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Goswami M, Schlom J, Donahue RN. Peripheral surrogates of tumor burden to guide chemotherapeutic and immunotherapeutic strategies for HPV-associated malignancies. Oncotarget 2023; 14:758-774. [PMID: 38958745 PMCID: PMC11221564 DOI: 10.18632/oncotarget.28487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/22/2023] [Indexed: 07/04/2024] Open
Abstract
With the rapid adoption of immunotherapy into clinical practice for HPV-associated malignancies, assessing tumor burden using "liquid biopsies" would further our understanding of clinical outcomes mediated by immunotherapy and allow for tailoring of treatment based on real-time tumor dynamics. In this review, we examine translational studies on peripheral surrogates of tumor burden derived from peripheral blood in HPV-associated malignancies, including levels and methylation of circulating tumor DNA (ctDNA), miRNA derived from extracellular vesicles, circulating tumor cells (CTCs), and HPV-specific antibodies and T cell responses. We review their utility as prognostic and predictive biomarkers of response to chemotherapy and radiation, with a focus on how they may inform and guide immunotherapies to treat locally advanced and metastatic HPV-associated malignancies. We also highlight unanswered questions that must be addressed to translate and integrate these peripheral tumor biomarkers into the clinic.
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Affiliation(s)
- Meghali Goswami
- Center for Immuno-Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Jeffrey Schlom
- Center for Immuno-Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Renee N. Donahue
- Center for Immuno-Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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2
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Chantre-Justino M, Alves G, Delmonico L. Clinical applications of liquid biopsy in HPV‐negative and HPV‐positive head and neck squamous cell carcinoma: advances and challenges. EXPLORATION OF TARGETED ANTI-TUMOR THERAPY 2022; 3:533-552. [PMID: 36071985 PMCID: PMC9446158 DOI: 10.37349/etat.2022.00099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/22/2022] [Indexed: 12/02/2022] Open
Abstract
Head and neck squamous cell carcinomas (HNSCCs) represent the most common epithelial tumors that arise from mucosa of the oral cavity, pharynx, and larynx. The development of HNSCCs is usually associated with tobacco use, alcohol consumption, and human papillomavirus (HPV) infection. Most HNSCCs are diagnosed in advanced states, leading to a worse clinical outcome. Screening tests based on potential biomarkers associated with HNSCCs could improve this scenario. Liquid biopsy has emerged as a promising area of cancer investigation, offering a minimally invasive approach to track circulating biomarkers in body fluids that could potentially contribute to the diagnosis, predict prognosis, and monitor response to treatment. This review will discuss translational studies describing the clinical applications of liquid biopsy in HPV-negative and HPV-positive HNSCCs focused on circulating nucleic acids [cell-free DNA (cfDNA) and cell-free RNA (cfRNA)], circulating tumor cells (CTCs), and extracellular vesicles (EVs), which can be found in plasma, serum, and saliva.
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Affiliation(s)
- Mariana Chantre-Justino
- 1Research Division, National Institute of Traumatology and Orthopaedics (INTO), Rio de Janeiro 20940-070, Brazil 2Circulating Biomarkers Laboratory, Pathology Department, Faculty of Medical Sciences, Rio de Janeiro State University, Rio de Janeiro 20550-170, Brazil
| | - Gilda Alves
- 2Circulating Biomarkers Laboratory, Pathology Department, Faculty of Medical Sciences, Rio de Janeiro State University, Rio de Janeiro 20550-170, Brazil
| | - Lucas Delmonico
- 3Oncoclínicas Precision Medicine, Vila Nova Conceição, São Paulo 04513-020, Brazil
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Application of circulating tumour cells to predict response to treatment in head and neck cancer. Cell Oncol (Dordr) 2022; 45:543-555. [PMID: 35737211 PMCID: PMC9219366 DOI: 10.1007/s13402-022-00681-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 05/06/2022] [Accepted: 05/20/2022] [Indexed: 12/24/2022] Open
Abstract
Background Local recurrence and metastasis remain the major causes of death in head and neck cancer (HNC) patients. Circulating tumour cells (CTCs) are shed from primary and metastatic sites into the circulation system and have been reported to play critical roles in the metastasis and recurrence of HNC. Here, we explored the use of CTCs to predict the response to treatment and disease progression in HNC patients. Methods Blood samples were collected at diagnosis from HNC patients (n = 119). CTCs were isolated using a spiral microfluidic device and were identified using immunofluorescence staining. Correlation of baseline CTC numbers to 13-week PET-CT data and multidisciplinary team consensus data were conducted. Results CTCs were detected in 60/119 (50.4%) of treatment naïve HNC patients at diagnosis. Baseline CTC numbers were higher in stage III vs. stage I-II p16-positive oropharyngeal cancers (OPCs) and other HNCs (p = 0.0143 and 0.032, respectively). In addition, we found that baseline CTC numbers may serve as independent predictors of treatment response, even after adjusting for other conventional prognostic factors. CTCs were detected in 10 out of 11 patients exhibiting incomplete treatment responses. Conclusions We found that baseline CTC numbers are correlated with treatment response in patients with HNC. The expression level of cell-surface vimentin (CSV) on CTCs was significantly higher in patients with persistent or progressive disease, thus providing additional prognostic information for stratifying the risk at diagnosis in HNC patients. The ability to detect CTCs at diagnosis allows more accurate risk stratification, which in the future may be translated into better patient selection for treatment intensification and/or de-intensification strategies. Supplementary information The online version contains supplementary material available at 10.1007/s13402-022-00681-w.
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Staudte S, Klinghammer K, Jurmeister PS, Jank P, Blohmer JU, Liebs S, Rhein P, Hauser AE, Tinhofer I. Multiparametric Phenotyping of Circulating Tumor Cells for Analysis of Therapeutic Targets, Oncogenic Signaling Pathways and DNA Repair Markers. Cancers (Basel) 2022; 14:cancers14112810. [PMID: 35681790 PMCID: PMC9179910 DOI: 10.3390/cancers14112810] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 01/02/2023] Open
Abstract
Simple Summary Detection of circulating tumor cells (CTCs) has been established as an independent prognostic marker in solid cancer. In order to expand the clinical utility of this blood–based minimally invasive biomarker we established a protocol allowing multiparametric phenotyping of CTCs to analyze the expression levels of therapeutic target proteins. By applying this assay, we demonstrated intratumoral heterogeneity of PD–L1 expression in CTCs from head and neck cancer patients, an observation previously reported in tumor tissue specimens. We further verified the feasibility of applying the protocol to analyze the activation status of important oncogenic pathways and the extent of DNA repair following radiation. These promising preliminary results warrant further study and may lead to the implementation of this assay in clinical routine for improved treatment selection and monitoring. Abstract Detection of circulating tumor cells (CTCs) has been established as an independent prognostic marker in solid cancer. Multiparametric phenotyping of CTCs could expand the area of application for this liquid biomarker. We evaluated the Amnis® brand ImageStream®X MkII (ISX) (Luminex, Austin, TX, USA) imaging flow cytometer for its suitability for protein expression analysis and monitoring of treatment effects in CTCs. This was carried out using blood samples from patients with head and neck squamous cell carcinoma (n = 16) and breast cancer (n = 8). A protocol for negative enrichment and staining of CTCs was established, allowing quantitative analysis of the therapeutic targets PD–L1 and phosphorylated EGFR (phospho–EGFR), and the treatment response marker γH2AX as an indicator of radiation–induced DNA damage. Spiking experiments revealed a sensitivity of 73% and a specificity of 100% at a cut–off value of ≥3 CTCs, and thus confirmed the suitability of the ISX-based protocol to detect phospho–EGFR and γH2AX foci in CTCs. Analysis of PD–L1/–L2 in both spiked and patient blood samples further showed that assessment of heterogeneity in protein expression within the CTC population was possible. Further validation of the diagnostic potential of this ISX protocol for multiparametric CTC analysis in larger clinical cohorts is warranted.
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Affiliation(s)
- Stephanie Staudte
- Department of Radiooncology and Radiotherapy, Charité University Hospital, 10117 Berlin, Germany;
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Correspondence:
| | - Konrad Klinghammer
- Department of Hematology and Oncology, Charité University Hospital, 10117 Berlin, Germany;
- Charité Comprehensive Cancer Center (CCCC), Charité University Hospital, 10117 Berlin, Germany;
| | - Philipp Sebastian Jurmeister
- Institute of Pathology, Charité University Hospital, 10117 Berlin, Germany;
- Institute of Pathology, Ludwig Maximilians University Hospital Munich, 80337 Munich, Germany
| | - Paul Jank
- Institute of Pathology, Philipps-University Marburg and University-Hospital Marburg (UKGM), 35039 Marburg, Germany;
| | - Jens-Uwe Blohmer
- Breast Cancer Center, Charité University Hospital, 10117 Berlin, Germany;
| | - Sandra Liebs
- Charité Comprehensive Cancer Center (CCCC), Charité University Hospital, 10117 Berlin, Germany;
| | - Peter Rhein
- Luminex B.V., A DiaSorin Company, 5215 MV‘s-Hertogenbosch, The Netherlands;
| | - Anja E. Hauser
- Department of Rheumatology and Clinical Immunology, Charité University Hospital, 10117 Berlin, Germany;
- Deutsches Rheuma-Forschungszentrum (DRFZ), Leibniz Association, 10117 Berlin, Germany
| | - Ingeborg Tinhofer
- Department of Radiooncology and Radiotherapy, Charité University Hospital, 10117 Berlin, Germany;
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
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Iacob R, Mandea M, Iacob S, Pietrosanu C, Paul D, Hainarosie R, Gheorghe C. Liquid Biopsy in Squamous Cell Carcinoma of the Esophagus and of the Head and Neck. Front Med (Lausanne) 2022; 9:827297. [PMID: 35572996 PMCID: PMC9098838 DOI: 10.3389/fmed.2022.827297] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
Squamous cell carcinomas of the esophagus (ESCC) and of the head and neck (HNSCC) are two neoplasms that share common risk factors and have the same embryological origin, but a very different prognosis, the 5-year survival of HNSCC being almost double (40–50%) compared to the 5-year survival of ESCC (20%). Current guidelines emphasize the importance of screening for ESCC in patients diagnosed with head and neck cancers. A liquid biopsy is a novel tool for diagnosis, prognostic stratification, and personalized therapy. Liquid biopsy biomarkers for these two malignancies could help both their early detection, facilitate residual disease identification, and provide prognosis information. The present systematic review of the literature was aimed at describing the liquid biopsy biomarkers present in these two malignancies, with an emphasis on potential clinical applications.
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Affiliation(s)
- Razvan Iacob
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Digestive Diseases and Liver Transplantation Center, Fundeni Clinical Institute, Bucharest, Romania
- Center of Excellence in Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania
| | - Matei Mandea
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
| | - Speranta Iacob
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Digestive Diseases and Liver Transplantation Center, Fundeni Clinical Institute, Bucharest, Romania
- Center of Excellence in Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania
| | - Catalina Pietrosanu
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Professor Doctor Dorin Hociota Institute of Phonoaudiology and Functional ENT Surgery, Bucharest, Romania
| | - Doru Paul
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Razvan Hainarosie
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Professor Doctor Dorin Hociota Institute of Phonoaudiology and Functional ENT Surgery, Bucharest, Romania
- *Correspondence: Razvan Hainarosie
| | - Cristian Gheorghe
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Digestive Diseases and Liver Transplantation Center, Fundeni Clinical Institute, Bucharest, Romania
- Center of Excellence in Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania
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Chen K, Chen Z, Ou M, Wang J, Huang X, Wu Y, Zhong W, Yang J, Huang J, Huang M, Pan D. Clinical significance of circulating tumor cells in predicating the outcomes of patients with colorectal cancer. Clinics (Sao Paulo) 2022; 77:100070. [PMID: 36087570 PMCID: PMC9464896 DOI: 10.1016/j.clinsp.2022.100070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/04/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Relapse and metastasis of patients with Colorectal Cancer (CRC) is the major obstacle to the long-term life of patients. Its mechanisms remain defined. METHODS A total of 48 CRC patients were enrolled and 68 samples were obtained from the peripheral blood of patients before or after treatments in this study. Twenty non-cancer patients were also detected as a negative control. Circulating Tumor Cells (CTCs), including Epithelial CTCs (eCTCs), Mesenchymal (MCTCs), and epithelial/mesenchymal mixed phenotypes (mixed CTCs), were identified by CanPatrolTM CTC enrichment and RNA in situ hybridization. The relationship between CTCs number and Progression-Free Survival (PFS) or Overall Survival (OS) was evaluated. RESULTS Thirty-four of 48 patients (70.8%) were found to have positive CTCs. Total CTCs and MCTCs in the post-treatment had a significant correlation PFS and OS. When total CTCs or MCTCs in 5 mL blood of patients were more than 6 CTCs or 5 MCTCs, PFS of the patients was significantly shorter (p < 0.05) than that in patients with less than 6 CTCs or 5 MCTCs. The patients with > 5 CTCs count changes were found to exhibit poor PFS and OS rates (p < 0.05). CONCLUSION Total CTCs and MCTCs number detection in patients with colorectal cancer was very useful biomarker for predicting the prognosis of patients. Higher CTCs or MCTCs had poorer PFS and OS rates.
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Affiliation(s)
- Kehe Chen
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Zhenxiang Chen
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Mei Ou
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Junping Wang
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xiao Huang
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yingying Wu
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Wenhe Zhong
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jiao Yang
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jinging Huang
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Min Huang
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Deng Pan
- Department of Medical Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
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Brandenburg LS, Metzger MC, Poxleitner P, Voss PJ, Vach K, Hell J, Hasel K, Weingart JV, Schwarz SJ, Ermer MA. Effects of Red Blood Cell Transfusions on Distant Metastases of Oral Squamous Cell Carcinomas. Cancers (Basel) 2021; 14:cancers14010138. [PMID: 35008301 PMCID: PMC8750075 DOI: 10.3390/cancers14010138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 11/24/2022] Open
Abstract
Simple Summary Patients with distant metastasis of oral squamous cell carcinoma should be identified at an early stage of disease. In this study, we investigated if patients who received red blood cell transfusions are at risk for the development of distant metastasis. A positive correlation was found between RBC transfusion (HR = 2.42) and the occurrence of M+ in a multivariate regression model. Therefore, the administration of RBC can be considered as an independent prognostic factor and special attention should be paid to its detrimental effects in the perioperative management of OSCC patients. Abstract There is no consensus on the effect of red blood cell (RBC) transfusions on patients with oral squamous cell carcinoma (OSCC). The aim of this study was to investigate the association between RBC administration and the occurrence of distant metastases (M+) after surgical treatment of OSCC. All medical records of patients who underwent primary surgery for OSCC in our department (2003–2019) were analyzed retrospectively (n = 609). Chi and Cox regression models were used to analyze the influence of transfusion on the development of M+, and survival rates. Kaplan–Meier curves were used for graphical presentation. A multitude of patient-specific factors showed a statistical impact in univariate analysis (transfusion, age, gender, diabetes, pT, pN, L, V, Pn, G, UICC, adjuvant therapy, free microvascular transplant, preoperative hemoglobin level). Transfusion status and pN stage were the only variables that showed a significant correlation to M+ in the multivariate Cox model. The hazard ratios for the occurrence of M+ were 2.42 for RBC transfusions and 2.99 for pN+. Administration of RBC transfusions was identified as a significant prognostic parameter for the occurrence of distant metastases after surgical treatment of OSCC. Hence, the administration of RBC transfusions should be considered carefully in the perioperative management.
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Affiliation(s)
- Leonard Simon Brandenburg
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany; (M.C.M.); (P.P.); (P.J.V.); (K.H.); (J.V.W.); (S.J.S.); (M.A.E.)
- Correspondence: ; Tel.: +49-761-270-49240
| | - Marc Christian Metzger
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany; (M.C.M.); (P.P.); (P.J.V.); (K.H.); (J.V.W.); (S.J.S.); (M.A.E.)
| | - Philipp Poxleitner
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany; (M.C.M.); (P.P.); (P.J.V.); (K.H.); (J.V.W.); (S.J.S.); (M.A.E.)
| | - Pit Jacob Voss
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany; (M.C.M.); (P.P.); (P.J.V.); (K.H.); (J.V.W.); (S.J.S.); (M.A.E.)
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Zinkmattenstr. 6A, 79108 Freiburg, Germany;
| | - Johannes Hell
- Department of Anesthesiology and Critical Care, Clinic, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany;
| | - Konstantin Hasel
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany; (M.C.M.); (P.P.); (P.J.V.); (K.H.); (J.V.W.); (S.J.S.); (M.A.E.)
| | - Julia Vera Weingart
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany; (M.C.M.); (P.P.); (P.J.V.); (K.H.); (J.V.W.); (S.J.S.); (M.A.E.)
| | - Steffen Jochen Schwarz
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany; (M.C.M.); (P.P.); (P.J.V.); (K.H.); (J.V.W.); (S.J.S.); (M.A.E.)
| | - Michael Andreas Ermer
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany; (M.C.M.); (P.P.); (P.J.V.); (K.H.); (J.V.W.); (S.J.S.); (M.A.E.)
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