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O'Meara CH, Jafri Z, Khachigian LM. Immune Checkpoint Inhibitors, Small-Molecule Immunotherapies and the Emerging Role of Neutrophil Extracellular Traps in Therapeutic Strategies for Head and Neck Cancer. Int J Mol Sci 2023; 24:11695. [PMID: 37511453 PMCID: PMC10380483 DOI: 10.3390/ijms241411695] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Immune checkpoint inhibitor (ICI) therapy has revolutionized the treatment of many cancer types, including head and neck cancers (HNC). When checkpoint and partner proteins bind, these send an "off" signal to T cells, which prevents the immune system from destroying tumor cells. However, in HNC, and indeed many other cancers, more people do not respond and/or suffer from toxic effects than those who do respond. Hence, newer, more effective approaches are needed. The challenge to durable therapy lies in a deeper understanding of the complex interactions between immune cells, tumor cells and the tumor microenvironment. This will help develop therapies that promote lasting tumorlysis by overcoming T-cell exhaustion. Here we explore the strengths and limitations of current ICI therapy in head and neck squamous cell carcinoma (HNSCC). We also review emerging small-molecule immunotherapies and the growing promise of neutrophil extracellular traps in controlling tumor progression and metastasis.
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Affiliation(s)
- Connor H O'Meara
- Department of Otorhinolaryngology, Head and Neck Surgery, Prince of Wales Hospital, Randwick, NSW 2031, Australia
| | - Zuhayr Jafri
- Vascular Biology and Translational Research, School of Biomedical Sciences, UNSW Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Levon M Khachigian
- Vascular Biology and Translational Research, School of Biomedical Sciences, UNSW Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
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Zou Z, Zhao W, Liang J, Chen M, Yu F. Identification of Core Genes and Prognostic Models of Laryngeal Cancer by Autophagy Related Biomarkers. J BIOMATER TISS ENG 2022. [DOI: 10.1166/jbt.2022.3071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: The aims of our article were to identify the core genes of the autophagy-related genes (ARGs) which abnormally expressed in laryngeal cancer (LC) and constructed a risk prognostic models with these genes. Methods: In this study, we identified genes with abnormally
expressed in LC, and they were mainly involved in some cancer-related gene ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes pathways (KEGG). Statistical analysis were conducted to identify the powerful independent prognostic factors associated with clinical factors and survival.
Results: A total of 35 DEGs were identified in our research. The risk prediction model was constructed with three potential prognostic genes (VEGFA, SPNS1 and CCL2) of autophagy by lasso regression analysis that can successfully predict the prognosis in LC. We applied ROC curve to evaluate
the effectiveness of the risk prognostic model, and found that AUC was 0.693 below the curve. Risk prediction model was only related to survival status (P < 0.01), and was not related to clinicopathological factors. Furthermore, the genes (VEGFA and CCL2) were considered as core
genes not only because they were the highly connected genes but also they were the composed genes of risk prognostic model. Conclusions: Taken together, ARGs were considered as important roles in the progression of LC and the prognostic model can help to identification of new targets
to guide the diagnosis and therapy.
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Affiliation(s)
- Zirou Zou
- Department of Otolaryngology, Head and Neck Surgery, Guangzhou Red Cross Hospital, Guangzhou, Guangdong, 510220, China
| | - Wenmin Zhao
- Department of Otolaryngology, Head and Neck Surgery, Guangzhou Red Cross Hospital, Guangzhou, Guangdong, 510220, China
| | - Jiajian Liang
- Department of Otolaryngology, Head and Neck Surgery, Guangzhou Red Cross Hospital, Guangzhou, Guangdong, 510220, China
| | - Mingtao Chen
- Department of Otolaryngology, Head and Neck Surgery, Guangzhou Red Cross Hospital, Guangzhou, Guangdong, 510220, China
| | - Feng Yu
- Department of Otolaryngology, Head and Neck Surgery, Guangzhou Red Cross Hospital, Guangzhou, Guangdong, 510220, China
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Gilbert M, Liang E, Li P, Salgia R, Abouljoud M, Siddiqui F. Outcomes of Primary Mucosal Head and Neck Squamous Cell Carcinoma in Solid Organ Transplant Recipients. Cureus 2022; 14:e24305. [PMID: 35607526 PMCID: PMC9123412 DOI: 10.7759/cureus.24305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Patients who undergo solid organ transplants have a higher risk of developing malignancies and subsequent recurrences. Clinical outcomes in transplant recipients with primary mucosal head and neck squamous cell carcinoma (HNSCC) are not well described in the published literature. Therefore, we retrospectively studied the outcomes in this group of patients. Methods This Institutional Review Board (IRB)-approved analysis included patients who had previously undergone solid organ transplants and subsequently were diagnosed with primary mucosal HNSCC between 2006 and 2021. Our institutional database of solid organ transplant recipients was cross-referenced with our head and neck cancer database to identify the patients included in this cohort. In addition, Kaplan-Meier analyses were performed to calculate overall and disease-free survival. Results Of 1,221 patients, 20 met the inclusion criteria. The median time from organ transplant to HNSCC diagnosis was 5.9 years (range: 0.5-18.5 years). A total of 11 (55.0%) and 9 (45.0%) patients presented with localized and locally advanced disease, respectively. Two-year overall and disease-free survivals were 59.1% and 73.5%, respectively. After initial treatment, six (30.0%) patients experienced a recurrence. All patients who developed a recurrence died within the follow-up period. The median time of death after recurrence for all six patients was 11.5 months (range: 2-22 months). Conclusion This series highlights a high mortality rate following recurrence among patients with primary mucosal HNSCC and a solid organ transplant history. A better understanding of how solid organ transplant history adversely impacts the course of HNSCC could help properly guide treatment, follow-up, and survivorship decisions.
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Affiliation(s)
| | - Evan Liang
- Radiation Oncology, Henry Ford Health, Detroit, USA
| | - Pin Li
- Public Health Sciences, Henry Ford Health, Detroit, USA
| | - Reena Salgia
- Gastroenterology and Hepatology, Henry Ford Health, Detroit, USA
| | - Marwan Abouljoud
- Transplant and Hepatobiliary Surgery, Henry Ford Health, Detroit, USA
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Chang J, Sunwoo JB, Shah JL, Hara W, Hong J, Colevas AD, Divi V. Association Between Immunosuppression and Outcomes in Oral Cavity Squamous Cell Carcinoma. Otolaryngol Head Neck Surg 2020; 164:1044-1051. [PMID: 32957854 DOI: 10.1177/0194599820960146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To assess the effect of immunosuppression on recurrence and mortality outcomes in oral cavity squamous cell carcinoma (SCC) after initial surgical treatment. STUDY DESIGN Retrospective cohort study. SETTING A single academic tertiary referral center. METHODS Patients with oral cavity SCC treated with initial surgery were included. Immunosuppressed versus nonimmunosuppressed groups were compared. Primary end points were 5-year overall recurrence and all-cause mortality. Secondary end points were recurrence subtypes (local, regional, and distant) and disease-specific mortality. RESULTS Of 803 patients with oral cavity SCC, 71 (9%) were immunosuppressed from therapeutic drug use (n = 48) or systemic disease (n = 23). The immunosuppressed group consisted of patients with a history of transplant (21%), autoimmune or pulmonary disorder (45%), hematologic malignancy or myeloproliferative disorder (30%), and HIV infection (3%). After adjusting for baseline variables of age, sex, comorbidities, pathologic tumor characteristics, and adjuvant treatment, all recurrence and mortality outcomes were worse in the immunosuppressed group. The multivariate-adjusted hazard ratio for overall recurrence was 2.16 (95% CI, 1.50-3.12; P < .01), and all-cause mortality was 1.79 (95% CI, 1.15-2.78; P < .01) in Cox regression analysis. The 2 groups were then matched in a 1:5 ratio according to the same baseline variables. All end points apart from disease-specific mortality were significantly worse in the immunosuppressed group after matching. CONCLUSION This study demonstrates that immunosuppression is associated with poor outcomes in oral cavity SCC, with an approximate 2-fold increase in rates of recurrence and mortality. Future studies are needed to assess the risks and benefits of adjusting therapeutic immunosuppression in this population.
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Affiliation(s)
- Julia Chang
- Department of Otolaryngology, School of Medicine, Stanford University, Stanford, California, USA
| | - John B Sunwoo
- Department of Otolaryngology, School of Medicine, Stanford University, Stanford, California, USA
| | - Jennifer Lobo Shah
- Department of Radiation Oncology, Medical School, University of Michigan, Ann Arbor, Michigan, USA
| | - Wendy Hara
- Department of Radiation Oncology, Kaiser Santa Clara, Santa Clara, California, USA
| | - Jison Hong
- Division of Immunology and Rheumatology, Department of Medicine, School of Medicine, Stanford University, Redwood City, California, USA
| | - A Dimitrios Colevas
- Division of Oncology, Department of Medicine, School of Medicine, Stanford University, Stanford, California, USA
| | - Vasu Divi
- Department of Otolaryngology, School of Medicine, Stanford University, Stanford, California, USA
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Douglas CM, Jethwa AR, Hasan W, Liu A, Gilbert R, Goldstein D, De Almedia J, Lipton J, Irish JC. Long-term survival of head and neck squamous cell carcinoma after bone marrow transplant. Head Neck 2020; 42:3389-3395. [PMID: 32820585 DOI: 10.1002/hed.26402] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 06/30/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
PURPOSE The risk of developing head and neck squamous cell carcinoma (HNSCC) in patients with graft versus host disease (GVHD) after bone marrow transplant (BMT) is well established but large series reporting outcomes are sparse. METHODS Retrospective, single institution, study of patients with GVHD and HNSCC after BMT, between January 1, 1968, and June 30, 2016. RESULTS In total, 25 patients were studied, of which 21 (84%) were male and 4 (16%) were female. Mean age for BMT was 41 (18-65) years. All patients developed GVHD, most common site was oral cavity (19 patients, 76%). Mean age for diagnosis of HNSCC was 52 (28-76) years. Mean time between BMT and diagnosis of HNSCC was 12 (2-13) years. The 2-year progression-free survival (PFS) was 61.4%, 5-year PFS was 56.7%. The 2-year overall survival (OS) was 82.8%, 5-year OS was 68.7%. CONCLUSION HNSCC can develop many years after BMT in patients without the classic risk factors for head and neck cancer. The majority were seen with oral cancer and with early-stage disease likely due to active surveillance and early detection in this patient population.
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Affiliation(s)
- Catriona M Douglas
- Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Ashock R Jethwa
- Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Wael Hasan
- Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Amy Liu
- Department of Biostatistics, Princess Margaret Hospital/University Health Network, Toronto, Ontario, Canada
| | - Ralph Gilbert
- Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - David Goldstein
- Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - John De Almedia
- Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Jeff Lipton
- Hans Messner Allogeneic Stem Cell Transplant Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Jonathan C Irish
- Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
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Head and neck squamous cell carcinoma in solid organ transplant recipients. Eur Arch Otorhinolaryngol 2020; 278:211-218. [PMID: 32562028 DOI: 10.1007/s00405-020-06129-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 06/11/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Characterize head and neck squamous cell carcinomas in solid transplant recipients and compare outcomes with non-transplanted population. METHODS We carried a retrospective cohort analysis in a tertiary care center in Madrid, Spain. The study reviews 26 cases of non-cutaneous HNSCC diagnosed in solid organ transplant recipients between 2000 and 2017. We select a cohort of 130 (1:5) non-transplanted patients among all non-transplanted patients diagnosed during the same period for comparison purposes, through hierarchical clustering analysis. Univariate, overall and specific survival analysis and multivariate Cox proportional hazards regression were used to evaluate our objectives. RESULTS The overall risk of non-cutaneous HNSCC in solid transplant recipients was 7.2 cases per 1000. Alcohol abuse (p = 0.021) and upfront surgery (p = 0.019) were more likely to occur in transplanted patients. Age > 60 was an independent predictor of worse outcomes both for overall (HR = 2.4, p < 0.001) and specific (HR = 2.1, p = 0.012) survival. Transplant significantly worse overall survival (HR = 2.1, p = 0.012) but no statistical significant differences were observed on specific survival (p = 0.392). CONCLUSIONS Solid organ transplant recipients have a higher risk of suffering non-cutaneous HNSCC. The higher mortality rate of these patients does not appear to be directly related to suffering from head and neck cancer, although it seems to contribute to developing other fatal complications in these fragile patients.
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Krajewska Wojciechowska J, Krajewski W, Zatoński T. Otorhinolaryngological dysfunctions induced by chronic kidney disease in pre- and post-transplant stages. Eur Arch Otorhinolaryngol 2020; 277:1575-1591. [PMID: 32222803 PMCID: PMC7198632 DOI: 10.1007/s00405-020-05925-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/16/2020] [Indexed: 12/16/2022]
Abstract
Purpose Otorhinolaryngological abnormalities are common complications of chronic kidney disease (CKD) and its treatment. The main aim of this study was to provide a brief and precise review of the current knowledge regarding CKD and its treatment-related influence on head and neck organs. Methods The Medline and Web of Science databases were searched using the terms “chronic kidney disease”, “kidney transplantation”, “immunosuppression”, “dialysis” in conjunction with “otorhinolaryngological manifestation”. Articles that did not address the topics, low-quality studies, case reports, and studies based on nonsignificant cohorts were excluded, and the full text of remaining high-quality, novel articles were examined and elaborated on. Results Patients with CKD are prone to develop sensorineural hearing loss, tinnitus, recurrent epistaxis, opportunistic infections including oropharyngeal candidiasis or rhino-cerebral mucormycosis, taste and smell changes, phonatory and vestibular dysfunctions, deep neck infections, mucosal abnormalities, gingival hyperplasia, halitosis or xerostomia. Immunosuppressive therapy after kidney transplantation increases the risk of carcinogenesis, both related and not-related to latent viral infection. The most commonly viral-related neoplasms observed in these patients are oral and oropharyngeal cancers, whereas the majority of not-related to viral infection tumors constitute lip and thyroid cancers. CKD-related otorhinolaryngological dysfunctions are often permanent, difficult to control, have a significant negative influence on patient’s quality of life, and can be life threatening. Conclusion Patients with CKD suffer from a number of otorhinolaryngological CKD-induced complications. The relationship between several otorhinolaryngological complications and CKD was widely explained, whereas the correlation between the rest of them and CKD remains unclear. Further studies on this subject are necessary.
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Affiliation(s)
- Joanna Krajewska Wojciechowska
- Department and Clinic of Otolaryngology, Head and Neck Surgery, Medical University in Wroclaw, Borowska 213 Street, 50556, Wroclaw, Poland.
| | - Wojciech Krajewski
- Department and Clinic of Urology and Urological Oncology, Medical University in Wroclaw, Borowska 213, 50556, Wroclaw, Poland
| | - Tomasz Zatoński
- Department and Clinic of Otolaryngology, Head and Neck Surgery, Medical University in Wroclaw, Borowska 213 Street, 50556, Wroclaw, Poland
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