Head and Neck Surgery; University Medical Center of the Johannes Gutenberg University; Mainz Germany
| | - Wilko Weichert
- Institute of Pathology; University Medical Center of the Johannes Gutenberg University; Mainz Germany
- Institute of Pathology; Technical University Munich (TUM); Munich Germany
| | - Albrecht Stenzinger
- Institute of Pathology; University Medical Center of the Johannes Gutenberg University; Mainz Germany
| | - Katharina Sommer
- Institute of Pathology; University Medical Center of the Johannes Gutenberg University; Mainz Germany
| | - Alexandra Jensen
- Department of Radiation Oncology; Heidelberg University Hospital; Heidelberg Germany
| | - Arnulf Mayer
- Department of Radiooncology and Radiotherapy; University Medical Center of the Johannes Gutenberg University; Mainz Germany
| | - Walburgis Brenner
- Department of Urology; University Medical Center of the Johannes Gutenberg University; Mainz Germany
| | - Wolf J. Mann
- Department of Otorhinolaryngology, Head and Neck Surgery; University Medical Center of the Johannes Gutenberg University; Mainz Germany
| | - Jürgen Brieger
- Department of Otorhinolaryngology, Head and Neck Surgery; University Medical Center of the Johannes Gutenberg University; Mainz Germany
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Kaka AS, Nowacki NB, Kumar B, Zhao S, Old MO, Agrawal A, Ozer E, Carrau RL, Schuller DE, Kumar P, Teknos TN. Notch1 Overexpression Correlates to Improved Survival in Cancer of the Oropharynx. Otolaryngol Head Neck Surg 2017; 156:652-659. [PMID: 28195818 DOI: 10.1177/0194599816688178] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objectives The Notch1 signaling pathway has recently been shown to be highly dysregulated in head and neck squamous cell carcinoma, but the value of Notch1 as a predictive biomarker is yet to be elucidated in oropharyngeal squamous cell carcinoma (OPSCC). The objective of this study is to evaluate Notch1 expression in surgical OPSCC specimens and determine clinicopathologic correlates. Study Design Case series with planned data collection. Setting Tertiary academic medical center. Subjects and Methods Surgical specimens from 181 patients with OPSCC were collected to create a tissue microarray (TMA). Human papillomavirus (HPV) status and Notch1 expression were determined and correlated with clinicopathologic characteristics. Results In univariate analysis, Notch1 expression correlated with improved survival as a categorical variable (hazard ratio [HR], 0.346; P < .0001) and correlated with HPV/p16 positivity as a continuous variable ( P < .0001). In multivariate analysis, Notch1 expression retained significance in HPV-positive (HR, 0.303; P = .033) and HPV-negative (HR, 0.416; P = .0055) subgroups. Similarly, Notch1 expression positively correlated with survival in p16-positive (HR, 0.469; P = .031) and p16-negative subgroups (HR, 0.310; P = .014). Conclusions In the largest OPSCC cohort to date, we found that Notch1 receptor expression positively correlates with overall survival, regardless of HPV or p16 status. Furthermore, we found higher Notch1 receptor expression in HPV/p16-positive tumors than their HPV/p16-negative counterparts.
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Affiliation(s)
- Azeem S Kaka
- 1 Department of Otolaryngology, Division of Head and Neck Surgery and The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Nicholas B Nowacki
- 2 Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Bhavna Kumar
- 1 Department of Otolaryngology, Division of Head and Neck Surgery and The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Songzhu Zhao
- 3 Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Matthew O Old
- 1 Department of Otolaryngology, Division of Head and Neck Surgery and The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Amit Agrawal
- 1 Department of Otolaryngology, Division of Head and Neck Surgery and The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Enver Ozer
- 1 Department of Otolaryngology, Division of Head and Neck Surgery and The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Ricardo L Carrau
- 1 Department of Otolaryngology, Division of Head and Neck Surgery and The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - David E Schuller
- 1 Department of Otolaryngology, Division of Head and Neck Surgery and The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Pawan Kumar
- 1 Department of Otolaryngology, Division of Head and Neck Surgery and The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Theodoros N Teknos
- 1 Department of Otolaryngology, Division of Head and Neck Surgery and The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Chen SW, Shen WC, Lin YC, Chen RY, Hsieh TC, Yen KY, Kao CH. Correlation of pretreatment 18F-FDG PET tumor textural features with gene expression in pharyngeal cancer and implications for radiotherapy-based treatment outcomes. Eur J Nucl Med Mol Imaging 2016; 44:567-580. [PMID: 27999896 DOI: 10.1007/s00259-016-3580-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 11/18/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE This study investigated the correlation of the matrix heterogeneity of tumors on 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) with gene-expression profiling in patients with pharyngeal cancer and determined the prognostic factors for radiotherapy-based treatment outcomes. METHODS We retrospectively reviewed the records of 57 patients with stage III-IV oropharyngeal or hypopharyngeal cancer who had completed definitive therapy. Four groups of the textural features as well as 31 indices were studied in addition to maximum standard uptake value, metastatic tumor volume, and total lesion glycolysis. Immunohistochemical data from pretreatment biopsy specimens (Glut1, CAIX, VEGF, HIF-1α, EGFR, Ki-67, Bcl-2, CLAUDIN-4, YAP-1, c-Met, and p16) were analyzed. The relationships between the indices and genomic expression were studied, and the robustness of various textural features relative to cause-specific survival and primary relapse-free survival was analyzed. RESULTS The overexpression of VEGF was positively associated with the increased values of the matrix heterogeneity obtained using gray-level nonuniformity for zone (GLNUz) and run-length nonuniformity (RLNU). Advanced T stage (p = 0.01, hazard ratio [HR] = 3.38), a VEGF immunoreactive score of >2 (p = 0.03, HR = 2.79), and a higher GLNUz value (p = 0.04, HR = 2.51) were prognostic factors for low cause-specific survival, whereas advanced T stage, a HIF-1α staining percentage of ≥80%, and a higher GLNUz value were prognostic factors for low primary-relapse free survival. CONCLUSIONS The overexpression of VEGF was associated with the increased matrix index of GLNUz and RLNU. For patients with pharyngeal cancer requiring radiotherapy, the treatment outcome can be stratified according to the textural features, T stage, and biomarkers.
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Affiliation(s)
- Shang-Wen Chen
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, China Medical University, Taichung, Taiwan.,School of Medicine, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 40447, Taiwan
| | - Wei-Chih Shen
- Cancer Center and Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Department of Computer Science and Information Engineering, Asia University, Taichung, Taiwan
| | - Ying-Chun Lin
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,The Ph.D. Program for Cancer Biology and Drug Discovery, China Medical University and Academia Sinica, Taichung, Taiwan
| | - Rui-Yun Chen
- Department of Pathology, China Medical University Hospital, Taichung, Taiwan
| | - Te-Chun Hsieh
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.,Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Kuo-Yang Yen
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.,Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 40447, Taiwan. .,Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. .,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
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Gupta S, Kushwaha VS, Verma S, Khan H, Bhatt MLB, Husain N, Negi MPS, Bhosale VV, Ghatak A. Understanding molecular markers in recurrent oral squamous cell carcinoma treated with chemoradiation. Heliyon 2016; 2:e00206. [PMID: 27981249 PMCID: PMC5148783 DOI: 10.1016/j.heliyon.2016.e00206] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 11/04/2016] [Accepted: 11/24/2016] [Indexed: 01/02/2023] Open
Abstract
Introduction Oral cancer accounts for approximately 2.1% of all cancers worldwide. In India, oral squamous cell carcinoma (OSCC) is the most common cancer with half a million new cases diagnosed every year. More than 50% of patients eventually develop local recurrence or metastasis usually within the first 2-years following completion of treatment. It is beneficial to analyze the prognostic significance of Cyclin D1, p53 and EGFR which are critical mediators in the pathogenesis of OSCC. The objective of this study was to assess the association of expression of these markers with recurrence and pattern of recurrence in OSCC patients undergoing chemoradiation. Materials and Methods A Total 290 OSCC cases of locally advanced stage (III, IV) oral cancer with World Health Organization (W.H.O.) performance status of grade 0/1 in the year 2009–2012 were enrolled in the study. Treatment response was assessed according to W.H.O. criteria. Cyclin D1, EGFR and p53 expression in tumor tissue was estimated by immunohistochemical (IHC) method and quantified as percentage positive nuclei. Results During the 2-years follow up, 56 (19.3%) patients recurred, out of which, 47 (83.9%) were locoregional and 9 (16.1%) distant sites. On correlating, χ2 test showed significant (P < 0.05 or P < 0.01 or P < 0.001) association of marker expressions (Cyclin D1, EGFR and p53) with recurrence. The strong positive expressions of all three markers showed significant association with early time of recurrence. The multivariate logistic regression analysis showed significant (P < 0.05 or P < 0.01 or P < 0.001) association of recurrence with primary site, differentiation, Cyclin D1 and p53 expressions indicating these as an independent predictors of recurrence in OSCC. The Cyclin D1, EGFR and p53 expressions also showed significant (P < 0.001) poor survivals (OS, DFS and RFS) in patients with positive/strong positive expressions than negative expression suggesting their prognosis in OSCC. Conclusion Our results signifies that tumors over expressing Cyclin D1, EGFR and p53 are resistant to chemoradiation and are associated with increased risk of locoregional recurrence and metastasis in OSCC patients undergoing chemoradiation.
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Affiliation(s)
- Seema Gupta
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Vandana Singh Kushwaha
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sandeep Verma
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Huma Khan
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - M L B Bhatt
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Nuzhat Husain
- Department of Pathology, RMLIMS, Lucknow, Uttar Pradesh, India
| | - Mahendra Pal Singh Negi
- Clinical and Experimental Medicine Division, CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India
| | - Vivek Vidyadhar Bhosale
- Clinical and Experimental Medicine Division, CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India
| | - Ashim Ghatak
- Clinical and Experimental Medicine Division, CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India
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Walline HM, Carey TE, Goudsmit CM, Bellile EL, D'Souza G, Peterson LA, McHugh JB, Pai SI, Lee JJ, Shin DM, Ferris RL. High-Risk HPV, Biomarkers, and Outcome in Matched Cohorts of Head and Neck Cancer Patients Positive and Negative for HIV. Mol Cancer Res 2016; 15:179-188. [PMID: 27899422 DOI: 10.1158/1541-7786.mcr-16-0255] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 09/28/2016] [Accepted: 11/07/2016] [Indexed: 01/27/2023]
Abstract
In this study, high-risk HPV (hrHPV) incidence, prognostic biomarkers, and outcome were assessed in HIV-positive (case) and HIV-negative (control) patients with head and neck squamous cell cancer (HNSCC). HIV-positive cases were matched to controls by tumor site, sex, and age at cancer diagnosis. A tissue microarray (TMA) was constructed and DNA isolated from tumor tissue. MultiPlex-PCR MassArray, L1-PCR, and in situ hybridization were used to assess hrHPV. TMA sections were stained for p16ink4a, TP53, RB, CCND1, EGFR, and scored for intensity and proportion of positive tumor cells. The HNSCC cohort included 41 HIV-positive cases and 41 HIV-negative controls. Tumors from 11 of 40 (28%) cases, and 10 of 41 (24%) controls contained hrHPV. p16 expression, indicative of E7 oncogene activity, was present in 10 of 11 HPV-positive cases and 7 of 10 HPV-positive controls. Low p16 and high TP53 expression in some HPV-positive tumors suggested HPV-independent tumorigenesis. Survival did not differ in cases and controls. RB expression was significantly associated with poor survival (P = 0.01). High TP53 expression exhibited a trend for poorer survival (P = 0.12), but among cases, association with poor survival reached statistical significance (P = 0.04). The proportion of HPV-positive tumors was similar, but the heterogeneity of HPV types was higher in the HIV-positive cases than in HIV-negative controls. High RB expression predicted poor survival, and high TP53 expression was associated with poorer survival in the HIV-positive cases but not HIV-negative controls. IMPLICATIONS HIV infection did not increase risk of death from HNSCC, and HPV-positive tumors continued to be associated with a significantly improved survival, independent of HIV status. Mol Cancer Res; 15(2); 179-88. ©2016 AACR.
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Affiliation(s)
- Heather M Walline
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan.,Cancer Biology Training Program, University of Michigan, Ann Arbor, Michigan
| | - Thomas E Carey
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan.
| | - Christine M Goudsmit
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Emily L Bellile
- Biostatistics Core, Comprehensive Cancer Center, University of Michigan, Ann Arbor, Michigan
| | - Gypsyamber D'Souza
- Department of Epidemiology, School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Lisa A Peterson
- Head and Neck SPORE, University of Michigan Cancer Center, Ann Arbor, Michigan
| | - Jonathan B McHugh
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Sara I Pai
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland
| | - J Jack Lee
- Department of Biostatistics, MD Anderson Cancer Center, Houston, Texas
| | - Dong M Shin
- Department of Medicine, Medical Oncology Winship Cancer Center, Emory University, Atlanta, Georgia
| | - Robert L Ferris
- Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
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Spector ME, Sacco AG, Bellile E, Taylor JMG, Jones T, Sun K, Brown WC, Birkeland AC, Bradford CR, Wolf GT, Prince ME, Moyer JS, Malloy K, Swiecicki P, Eisbruch A, McHugh JB, Chepeha DB, Rozek L, Worden FP. E6 and E7 Antibody Levels Are Potential Biomarkers of Recurrence in Patients with Advanced-Stage Human Papillomavirus-Positive Oropharyngeal Squamous Cell Carcinoma. Clin Cancer Res 2016; 23:2723-2729. [PMID: 27872102 DOI: 10.1158/1078-0432.ccr-16-1617] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Revised: 10/10/2016] [Accepted: 10/31/2016] [Indexed: 11/16/2022]
Abstract
Purpose: There is a paucity of biomarkers to predict failure in human papillomavirus-positive (HPV+) oropharyngeal squamous cell carcinoma (OPSCC) following curative therapy. E6/E7 viral oncoproteins are constitutively expressed in HPV+ tumors and highly immunogenic, resulting in readily detected serum antibodies. The purpose of this study is to determine whether serum E6 and E7 antibody levels can potentially serve as a biomarker of recurrence in patients with HPV+OPSCC.Experimental Design: We evaluated E6/E7 antibody levels in patients with previously untreated, advanced stage (III, IVa-b), HPV+OPSCC receiving definitive chemoradiation under a uniform protocol from 2003 to 2010. Baseline and longitudinal serum samples were obtained from our archived repository. E6/E7 serum levels were measured using a glutathione-S-transferase capture ELISA and quantified by approximating the area under the dilution curve, and were analyzed using ANOVA and linear mixed model for longitudinal analysis.Results: We compared 22 HPV+OPSCC patients who developed recurrence with 30 patients who remained disease-free. There were no differences in T classification, N classification, disease subsite, or smoking status between the groups. In a longitudinal analysis, recurrent patients had significantly higher E6 and E7 serum antibody levels than the nonrecurrent patients over the follow-up period (P = 0.02 and P = 0.002, respectively). Patients who recurred had a lower clearance of E7 antibody than patients who remained disease-free (P = 0.0016).Conclusions: Patients with HPV+OPSCC whose disease recurs have a lower clearance of E6 and E7 antibodies than patients who do not have recurrence. The ratio of E7 antibody at disease recurrence compared with baseline is potentially a clinically significant measurement of disease status in HPV+OPSCC. Clin Cancer Res; 23(11); 2723-9. ©2016 AACR.
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MESH Headings
- Adult
- Aged
- Antibodies, Viral/blood
- Antibodies, Viral/immunology
- Biomarkers, Tumor/blood
- Biomarkers, Tumor/immunology
- Carcinoma, Squamous Cell/blood
- Carcinoma, Squamous Cell/immunology
- Carcinoma, Squamous Cell/pathology
- Enzyme-Linked Immunosorbent Assay
- Female
- Humans
- Male
- Middle Aged
- Neoplasm Recurrence, Local/blood
- Neoplasm Recurrence, Local/immunology
- Oncogene Proteins, Viral/blood
- Oncogene Proteins, Viral/immunology
- Oropharyngeal Neoplasms/blood
- Oropharyngeal Neoplasms/immunology
- Oropharyngeal Neoplasms/pathology
- Papillomaviridae/immunology
- Papillomavirus E7 Proteins/blood
- Papillomavirus E7 Proteins/immunology
- Papillomavirus Infections/blood
- Papillomavirus Infections/immunology
- Repressor Proteins/blood
- Repressor Proteins/immunology
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Affiliation(s)
- Matthew E Spector
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan.
| | - Assuntina G Sacco
- Moores Cancer Center, University of California at San Diego, La Jolla, California
| | - Emily Bellile
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Jeremy M G Taylor
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Tamara Jones
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Kan Sun
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
| | - William C Brown
- University of Michigan High-throughput Protein Laboratory, Center for Structural Biology, Life Sciences Institute, Ann Arbor, Michigan
| | | | - Carol R Bradford
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Gregory T Wolf
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Mark E Prince
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Jeffrey S Moyer
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Kelly Malloy
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Paul Swiecicki
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Avraham Eisbruch
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Jonathan B McHugh
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Douglas B Chepeha
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
- University of Toronto, Toronto, Ontario, Canada
| | - Laura Rozek
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
| | - Francis P Worden
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan
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Lin YC, Chen RY, Chen SW, Hsieh TC, Yen KY, Liang JA, Yang SN, Wang YC, Chen YH, Chow NH, Kao CH. Immunohistochemical studies and fluorodeoxyglucose uptake on positron emission tomography in pharyngeal cancer for predicting radiotherapy-based treatment outcomes. Clin Otolaryngol 2016; 42:608-619. [PMID: 27762071 DOI: 10.1111/coa.12783] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Y.-C. Lin
- Department of Radiation Oncology; China Medical University Hospital; Taichung Taiwan
- The Ph.D. Program for Cancer Biology and Drug Discovery; China Medical University and Academia Sinica; Taipei Taiwan
| | - R.-Y. Chen
- Department of Pathology; China Medical University Hospital; Taichung Taiwan
| | - S.-W. Chen
- Department of Radiation Oncology; China Medical University Hospital; Taichung Taiwan
- Graduate Institute of Clinical Medical Science; School of Medicine; College of Medicine; China Medical University; Taichung Taiwan
- School of Medicine; Taipei Medical University; Taipei Taiwan
| | - T.-C. Hsieh
- Department of Nuclear Medicine and PET Center; China Medical University Hospital; Taichung Taiwan
- Department of Biomedical Imaging and Radiological Science; China Medical University; Taichung Taiwan
| | - K.-Y. Yen
- Department of Nuclear Medicine and PET Center; China Medical University Hospital; Taichung Taiwan
- Department of Biomedical Imaging and Radiological Science; China Medical University; Taichung Taiwan
| | - J.-A. Liang
- Department of Radiation Oncology; China Medical University Hospital; Taichung Taiwan
- Graduate Institute of Clinical Medical Science; School of Medicine; College of Medicine; China Medical University; Taichung Taiwan
| | - S.-N. Yang
- Department of Radiation Oncology; China Medical University Hospital; Taichung Taiwan
- Department of Biomedical Imaging and Radiological Science; China Medical University; Taichung Taiwan
| | - Y.-C. Wang
- Department of Radiation Oncology; China Medical University Hospital; Taichung Taiwan
| | - Y.-H. Chen
- Graduate Institute of Cancer Biology; China Medical University; Taichung Taiwan
- Center for Molecular Medicine; China Medical University Hospital; Taichung Taiwan
| | - N.-H. Chow
- Department of Pathology; National Cheng Kung University; Tainan Taiwan
| | - C.-H. Kao
- Graduate Institute of Clinical Medical Science; School of Medicine; College of Medicine; China Medical University; Taichung Taiwan
- Department of Nuclear Medicine and PET Center; China Medical University Hospital; Taichung Taiwan
- Department of Bioinformatics and Medical Engineering; Asia University; Taichung Taiwan
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Chen SW, Lin YC, Chen RY, Hsieh TC, Yen KY, Liang JA, Yang SN, Wang YC, Chen YH, Chow NH, Kao CH. Immunohistochemical overexpression of hypoxia-induced factor 1α associated with slow reduction in 18fluoro-2-deoxy-D-glucose uptake for chemoradiotherapy in patients with pharyngeal cancer. Eur J Nucl Med Mol Imaging 2016; 43:2343-2352. [PMID: 27311919 DOI: 10.1007/s00259-016-3436-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/02/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND This study examined genomic factors associated with a reduction in 18fluoro-2-deoxy-D-glucose (FDG) uptake during positron emission tomography-computed tomography (PET-CT) for definitive chemoradiotherapy (CRT) in patients with pharyngeal cancer. METHODS The pretreatment and interim PET-CT images of 25 patients with advanced pharyngeal cancers receiving definitive CRT were prospectively evaluated. The maximum standardized uptake value (SUVmax) of the interim PET-CT and the reduction ratio of the SUVmax (SRR) between the two images were measured. Genomic data from pretreatment incisional biopsy specimens (SLC2A1, CAIX, VEGF, HIF1A, BCL2, Claudin-4, YAP1, MET, MKI67, and EGFR) were analyzed using tissue microarrays. Differences in FDG uptake and SRRs between tumors with low and high gene expression were examined using the Mann-Whitney test. Cox regression analysis was performed to examine the effects of variables on local control. RESULTS The SRR of the primary tumors (SRR-P) was 0.59 ± 0.31, whereas the SRR of metastatic lymph nodes (SRR-N) was 0.54 ± 0.32. Overexpression of HIF1A was associated with a high iSUVmax of the primary tumor (P < 0.001) and neck lymph node (P = 0.04) and a low SRR-P (P = 0.02). Multivariate analysis revealed that patients who had tumors with low SRR-P or high HIF1A expression levels showed inferior local control. CONCLUSION In patients with pharyngeal cancer requiring CRT, HIF1A overexpression was positively associated with high interim SUVmax or a slow reduction in FDG uptake. Prospective trials are needed to determine whether the local control rate can be stratified using the HIF1A level as a biomarker and SRR-P.
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Affiliation(s)
- Shang-Wen Chen
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, China Medical University, Taichung, Taiwan.,School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ying-Chun Lin
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,The Ph.D. Program for Cancer Biology and Drug Discovery, China Medical University and Academia Sinica, Taichung, Taiwan
| | - Rui-Yun Chen
- Department of Pathology, China Medical University Hospital, Taichung, Taiwan
| | - Te-Chun Hsieh
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.,Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Kuo-Yang Yen
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.,Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Ji-An Liang
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 40447, Taiwan
| | - Shih-Neng Yang
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Yao-Ching Wang
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Ya-Huey Chen
- Graduate Institute of Cancer Biology, China Medical University, Taichung, Taiwan.,Center for Molecular Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Nan-Haw Chow
- Department of Pathology, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Hung Kao
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. .,Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 40447, Taiwan.
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Guo L, Liu S, Zhang S, Chen Q, Zhang M, Quan P, Sun XB. Human papillomavirus-related esophageal cancer survival: A systematic review and meta-analysis. Medicine (Baltimore) 2016; 95:e5318. [PMID: 27861358 PMCID: PMC5120915 DOI: 10.1097/md.0000000000005318] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) has been identified to be related to progression of esophageal cancer. However, the results remain controversial. A meta-analysis of epidemiologic studies was therefore conducted to address this issue. METHODS The electronic databases of MEDLINE and Excerpta Medica database were searched till April 30, 2016. Study-specific risk estimates were pooled using a random-effects model. RESULTS Ten studies involving a total of 1184 esophageal cancer cases were included in this meta-analysis. The pooled hazard ratio comparing HPV-positive to HPV-negative esophageal cancers was 1.03 (95% confidence interval 0.78-1.37), which was not significantly correlated with improved survival. However, HPV-16-positive patients might have a significantly favorable survival (hazard ratio 0.73, 95% confidence interval 0.44-1.21). CONCLUSION The meta-analysis indicated that HPV infection may not be of prognostic utility in the evaluation of factors contributing to esophageal cancer. Further large prospective studies are encouraged to stratify survival analysis by HPV type.
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Subgroup Analysis According to Human Papillomavirus Status and Tumor Site of a Randomized Phase II Trial Comparing Cetuximab and Cisplatin Combined With Radiation Therapy for Locally Advanced Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2016; 97:462-472. [PMID: 27986347 DOI: 10.1016/j.ijrobp.2016.10.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 10/04/2016] [Accepted: 10/12/2016] [Indexed: 11/23/2022]
Abstract
PURPOSE We report a subgroup analysis primarily focused on human papillomavirus (HPV)-related oropharyngeal cancer (OPC) from the Cetuximab Plus Radiotherapy Versus Cisplatin Plus Radiotherapy in Locally Advanced Head and Neck Cancer (CTXMAB+RT; ClinicalTrials.gov identifier NCT01216020) trial comparing radiation therapy with concomitant cisplatin (CDDP) versus concomitant cetuximab (CTX) as first-line treatment of locally advanced head and neck cancer. METHODS AND MATERIALS The data from all the patients in the CTXMAB+RT trial were reviewed and separately analyzed in 3 groups: p16-positive OPC, p16-negative OPC, and all other cancer sites. The endpoints of interest were locoregional control (LC), metastasis-free survival, cancer-specific survival (CSS), and overall survival (OS). Severe and fatal infectious complications were also reanalyzed to more thoroughly investigate the association between CTX treatment and potentially life-threatening reactions. RESULTS A total of 33 patients had OPC. The HPV status was available for 30 of the 33 patients. Thus, 3 patients treated with CDDP but with unknown HPV status were excluded from the survival analysis. The small number of patients in each group did not allow for significance to be reached for any of the outcomes analyzed. A trend favored the CDDP arm in the p16-positive group for the 2-year LC and OS/CSS rates (100% vs 72.9% and 100% vs 77.8% for CDDP vs CTX). In this group of patients, the hazard ratio for the treatment arm (CTX vs CDDP) was 4.7 (95% confidence interval [CI] 0.5-40.3) for LC, 3.4 (95% CI 0.4-30.5) for OS, and 2.4 for CSS (95% CI 0.2-23.2). A survival benefit favoring the CDDP arm was not evident in the p16-negative OPC group or for patients with cancer located in other sites. Serious or fatal infectious complications occurred only in the CTX arm. CONCLUSIONS In patients with p16-positive OPC in the CTXMAB+RT trial, CTX had lower efficacy than CDDP, with possible implications for treatment selection in this clinical setting.
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Mena E, Thippsandra S, Yanamadala A, Redy S, Pattanayak P, Subramaniam RM. Molecular Imaging and Precision Medicine in Head and Neck Cancer. PET Clin 2016; 12:7-25. [PMID: 27863568 DOI: 10.1016/j.cpet.2016.08.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The concept of using tumor genomic profiling information has revolutionized personalized cancer treatment. Head and neck (HN) cancer management is being influenced by recent discoveries of activating mutations in epidermal growth factor receptor and related targeted therapies with tyrosine kinase inhibitors, targeted therapies for Kristen Rat Sarcoma, and MET proto-oncogenes. Molecular imaging using PET plays an important role in assessing the biologic behavior of HN cancer with the goal of delivering individualized cancer treatment. This review summarizes recent genomic discoveries in HN cancer and their implications for functional PET imaging in assessing response to targeted therapies, and drug resistance mechanisms.
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Affiliation(s)
- Esther Mena
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD 21287, USA
| | - Shwetha Thippsandra
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD 21287, USA
| | - Anusha Yanamadala
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD 21287, USA
| | - Siddaling Redy
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD 21287, USA
| | - Puskar Pattanayak
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD 21287, USA
| | - Rathan M Subramaniam
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD 21287, USA; Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8896, USA; Department of Clinical Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9096, USA; Department of Biomedical Engineering, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390-8896, USA; Advanced Imaging Research Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390-8896, USA.
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Ramer I, Varier I, Zhang D, Demicco EG, Posner MR, Misiukiewicz K, Genden EM, Miles BA, Teng MS, Sikora AG. Racial disparities in incidence of human papillomavirus-associated oropharyngeal cancer in an urban population. Cancer Epidemiol 2016; 44:91-95. [DOI: 10.1016/j.canep.2016.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 06/03/2016] [Accepted: 07/06/2016] [Indexed: 10/21/2022]
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Aggarwal C. DNA-based immunotherapy for HPV-associated head and neck cancer. Immunotherapy 2016; 8:1187-92. [DOI: 10.2217/imt-2016-0055] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Squamous cell carcinoma of the head and neck (SCCHN) accounts for 3% of all cancers. Most patients present with locally advanced disease, where multimodality therapies are used with curative intent. Despite favorable early local treatment results, about one third of the patients will eventually develop metastatic disease. Immunotherapy offers a novel therapeutic strategy beyond cytotoxic chemotherapy, with initial approvals in melanoma and non-small-cell lung cancer. HPV-associated SCCHN is a distinct subset, with unique epidemiology and treatment outcomes. Both subsets of SCCHN (HPV-related or not) are particularly favorable for immunotherapy, as immune evasion and dysregulation have been shown to play a key role in the initiation and progression of disease. This review focuses on the latest developments in immunotherapy in SCCHN, with a particular focus on DNA-based approaches including vaccine and adoptive cellular therapies.
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Affiliation(s)
- Charu Aggarwal
- Assistant Professor, University of Pennsylvania, Department of Medicine, Hematology–Oncology Division, 624 South Pavilion, Perelman Center for Advanced Medicine, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA
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Moore SJ, Rashidipour O, Moore RB. Primary Metastatic Squamous Cell Carcinoma of the Male Urethra Presenting with Scrotal Abscess and Subsequent Development of Fournier's Gangrene. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2016; 9:83-86. [PMID: 27721660 PMCID: PMC5045045 DOI: 10.4137/ccrep.s40420] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/18/2016] [Accepted: 08/19/2016] [Indexed: 11/05/2022]
Abstract
This male patient presented with a scrotal abscess and urinary obstruction. The patient's history included a perineal abscess and the development of urethrocutaneous fistulae (watering-can perineum). He underwent multiple debridement procedures without resolution. During the fifth debridement for Fournier's gangrene, a biopsy revealed invasive squamous cell carcinoma. The patient was bedridden because of the large mass, a wide en bloc resection with lymphadenectomy and reconstruction was performed revealing a large (22 cm) squamous cell carcinoma originating from the urethra. He also received palliative chemoradiotherapy and hip hemiarthroplasty. Unfortunately, he succumbed to the disease. Given the recognized relationship between inflammation and the development of cancer, it is important to entertain a differential diagnosis of cancer, especially with erosive infections. This case report highlights the all too common late presentation of urethral cancer. Interestingly, despite correction of the bedridden state with palliative surgery, the patient did not perceive an improvement in quality of life based on the FACT-G questionnaire.
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Affiliation(s)
- Sarah J Moore
- Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Omid Rashidipour
- Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Ronald B Moore
- Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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Chaturvedi AK, D’Souza G, Gillison ML, Katki HA. Burden of HPV-positive oropharynx cancers among ever and never smokers in the U.S. population. Oral Oncol 2016; 60:61-7. [DOI: 10.1016/j.oraloncology.2016.06.006] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 05/07/2016] [Accepted: 06/08/2016] [Indexed: 12/11/2022]
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Michmerhuizen NL, Birkeland AC, Bradford CR, Brenner JC. Genetic determinants in head and neck squamous cell carcinoma and their influence on global personalized medicine. Genes Cancer 2016; 7:182-200. [PMID: 27551333 PMCID: PMC4979591 DOI: 10.18632/genesandcancer.110] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
While sequencing studies have provided an improved understanding of the genetic landscape of head and neck squamous cell carcinomas (HNSCC), there remains a significant lack of genetic data derived from non-Caucasian cohorts. Additionally, there is wide variation in HNSCC incidence and mortality worldwide both between and within various geographic regions. These epidemiologic differences are in part accounted for by varying exposure to environmental risk factors such as tobacco, alcohol, high risk human papilloma viruses and betel quid. However, inherent genetic factors may also play an important role in this variability. As limited sequencing data is available for many populations, the involvement of unique genetic factors in HNSCC pathogenesis from epidemiologically diverse groups is unknown. Here, we review current knowledge about the epidemiologic, environmental, and genetic variation in HNSCC cohorts globally and discuss future studies necessary to further our understanding of these differences. Long-term, a more complete understanding of the genetic drivers found in diverse HNSCC cohorts may help the development of personalized medicine protocols for patients with rare or complex genetic events.
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Affiliation(s)
- Nicole L Michmerhuizen
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Pharmacology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Andrew C Birkeland
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Carol R Bradford
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, USA; Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI, USA
| | - J Chad Brenner
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, USA; Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor, MI, USA
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Mikami S, Ota I, Masui T, Itaya-Hironaka A, Shobatake R, Okamoto H, Takasawa S, Kitahara T. Effect of resveratrol on cancer progression through the REG Ⅲ expression pathway in head and neck cancer cells. Int J Oncol 2016; 49:1553-1560. [PMID: 27633858 DOI: 10.3892/ijo.2016.3664] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 08/12/2016] [Indexed: 11/05/2022] Open
Abstract
Identification of reliable markers of chemo- and radiosensitivity and the key molecules that enhance the susceptibility of head and neck squamous cell carcinoma (HNSCC) to anticancer treatments is highly desirable. Previously, we have reported that regenerating gene (REG) Ⅲ expression was such a marker associated with an improved survival rate for HNSCC patients. In the present study, we investigated the stimulators for induction of REG Ⅲ expression using REG Ⅲ promoter assay in HNSCC cells transfected with REG Ⅲ promoter vector. We tested inflammatory cytokines, growth factors, polyphenols, PPARγ activator of thiazolidinediones, and histone deacetylase inhibitors, and found that 3,4',5-trihydroxy-trans-stilbene (resveratrol) significantly increased the REG Ⅲ promoter activity and the mRNA levels of REG Ⅲ in HNSCC cells. Moreover, we demonstrated the effect of resveratrol on cancer cell progression, such as cell proliferation, chemo‑ and radiosensitivity and cancer invasion of HNSCC cells. Resveratrol significantly inhibited cell growth, enhanced chemo‑ and radiosensitivity, and blocked cancer invasion of HNSCC cells. These data suggested that resveratrol could inhibit cancer progression through the REG Ⅲ expression pathway in HNSCC cells.
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Affiliation(s)
- Shinji Mikami
- Department of Otolaryngology‑Head and Neck Surgery, Nara Medical University, Kashihara, Nara 634‑8522, Japan
| | - Ichiro Ota
- Department of Otolaryngology‑Head and Neck Surgery, Nara Medical University, Kashihara, Nara 634‑8522, Japan
| | - Takashi Masui
- Department of Otolaryngology‑Head and Neck Surgery, Nara Medical University, Kashihara, Nara 634‑8522, Japan
| | - Asako Itaya-Hironaka
- Department of Biochemistry, Nara Medical University, Kashihara, Nara 634‑8522, Japan
| | - Ryogo Shobatake
- Department of Biochemistry, Nara Medical University, Kashihara, Nara 634‑8522, Japan
| | - Hideyuki Okamoto
- Department of Otolaryngology, Nara City Hospital, Nara 630‑8305, Japan
| | - Shin Takasawa
- Department of Biochemistry, Nara Medical University, Kashihara, Nara 634‑8522, Japan
| | - Tadashi Kitahara
- Department of Otolaryngology‑Head and Neck Surgery, Nara Medical University, Kashihara, Nara 634‑8522, Japan
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Choi SH, Terrell JE, Bradford CR, Ghanem T, Spector ME, Wolf GT, Lipkus IM, Duffy SA. Does Quitting Smoking Make a Difference Among Newly Diagnosed Head and Neck Cancer Patients? Nicotine Tob Res 2016; 18:2216-2224. [PMID: 27613928 DOI: 10.1093/ntr/ntw189] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 07/18/2016] [Indexed: 12/18/2022]
Abstract
INTRODUCTION To determine if smoking after a cancer diagnosis makes a difference in mortality among newly diagnosed head and neck cancer patients. METHODS Longitudinal data were collected from newly diagnosed head and neck cancer patients with a median follow-up time of 1627 days (N = 590). Mortality was censored at 8 years or September 1, 2011, whichever came first. Based on smoking status, all patients were categorized into four groups: continuing smokers, quitters, former smokers, or never-smokers. A broad range of covariates were included in the analyses. Kaplan-Meier curves, bivariate and multivariate Cox proportional hazards models were constructed. RESULTS Eight-year overall mortality and cancer-specific mortality were 40.5% (239/590) and 25.4% (150/590), respectively. Smoking status after a cancer diagnosis predicted overall mortality and cancer-specific mortality. Compared to never-smokers, continuing smokers had the highest hazard ratio (HR) of dying from all causes (HR = 2.71, 95% confidence interval [CI] = 1.48-4.98). Those who smoked at diagnosis, but quit and did not relapse-quitters-had an improved hazard ratio of dying (HR = 2.38, 95% CI = 1.29-4.36) and former smokers at diagnosis with no relapse after diagnosis-former smokers-had the lowest hazard ratio of dying from all causes (HR = 1.68, 95% CI = 1.12-2.56). Similarly, quitters had a slightly higher hazard ratio of dying from cancer-specific reasons (HR = 2.38, 95% CI = 1.13-5.01) than never-smokers, which was similar to current smokers (HR = 2.07, 95% CI = 0.96-4.47), followed by former smokers (HR = 1.70, 95% CI = 1.00-2.89). CONCLUSIONS Compared to never-smokers, continuing smokers have the highest HR of overall mortality followed by quitters and former smokers, which indicates that smoking cessation, even after a cancer diagnosis, may improve overall mortality among newly diagnosed head and neck cancer patients. Health care providers should consider incorporating smoking cessation interventions into standard cancer treatment to improve survival among this population. IMPLICATIONS Using prospective observational longitudinal data from 590 head and neck cancer patients, this study showed that continuing smokers have the highest overall mortality relative to never-smokers, which indicates that smoking cessation, even after a cancer diagnosis, may have beneficial effects on long-term overall mortality. Health care providers should consider incorporating smoking cessation interventions into standard cancer treatment to improve survival among this population.
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Affiliation(s)
- Seung Hee Choi
- College of Nursing, Michigan State University, East Lansing, MI
| | | | | | | | | | | | | | - Sonia A Duffy
- College of Nursing, Ohio State University, Columbus, OH; .,Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
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McMullen KP, Chalmers JJ, Lang JC, Kumar P, Jatana KR. Circulating tumor cells in head and neck cancer: A review. World J Otorhinolaryngol Head Neck Surg 2016; 2:109-116. [PMID: 29204555 PMCID: PMC5698518 DOI: 10.1016/j.wjorl.2016.05.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 05/12/2016] [Indexed: 11/25/2022] Open
Abstract
Carcinoma of the head and neck represents 3.5% of all cancers, and the vast majority of these tumors are squamous cell carcinoma (HNSCC). With a stable overall survival rate of 50% among all stages, there is continued interested in developing measures for early detection and disease aggressiveness. Circulating tumor cells (CTCs) have been identified as a potential marker for early metastatic disease, response to treatment, and surveillance in head and neck squamous cell carcinoma. In this article, techniques of CTC detection, applications of CTC technology, and outcomes of HNSCC patients will be discussed.
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Affiliation(s)
- Kyle P McMullen
- Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at Ohio State University, Columbus, OH, USA
| | - Jeffrey J Chalmers
- William G. Lowrie Department of Chemical and Biomolecular Engineering, Ohio State University, Columbus, OH, USA
| | - Jas C Lang
- Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at Ohio State University, Columbus, OH, USA
| | - Pawan Kumar
- Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at Ohio State University, Columbus, OH, USA
| | - Kris R Jatana
- Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at Ohio State University, Columbus, OH, USA.,Department of Pediatric Otolaryngology-Head & Neck Surgery, Nationwide Children's Hospital, Columbus, OH, USA
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Walline HM, Komarck CM, McHugh JB, Bellile EL, Brenner JC, Prince ME, McKean EL, Chepeha DB, Wolf GT, Worden FP, Bradford CR, Carey TE. Genomic Integration of High-Risk HPV Alters Gene Expression in Oropharyngeal Squamous Cell Carcinoma. Mol Cancer Res 2016; 14:941-952. [PMID: 27422711 DOI: 10.1158/1541-7786.mcr-16-0105] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 06/23/2016] [Indexed: 11/16/2022]
Abstract
High-risk HPV (hrHPV) is the leading etiologic factor in oropharyngeal cancer. HPV-positive oropharyngeal tumors generally respond well to therapy, with complete recovery in approximately 80% of patients. However, it remains unclear why some patients are nonresponsive to treatment, with 20% of patients recurring within 5 years. In this study, viral factors were examined for possible clues to differences in tumor behavior. Oropharynx tumors that responded well to therapy were compared with those that persisted and recurred. Viral oncogene alternate transcripts were assessed, and cellular sites of viral integration were mapped and sequenced. Effects of integration on gene expression were assessed by transcript analysis at the integration sites. All of the tumors demonstrated active viral oncogenesis, indicated by expression of HPV E6 and E7 oncogenes and alternate E6 splicing. In the responsive tumors, HPV integration occurred exclusively in intergenic chromosome regions, except for one tumor with viral integration into TP63. Each recurrent tumor exhibited complex HPV integration patterns into cancer-associated genes, including TNFRSF13B, SCN2A, SH2B1, UBE2V2, SMOC1, NFIA, and SEMA6D Disrupted cellular transcripts were identified in the region of integration in four of the seven affected genes. IMPLICATIONS Integration of transcriptionally active hrHPV into cellular intergenic regions associates with tumor behavior by altering gene expression. Mol Cancer Res; 14(10); 941-52. ©2016 AACR.
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Affiliation(s)
- Heather M Walline
- Cancer Biology Program, Program in the Biomedical Sciences, Rackham Graduate School, University of Michigan, Ann Arbor, Michigan. Department of Otolaryngology/Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Christine M Komarck
- Department of Otolaryngology/Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Jonathan B McHugh
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Emily L Bellile
- Biostatistics, University of Michigan Cancer Center, Ann Arbor, Michigan
| | - J Chad Brenner
- Department of Otolaryngology/Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Mark E Prince
- Department of Otolaryngology/Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Erin L McKean
- Department of Otolaryngology/Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Douglas B Chepeha
- Department of Otolaryngology/Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Gregory T Wolf
- Department of Otolaryngology/Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Francis P Worden
- Department of Internal Medicine, Division of Clinical Oncology, University of Michigan, Ann Arbor, Michigan
| | - Carol R Bradford
- Department of Otolaryngology/Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Thomas E Carey
- Department of Otolaryngology/Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan.
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Naghavi AO, Strom TJ, Ahmed KA, Echevarria MI, Abuodeh YA, Venkat PS, Frakes JM, Harrison LB, Trotti AM, Caudell JJ. Management of Oropharyngeal Cancer in the HPV Era. Cancer Control 2016; 23:197-207. [DOI: 10.1177/107327481602300302] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Historically, oropharyngeal cancer (OPC) has been attributed to risk factors such as smoking and alcohol use. The increased incidence of OPC has been driven by human papillomavirus (HPV) infection. Methods A search of the literature involving HPV infection and OPC was performed, along with a search of ongoing clinical trials regarding HPV-positive OPC. Results This review summarizes the differences in epidemiology and prognosis of HPV-positive OPC compared with non–HPV-related OPC. It will also discuss use of de-escalating treatment to minimize toxicity while maintaining excellent outcomes. Disease management is also addressed, including prevention and follow-up recommendations for this cohort of patients. Conclusions HPV-positive OPC is a distinct disease, and efforts should be made to personalize its management. Preventive measures and vaccinations, along with de-escalation of treatment, may help optimize outcomes in this population.
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Affiliation(s)
- Arash O. Naghavi
- H. Lee Moffitt Cancer Center & Research Institute, Department of Radiation Oncology, Tampa, Florida
| | - Tobin J. Strom
- H. Lee Moffitt Cancer Center & Research Institute, Department of Radiation Oncology, Tampa, Florida
| | - Kamran A. Ahmed
- H. Lee Moffitt Cancer Center & Research Institute, Department of Radiation Oncology, Tampa, Florida
| | - Michelle I. Echevarria
- H. Lee Moffitt Cancer Center & Research Institute, Department of Radiation Oncology, Tampa, Florida
| | - Yazan A. Abuodeh
- H. Lee Moffitt Cancer Center & Research Institute, Department of Radiation Oncology, Tampa, Florida
| | - Puja S. Venkat
- H. Lee Moffitt Cancer Center & Research Institute, Department of Radiation Oncology, Tampa, Florida
| | - Jessica M. Frakes
- H. Lee Moffitt Cancer Center & Research Institute, Department of Radiation Oncology, Tampa, Florida
| | - Louis B. Harrison
- H. Lee Moffitt Cancer Center & Research Institute, Department of Radiation Oncology, Tampa, Florida
| | - Andy M. Trotti
- H. Lee Moffitt Cancer Center & Research Institute, Department of Radiation Oncology, Tampa, Florida
| | - Jimmy J. Caudell
- H. Lee Moffitt Cancer Center & Research Institute, Department of Radiation Oncology, Tampa, Florida
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Descamps G, Karaca Y, Lechien JR, Kindt N, Decaestecker C, Remmelink M, Larsimont D, Andry G, Hassid S, Rodriguez A, Khalife M, Journe F, Saussez S. Classical risk factors, but not HPV status, predict survival after chemoradiotherapy in advanced head and neck cancer patients. J Cancer Res Clin Oncol 2016; 142:2185-96. [PMID: 27370781 PMCID: PMC5018052 DOI: 10.1007/s00432-016-2203-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 06/24/2016] [Indexed: 01/22/2023]
Abstract
Purpose Despite the advent of concomitant chemoradiotherapy (CCRT), the prognosis of advanced head and neck squamous cell carcinoma (HNSCC) patients remains particularly poor. Classically, HNSCC, especially oropharyngeal carcinomas, associated with human papillomavirus (HPV) exhibits better treatment outcomes than HNSCCs in non-infected patients, eliciting a call for the de-escalation of current therapies. To improve the management of HNSCC patients, we aimed to determine the impact of active HPV infection on patient response, recurrence and survival after CCRT in a population of heavy tobacco and alcohol consumers. Methods Paraffin-embedded samples from 218 advanced HNSCC patients, mostly smokers and/or drinkers treated by CCRT, were tested for the presence of HPV DNA by surrogate type-specific E6/E7 qPCR and p16 immunohistochemistry. Associations between the response to CCRT and patient outcomes according to HPV status and clinical data were evaluated by Kaplan–Meier analysis and both univariate and multivariate Cox regression. Results Type-specific E6/E7 PCR demonstrated HPV positivity in 20 % of HNSCC. Regarding HPV status, we did not find any significant relation with response to therapy in terms of progression-free survival or overall survival. However, we observed a significantly worse prognosis for consumers of alcohol and tobacco compared to nondrinkers (p = 0.003) and non-smokers (p = 0.03). Survival analyses also revealed that the outcome is compromised in stage IV patients (p = 0.007) and, in particular, for oral cavity, hypopharynx and oropharynx carcinoma patients (p = 0.001). Conclusion The risk of death from HNSCC significantly increases when patients are exposed to tobacco and alcohol during their therapy, regardless of HPV status.
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Affiliation(s)
- Géraldine Descamps
- Laboratory of Anatomy and Cell Biology, Faculty of Medicine and Pharmacy, University of Mons, Pentagone 2A, Avenue du Champ de Mars, 6, 7000, Mons, Belgium
| | - Yasemin Karaca
- Laboratory of Anatomy and Cell Biology, Faculty of Medicine and Pharmacy, University of Mons, Pentagone 2A, Avenue du Champ de Mars, 6, 7000, Mons, Belgium
| | - Jérôme R Lechien
- Laboratory of Anatomy and Cell Biology, Faculty of Medicine and Pharmacy, University of Mons, Pentagone 2A, Avenue du Champ de Mars, 6, 7000, Mons, Belgium
| | - Nadège Kindt
- Laboratory of Anatomy and Cell Biology, Faculty of Medicine and Pharmacy, University of Mons, Pentagone 2A, Avenue du Champ de Mars, 6, 7000, Mons, Belgium
| | - Christine Decaestecker
- Laboratories of Image, Signal Processing and Acoustics, Ecole polytechnique de Bruxelles, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Myriam Remmelink
- Department of Pathology, Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Denis Larsimont
- Department of Pathology, Bordet Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Guy Andry
- Department of Head and Neck Surgery, Bordet Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Samantha Hassid
- Department of Oto-Rhino-Laryngology, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Alexandra Rodriguez
- Department of Oto-Rhino-Laryngology, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | | | - Fabrice Journe
- Laboratory of Anatomy and Cell Biology, Faculty of Medicine and Pharmacy, University of Mons, Pentagone 2A, Avenue du Champ de Mars, 6, 7000, Mons, Belgium.,Laboratory of Oncology and Experimental Surgery, Bordet Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Sven Saussez
- Laboratory of Anatomy and Cell Biology, Faculty of Medicine and Pharmacy, University of Mons, Pentagone 2A, Avenue du Champ de Mars, 6, 7000, Mons, Belgium. .,Department of Oto-Rhino-Laryngology, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium. .,Department of Head and Neck Surgery, EpiCURA, Baudour, Belgium.
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140
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Halec G, Schmitt M, Egger S, Abnet CC, Babb C, Dawsey SM, Flechtenmacher C, Gheit T, Hale M, Holzinger D, Malekzadeh R, Taylor PR, Tommasino M, Urban MI, Waterboer T, Pawlita M, Sitas F. Mucosal alpha-papillomaviruses are not associated with esophageal squamous cell carcinomas: Lack of mechanistic evidence from South Africa, China and Iran and from a world-wide meta-analysis. Int J Cancer 2016; 139:85-98. [PMID: 26529033 PMCID: PMC5772872 DOI: 10.1002/ijc.29911] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 10/07/2015] [Accepted: 10/15/2015] [Indexed: 12/19/2022]
Abstract
Epidemiological and mechanistic evidence on the causative role of human papillomaviruses (HPV) in esophageal squamous cell carcinoma (ESCC) is unclear. We retrieved alcohol- and formalin-fixed paraffin-embedded ESCC tissues from 133 patients seropositive for antibodies against HPV early proteins, from high-incidence ESCC regions: South Africa, China and Iran. With rigorous care to prevent nucleic acid contamination, we analyzed these tissues for the presence of 51 mucosotropic human alpha-papillomaviruses by two sensitive, broad-spectrum genotyping methods, and for the markers of HPV-transformed phenotype: (i) HPV16/18 viral loads by quantitative real-time PCR, (ii) type-specific viral mRNA by E6*I/E6 full-length RT-PCR assays and (iii) expression of cellular protein p16(INK4a). Of 118 analyzable ESCC tissues, 10 (8%) were positive for DNA of HPV types: 16 (4 tumors); 33, 35, 45 (1 tumor each); 11 (2 tumors) and 16, 70 double infection (1 tumor). Inconsistent HPV DNA+ findings by two genotyping methods and negativity in qPCR indicated very low viral loads. A single HPV16 DNA+ tumor additionally harbored HPV16 E6*I mRNA but was p16(INK4a) negative (HPV16 E1 seropositive patient). Another HPV16 DNA+ tumor from an HPV16 E6 seropositive patient showed p16(INK4a) upregulation but no HPV16 mRNA. In the tumor tissues of these serologically preselected ESCC patients, we did not find consistent presence of HPV DNA, HPV mRNA or p16(INK4a) upregulation. These results were supported by a meta-analysis of 14 other similar studies regarding HPV-transformation of ESCC. Our study does not support the etiological role of the 51 analyzed mucosotropic HPV types in the ESCC carcinogenesis.
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Affiliation(s)
- Gordana Halec
- Division of Molecular Diagnostics of Oncogenic Infections, Research Program Infection, Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Obstetrics & Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Markus Schmitt
- Division of Molecular Diagnostics of Oncogenic Infections, Research Program Infection, Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sam Egger
- Cancer Council NSW, Cancer Research Division, Sydney, New South Wales, Australia
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Bethesda, MD
| | - Chantal Babb
- National Health Laboratory Service, NHLS/MRC Cancer Epidemiology Research Group, Johannesburg, South Africa
| | - Sanford M Dawsey
- Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Bethesda, MD
| | | | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Martin Hale
- Department of Anatomical Pathology, National Health Laboratory Service, Johannesburg, South Africa
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Dana Holzinger
- Division of Molecular Diagnostics of Oncogenic Infections, Research Program Infection, Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Reza Malekzadeh
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Philip R Taylor
- Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Bethesda, MD
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Margaret I Urban
- National Health Laboratory Service, NHLS/MRC Cancer Epidemiology Research Group, Johannesburg, South Africa
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tim Waterboer
- Division of Molecular Diagnostics of Oncogenic Infections, Research Program Infection, Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Pawlita
- Division of Molecular Diagnostics of Oncogenic Infections, Research Program Infection, Inflammation and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Freddy Sitas
- Cancer Council NSW, Cancer Research Division, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, New South Wales, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
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141
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Masterson L, Winder DM, Ball SLR, Vaughan K, Lehmann M, Scholtz LU, Sterling JC, Sudhoff HH, Goon PKC. Molecular analyses of unselected head and neck cancer cases demonstrates that human papillomavirus transcriptional activity is positively associated with survival and prognosis. BMC Cancer 2016; 16:367. [PMID: 27296171 PMCID: PMC4906991 DOI: 10.1186/s12885-016-2398-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 06/03/2016] [Indexed: 12/16/2022] Open
Abstract
Background Human papillomavirus DNA detection in head and neck squamous cell carcinoma has been linked to improved patient prognosis. The main aims of the study was to test the hypotheses that HPV16 E6/E7 oncogene and p53 function within tumours were associated with the widely reported improved patient survival and prognosis in head and neck cancer. Methods HPV16 DNA, mRNA and p53 mRNA presence were analysed in a prospective study of 42 unselected HNSCC patients; correlating the data with patient age, tumour staging/grade, treatment response, disease recurrence and survival. Results HPV16 DNA and HPV16 mRNA were present in 45.2 % and 21.4 % of patients, respectively. There was a significant positive association between the detection of HPV16 E6/E7 mRNA and p53 mRNA (p = 0.032), but this was not replicated for HPV16 DNA. Five-year disease free survival for the whole cohort was 63 % (CI 52.5–73.5 %). Multivariable analysis revealed only HPV16 E6/E7 mRNA expression to have significant prognostic influence (p = 0.04). Conclusions Our study suggests that HPV16 oncogenic transcriptional activity within HNSCC tumours is associated with improved patient survival and better prognosis in a German population. Simple HPV DNA detection alone did not demonstrate this association. The significant association of full-length (wild-type) p53 with HPV16 E6/E7 mRNA is further evidence for a functional relationship, which could contribute to the widely reported improved survival and prognosis. Larger studies are required to validate the frequency of HPV16 mRNA expression in HNSCC.
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Affiliation(s)
- Liam Masterson
- Department of Pathology, University of Cambridge, Cambridge, UK.,Department of Otorhinolaryngology, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - David M Winder
- Department of Pathology, University of Cambridge, Cambridge, UK
| | | | - Katie Vaughan
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Martin Lehmann
- Department of Otorhinolaryngology, Bielefeld Academic Teaching Hospital, Bielefeld, Germany
| | - Lars-Uwe Scholtz
- Department of Otorhinolaryngology, Bielefeld Academic Teaching Hospital, Bielefeld, Germany
| | - Jane C Sterling
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Holger H Sudhoff
- Department of Otorhinolaryngology, Bielefeld Academic Teaching Hospital, Bielefeld, Germany
| | - Peter K C Goon
- Department of Pathology, University of Cambridge, Cambridge, UK.
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142
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O'Leary P, Kjærgaard T. Transoral robotic surgery and oropharyngeal cancer: a literature review. EAR, NOSE & THROAT JOURNAL 2016; 93:E14-21. [PMID: 25181669 DOI: 10.1177/014556131409300821] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The incidence of head and neck squamous cell carcinoma has risen steadily over the past decade due to the increase in cancers associated with the human papillomavirus (HPV). The prognosis for the treatment of this type of cancer with radiotherapy and chemoradiotherapy is good. However, because these treatments can have detrimental effects on organ function and quality of life, researchers are looking into transoral robotic surgery (TORS) as a possible alternate therapy. TORS might have a positive effect on postoperative function and quality of life for cancer survivors. The aim of this review is to report on the current situation regarding the treatment of oropharyngeal cancer with TORS, with a focus on the long-term oncologic and functional outcomes of this strategy. The articles cited in this review were selected from the PubMed and MEDLINE database. They contain study results pertaining to TORS implementation, complications, oncologic and functional outcomes, and the implications of HPV-associated cancer. We found that while TORS has some clear advantages and strengths and almost certainly a permanent place in future treatment, further research is necessary to correctly evaluate the role it will play in the complete management of oropharyngeal cancer.
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Affiliation(s)
- Pádraig O'Leary
- Department of Otorhinolaryngology-Head and Neck Surgery, Aarhus University Hospital, Nørrebrogade 44, Byg. 10, 1. Sal., 8000 Aarhus C, Denmark.
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143
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Varier I, Keeley BR, Krupar R, Patsias A, Dong J, Gupta N, Parasher AK, Genden EM, Miles BA, Teng M, Bakst RL, Gupta V, Misiukiewicz KJ, Chiao EY, Scheurer ME, Laban S, Zhang D, Ye F, Cui M, Demicco EG, Posner MR, Sikora AG. Clinical characteristics and outcomes of oropharyngeal carcinoma related to high-risk non-human papillomavirus16 viral subtypes. Head Neck 2016; 38:1330-7. [PMID: 27080140 DOI: 10.1002/hed.24442] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The majority of human papillomavirus (HPV)-related oropharyngeal carcinomas (OPCs) are associated with HPV genotype 16; however, OPC can be associated with other high-risk non-HPV16 genotypes. METHODS This was a retrospective analysis of patients with high-risk non-HPV16 OPC treated at a single tertiary institution. Sociodemographic and clinical information was obtained by chart review. HPV genotype was determined by polymerase chain reaction (PCR). Baseline data and outcomes were compared between HPV16 and high-risk non-HPV16 groups. RESULTS High-risk non-HPV16 genotypes accounted for 9% of HPV-related OPC. Of the 27 total high-risk non-HPV16 OPCs, HPV35 was most prevalent (48%). High-risk non-HPV16 OPC presented at a slightly higher age (p = .021) and higher clinical T classification (p = .008) compared to HPV16 OPC, but there was no significant survival difference. CONCLUSION Clinical characteristics of high-risk non-HPV16 OPC were largely consistent with those of HPV16 OPC. Additional multi-institutional studies will be required to demonstrate conclusively that the favorable prognosis of patients with HPV16 applies to all high-risk HPV types. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1330-1337, 2016.
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Affiliation(s)
- Indu Varier
- Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Brieze R Keeley
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine, NY, USA
| | - Rosemarie Krupar
- Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Alexis Patsias
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine, NY, USA.,Department of Otolaryngology - Head and Neck Surgery, University Oklahoma Health Sciences Center, OK, USA
| | - Joanna Dong
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine, NY, USA
| | - Nikita Gupta
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine, NY, USA
| | - Arjun K Parasher
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine, NY, USA
| | - Eric M Genden
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine, NY, USA
| | - Brett A Miles
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine, NY, USA
| | - Marita Teng
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine, NY, USA
| | - Richard L Bakst
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Vishal Gupta
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, NY, USA
| | | | - Elizabeth Y Chiao
- Department of Internal Medicine and Health Services Research, Baylor College of Medicine, Houston, TX, USA.,Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Michael E Scheurer
- Department of Pediatrics, Section of Hematology/Oncology, Baylor College of Medicine, Houston, TX, USA
| | - Simon Laban
- Head and Neck Cancer Center Ulm, Department of Oto-Rhino-Laryngology and Head and Neck Surgery, University Medical Center Ulm, Ulm, Baden-Württemberg, Germany
| | - David Zhang
- Department of Pathology, Icahn school of Medicine at Mount Sinai, NY, USA
| | - Fei Ye
- Department of Pathology, Icahn school of Medicine at Mount Sinai, NY, USA
| | - Miao Cui
- Department of Pathology, Icahn school of Medicine at Mount Sinai, NY, USA
| | | | - Marshall R Posner
- Department of Medical Oncology, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Andrew G Sikora
- Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA
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144
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Dok R, Nuyts S. HPV Positive Head and Neck Cancers: Molecular Pathogenesis and Evolving Treatment Strategies. Cancers (Basel) 2016; 8:cancers8040041. [PMID: 27043631 PMCID: PMC4846850 DOI: 10.3390/cancers8040041] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 03/09/2016] [Accepted: 03/23/2016] [Indexed: 01/02/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a highly heterogeneous disease that is the result of tobacco and/or alcohol abuse or infection with high-risk Human papillomaviruses. Despite the fact that HPV positive HNSCC cancers form a distinct clinical entity with better treatment outcome, all HNSCC are currently treated uniformly with the same treatment modality. At present, biologic basis of these different outcomes and their therapeutic influence are areas of intense investigation. In this review, we will summarize the molecular basis for this different outcome, novel treatment opportunities and possible biomarkers for HPV positive HNSCC. In particular, the focus will be on several molecular targeted strategies that can improve the chemoradiation response by influencing DNA repair mechanisms.
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Affiliation(s)
- Rüveyda Dok
- Laboratory of Experimental Radiotherapy, Department of Oncology, Katholieke Universiteit Leuven (KU Leuven), 3000 Leuven, Belgium.
| | - Sandra Nuyts
- Laboratory of Experimental Radiotherapy, Department of Oncology, Katholieke Universiteit Leuven (KU Leuven), 3000 Leuven, Belgium.
- Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, 3000 Leuven, Belgium.
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145
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Abstract
Treatment of patients with oropharyngeal squamous cell carcinoma (OPSCC) requires interdisciplinary collaboration. Besides oncologic control, organ and function preservation are important priorities. One treatment option is primary concomitant chemoradiotherapy (CRT), particularly for locally advanced head and neck cancer. Another option is sequential CRT, where induction chemotherapy may be followed either by radiation alone or by CRT. An important aspect of these modalities is the development of functional sequelae with regards to swallowing as a direct consequence of radiogenic fibrosis, as well as tissue ctoxicity associated with cisplatin-based chemotherapy. Conventional open surgical approaches are being increasingly replaced by transoral surgical modalities with less treatment-related morbidity. As a further, equally important goal of appropriately indicated surgery, adjuvant (C)RT may be omitted or the dose significantly reduced. The advantages of primary surgery over primary CRT may be less obvious in cases still requiring adjuvant treatment, although not necessarily completely eliminated. For patients with human papillomavirus (HPV)-driven OPSCC, it is important to note that primary surgery may provide comparable or even increased survival benefit. To date, there is no evidence for a clear advantage of primary CRT over primary surgery in this group. In these cases, a de-escalated treatment package may be the preferred option. Here, the application of radioimmunotherapy as well as a reduced radiation dose may minimize long-term treatment-related morbidities.
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146
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Biron VL, Kostiuk M, Isaac A, Puttagunta L, O'Connell DA, Harris J, Côté DWJ, Seikaly H. Detection of human papillomavirus type 16 in oropharyngeal squamous cell carcinoma using droplet digital polymerase chain reaction. Cancer 2016; 122:1544-51. [PMID: 26989832 DOI: 10.1002/cncr.29976] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 12/01/2015] [Accepted: 12/22/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND The incidence of oropharyngeal squamous cell carcinoma caused by oncogenic HPV (HPV-OPSCC) is rising worldwide. HPV-OPSCC is commonly diagnosed by RT-qPCR of HPV-16 E6 and E7 oncoproteins or by cyclin-dependent kinase inhibitor 2A, multiple tumor suppressor 1 (p16) immunohistochemistry (IHC). Droplet digital PCR (ddPCR) has been recently reported as ultra-sensitive and highly precise method of nucleic acid quantification for biomarker analysis. We aimed to validate this method for the detection of HPV-16 E6 and E7 in HPV-OPSCC. METHODS Participants were recruited from January 2015-November 2015 at initial presentation to the University of Alberta Head and Neck Oncology Clinic. RNA was extracted, purified and quantified from prospectively collected participant tissues, and ddPCR was performed with fluorescent probes detecting HPV-16 E6 and E7. Results from ddPCR were compared with p16 IHC performed by clinical pathology as standard of care. RESULTS Head and neck tissues were prospectively obtained from 68 participants including 29 patients with OPSCC, 29 patients with non-OPSCC and 10 patients without carcinoma. 79.2% of patients with OPSCC were p16 positive. The sensitivity and specificity of ddPCR HPV E6/E7 compared with p16 IHC in OPSCC was 91.3 and 100%, respectively. The amount of target RNA used was ≤1 ng, 20-50 times lower than reported by other for RT-qPCR HPV E6/E7. CONCLUSIONS The ddPCR of HPV E6/E7 is a novel and highly specific method of detecting HPV-16 in OPSCC. Cancer 2016;122:1544-51. © 2016 American Cancer Society.
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Affiliation(s)
- Vincent L Biron
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery University of Alberta, Edmonton, Alberta, Canada
| | - Morris Kostiuk
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery University of Alberta, Edmonton, Alberta, Canada
| | - Andre Isaac
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery University of Alberta, Edmonton, Alberta, Canada
| | - Lakshmi Puttagunta
- Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Daniel A O'Connell
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery University of Alberta, Edmonton, Alberta, Canada
| | - Jeffrey Harris
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery University of Alberta, Edmonton, Alberta, Canada
| | - David W J Côté
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery University of Alberta, Edmonton, Alberta, Canada
| | - Hadi Seikaly
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery University of Alberta, Edmonton, Alberta, Canada
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147
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Rosko AJ, Birkeland AC, Wilson KF, Muenz DG, Bellile E, Bradford CR, McHugh JB, Spector ME. Tumor Biomarkers in Spindle Cell Variant Squamous Cell Carcinoma of the Head and Neck. Otolaryngol Head Neck Surg 2016; 155:106-12. [PMID: 26980915 DOI: 10.1177/0194599816636612] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 02/10/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine biomarkers of recurrence and survival in patients with spindle cell variant squamous cell carcinoma (SpSCC) of the head and neck. STUDY DESIGN Retrospective case control study. SETTING Tertiary academic center. SUBJECTS AND METHODS Thirty-two SpSCC patients (mean age, 68.8) between 1987 and 2009 were identified and reviewed. A tissue microarray (TMA) was constructed from tumor specimens. Tumor biomarkers under study included p16, epidermal growth factor receptor (EGFR), p53, EZH2, cyclin D1, CD104, HGFa, p21, and cMET. An additional TMA was constructed from patients with non-SpSCC oral cavity squamous cell carcinoma for comparative purposes. The main outcomes were overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS). RESULTS In the SpSCC cohort, tumors positive for cMet had worse OS (P < .001). Patients positive for cMet (P = .007), cyclin D1 (P = .019), and p16 (P = .004) had worse DSS. Recurrence-free survival was also worse in patients with tumors positive for cMet (P = .037), cyclin D1 (P = .012), and p16 (P < .001). Compared with the oral cavity cohort, there was a significantly larger proportion of patients in the SpSCC group with tumors staining positive for cMet and a lower proportion of tumors positive for cyclin D1. CONCLUSION cMet, cyclin D1, and p16 are predictive tumor biomarkers for risk of recurrence and worse DSS in patients with SpSCC.
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Affiliation(s)
- Andrew J Rosko
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Andrew C Birkeland
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Kevin F Wilson
- Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Daniel G Muenz
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Emily Bellile
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Carol R Bradford
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Jonathan B McHugh
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Matthew E Spector
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
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148
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Abstract
We examined p16 expression in tumors from a population-based sample of laryngeal cancer cases diagnosed in the U.S. Samples had been previously genotyped for HPV DNA. Overall, p16 expression was observed in laryngeal tissue from 8 of 101 (7.9%) cases. p16 expression was observed in 2 of 16 (12.5%) cases previously determined to be HPV DNA positive. The two cases dually positive for p16 and HPV DNA were non-keratinizing SCC and papillary SCC tumors that were positive for genotypes 18 and 35/89, respectively. Positivity for p16 and/or HPV DNA was not associated with 5-year survival (log-rank p value=0.55). Our findings support a limited role of HPV in laryngeal carcinogenesis. p16 is not a reliable surrogate for HPV status in laryngeal cancers and is not a predictor of laryngeal cancer survival.
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149
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Hong A, Zhang X, Jones D, Veillard AS, Zhang M, Martin A, Lyons JG, Lee CS, Rose B. Relationships between p53 mutation, HPV status and outcome in oropharyngeal squamous cell carcinoma. Radiother Oncol 2016; 118:342-9. [PMID: 26952933 DOI: 10.1016/j.radonc.2016.02.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 01/06/2016] [Accepted: 02/01/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE This study aimed to examine the rate and type of p53 mutation in oropharyngeal cancer (OSCC). Relationships were sought between human papillomavirus (HPV) status and p53 mutation. The role of p53 mutation as a prognostic factor independent of HPV status and as a modifier of the effect of HPV on outcomes was also examined. METHODS The HPV status of 202 cases was determined by HPV DNA by RT-PCR and p16 immunohistochemistry. P53 mutation in exon 5-8 was determined by pyrosequencing. Findings were correlated with known clinicopathological factors and outcomes. RESULTS 48% of the cases were HPV positive and they were significantly less likely to have a p53 mutation than HPV-negative OSCCs (25.8% vs 46.7%, p=0.0021). Mutation was most common in exon 5. Among patients with HPV-positive OSCC, there was no significant difference in p53 mutation by smoking status (22.2% for never smokers and 30.8% for current or ex-smokers). Patients with p53 mutant OSCC had significantly worse overall survival (p=0.01). There was no statistical evidence that p53 mutation modified the effect of HPV status on outcomes. In the multivariate analysis, positive HPV status remained the strongest predictor of outcomes. p53 mutation status was not a significant predictor of outcome after adjusting for age, gender, T stage, N stage and HPV status. CONCLUSIONS In summary, HPV-positive OSCC are less likely to have mutant p53 than HPV-negative OSCC. Our study did not show any evidence that p53 mutation could modify the effect of HPV status on outcomes.
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Affiliation(s)
- Angela Hong
- Central Clinical School, Sydney Medical School, The University of Sydney, Australia; Department of Radiation Oncology, Lifehouse, Australia.
| | - Xiaoying Zhang
- Department of Infectious Diseases and Immunology, Sydney Medical School, The University of Sydney, Australia
| | - Deanna Jones
- Department of Anatomical Pathology, Royal Prince Alfred Hospital, Australia
| | | | - Mei Zhang
- Central Clinical School, Sydney Medical School, The University of Sydney, Australia; Department of Radiation Oncology, Lifehouse, Australia
| | - Andrew Martin
- NHMRC Clinical Trials Centre, The University of Sydney, Australia
| | - J Guy Lyons
- Central Clinical School, Sydney Medical School, The University of Sydney, Australia
| | - C Soon Lee
- Cancer Services, Royal Prince Alfred Hospital, Australia
| | - Barbara Rose
- Department of Anatomical Pathology, Royal Prince Alfred Hospital, Australia
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150
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Dahlstrom KR, Garden AS, William WN, Lim MY, Sturgis EM. Proposed Staging System for Patients With HPV-Related Oropharyngeal Cancer Based on Nasopharyngeal Cancer N Categories. J Clin Oncol 2016; 34:1848-54. [PMID: 26884553 DOI: 10.1200/jco.2015.64.6448] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Patients with human papillomavirus (HPV)-related oropharyngeal cancer (OPC) generally present with more advanced disease but have better survival than patients with HPV-unrelated OPC. The current American Joint Commission on Cancer (AJCC)/Union for International Cancer Control (UICC) TNM staging system for OPC was developed for HPV-unrelated OPC. A new staging system is needed to adequately predict outcomes of patients with HPV-related OPC. PATIENTS AND METHODS Patients with newly diagnosed HPV-positive OPC (by p16 immunohistochemistry or in situ hybridization) treated at our institution from January 2003 through December 2012 were included. By using recursive partitioning analysis (RPA), we developed new stage groupings with both traditional OPC regional lymph node (N) categories and nasopharyngeal carcinoma (NPC) N categories. Survival was estimated by the Kaplan-Meier method, and the relationship between stage and survival was examined by using Cox proportional hazards regression analysis. RESULTS A total of 661 patients with HPV-positive OPC met the inclusion criteria. With the traditional TNM staging system, there was no difference in survival between stages (P = .141). RPA with NPC N categories resulted in more balanced stage groups and better separation between groups for 5-year survival than RPA with traditional OPC N categories. With the stage groupings that were based in part on NPC N categories, the risk of death increased with increasing stage (P for trend < .001), and patients with stage III disease had five times the risk of death versus patients with stage IA disease. CONCLUSION New stage groupings that are based on primary tumor (T) categories and NPC N categories better separate patients with HPV-positive OPC with respect to survival than does the current AJCC/UICC TNM staging system. Although confirmation of our findings in other patient populations is needed, we propose consideration of NPC N categories as an alternative to the traditional OPC N categories in the new AJCC/UICC TNM staging system that is currently being developed.
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Affiliation(s)
| | - Adam S Garden
- All authors: The University of Texas MD Anderson Cancer Center, Houston, TX
| | - William N William
- All authors: The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ming Yann Lim
- All authors: The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Erich M Sturgis
- All authors: The University of Texas MD Anderson Cancer Center, Houston, TX
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