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Ong CAJ, Shannon NB, Mueller S, Lek SM, Qiu X, Chong FT, Li K, Koh KK, Tay GC, Skanthakumar T, Hwang JS, Hon Lim TK, Ang MK, Tan DS, Tan NC, Tan HK, Soo KC, Iyer NG. A three gene immunohistochemical panel serves as an adjunct to clinical staging of patients with head and neck cancer. Oncotarget 2017; 8:79556-79566. [PMID: 29108335 PMCID: PMC5668068 DOI: 10.18632/oncotarget.18568] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 06/08/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Current management of head and neck squamous cell carcinoma (HNSCC) depends on tumor staging. Despite refinements in clinical staging algorithms, outcomes remain unchanged for the last two decades. In this study, we set out to identify a small, clinically applicable molecular panel to aid prognostication of patients with HNSCC. MATERIALS AND METHODS Data from The Cancer Genome Atlas (TCGA) was used to derive copy number aberrations and expression changes to identify putative prognostic genes. To account for cross entity relevance of the biomarkers, HNSCC (n = 276), breast (n = 808) and lung cancer (n = 282) datasets were used to identify robust and reproducible markers with prognostic potential. Validation was performed using immunohistochemistry (IHC) on tissue microarrays of an independent cohort of HNSCC (n = 333). FINDINGS Using GISTIC algorithm together with gene expression analysis, we identified six putative prognostic genes in at least two out of three cancers analyzed, of which four were successfully optimized for automated IHC. Of these, three were successfully validated; each molecular target being significantly prognostic on univariate analysis. Patients were differentially segregated into four prognostic groups based on the number of genes dysregulated (p < 0.001). The IHC panel remained an independent predictor of survival after adjusting for known survival covariates including clinical staging criteria in a multivariate Cox regression model (p < 0.001). . INTERPRETATION We have identified and validated a clinically applicable IHC biomarker panel that is independently associated with overall survival. This panel is readily applicable, serving as a useful adjunct to current staging systems and provides novel targets for future therapeutic strategies.
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Affiliation(s)
- Chin-Ann J. Ong
- Department of General Surgery, Singapore General Hospital, S169856, Singapore
- Division of Surgical Oncology, National Cancer Centre, S169610, Singapore
| | - Nicholas B. Shannon
- Cancer and Stem Cell Biology, Duke-NUS Graduate Medical School, S169857, Singapore
| | - Stefan Mueller
- Division of Surgical Oncology, National Cancer Centre, S169610, Singapore
- Singhealth Duke-NUS Head and Neck Centre, Singhealth, S169856, Singapore
| | - Sze Min Lek
- Cancer and Stem Cell Biology, Duke-NUS Graduate Medical School, S169857, Singapore
| | - Xuan Qiu
- Department of General Surgery, Singapore General Hospital, S169856, Singapore
| | - Fui Teen Chong
- Cancer Therapeutics Research Laboratory, National Cancer Centre, S169610, Singapore
| | - Ke Li
- Cancer and Stem Cell Biology, Duke-NUS Graduate Medical School, S169857, Singapore
| | - Kelvin K.N. Koh
- Cancer and Stem Cell Biology, Duke-NUS Graduate Medical School, S169857, Singapore
| | - Gerald C.A. Tay
- Department of General Surgery, Singapore General Hospital, S169856, Singapore
- Singhealth Duke-NUS Head and Neck Centre, Singhealth, S169856, Singapore
| | | | | | - Tony Kiat Hon Lim
- Department of Anatomical Pathology, Singapore General Hospital, S169856, Singapore
| | - Mei Kim Ang
- Department of Medical Oncology, National Cancer Centre, S169610, Singapore
| | - Daniel S.W. Tan
- Department of Medical Oncology, National Cancer Centre, S169610, Singapore
| | - Ngian-Chye Tan
- Singhealth Duke-NUS Head and Neck Centre, Singhealth, S169856, Singapore
| | - Hiang Khoon Tan
- Singhealth Duke-NUS Head and Neck Centre, Singhealth, S169856, Singapore
| | - Khee Chee Soo
- Singhealth Duke-NUS Head and Neck Centre, Singhealth, S169856, Singapore
| | - N. Gopalakrishna Iyer
- Cancer and Stem Cell Biology, Duke-NUS Graduate Medical School, S169857, Singapore
- Cancer Therapeutics Research Laboratory, National Cancer Centre, S169610, Singapore
- Singhealth Duke-NUS Head and Neck Centre, Singhealth, S169856, Singapore
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Aderhold C, Grobschmidt GM, Sauter A, Faber A, Hörmann K, Schultz JD. Interleukin 4, interleukin 6 and osteopontin-serological markers of head and neck malignancy in primary diagnostics: A pilot study. Oncol Lett 2014; 8:1112-1118. [PMID: 25120668 PMCID: PMC4114600 DOI: 10.3892/ol.2014.2312] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Accepted: 04/01/2014] [Indexed: 12/16/2022] Open
Abstract
The progression of head and neck squamous cell carcinoma (HNSCC) is stimulated by various angiogenic peptides and growth factors. A correlation between tumor progression and the secretion of various serological mediators in patients with malignant tumors of the head and neck is of major interest for tumor diagnostics, evaluation of the therapy response and it may predict prognosis by specifying the individual tumor biology. Established chemotherapeutic regimes for head and neck tumors usually consist of platinum-based chemotherapeutic drugs and 5-fluorouracil (5-FU). The present pilot study sought to assess the eligibility of seven serological factors as biomarkers for malignant tumors of the head and neck: Platelet-derived growth factor, vascular endothelial growth factor, epidermal growth factor receptor, osteopontin, granulocyte-colony stimulating factor, interleukin-4 (IL-4) and IL-6. The serum levels of each factor in 20 patients receiving concomitant radiochemotherapy with cisplatin or carboplatin and 5-FU with curative intent were determined prior and subsequent to chemotherapy and were compared with 40 healthy controls. Another aim of the pilot study was to investigate whether the serum of patients showed significant differences in the concentrations of the analyzed factors at the start of concomitant radiochemotherapy compared with the controls, whether those markers indicated a neoplastic process and whether concomitant radiochemotherapy with cisplatin or carboplatin and 5-FU induced significant alterations of concentration compared with pre-therapeutic levels. The included patients were histopathologically diagnosed with HNSCC and the average age was 62.3 years. The serum samples of the patients were obtained during the course of regular pre- and post-chemotherapeutic blood draws one week prior to the start of radiochemotherapy and one week following the completion of chemotherapy. The healthy controls were collected from patients of the Sleep Laboratory of the Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital (Mannheim, Germany) without clinical evidence or laboratory signs of inflammation or history of a malignant disease. The average age was 50.3 years. The serological level of each factor was ascertained by enzyme-linked immunosorbent assay in duplicate. Serum levels of IL-4, IL-6 and osteopontin were significantly increased in patients with HNSCC compared with those in chemotherapy-naive healthy controls. IL-4 and osteopontin showed no significant therapy-associated alterations. Notably, IL-6 levels significantly increased post-therapeutically. Using logistic regression with osteopontin and IL-4, an individual risk-profile for random samples was calculated. IL-4, IL-6 and osteopontin appear to be suitable indicators of the neoplastic process as they are significantly increased in HNSCC patients compared with the control group. With the exception of IL-6, whose levels were in fact increased following therapy, a significant therapy-associated alteration of these factors was missing. Therefore, these serological markers failed to predict the therapy response, but they may be valuable as a screening instrument in primary diagnostics.
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Affiliation(s)
- Christoph Aderhold
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty of Mannheim, University of Heidelberg, Mannheim D-68167, Germany
| | - Guido Manuel Grobschmidt
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty of Mannheim, University of Heidelberg, Mannheim D-68167, Germany
| | - Alexander Sauter
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty of Mannheim, University of Heidelberg, Mannheim D-68167, Germany
| | - Anne Faber
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty of Mannheim, University of Heidelberg, Mannheim D-68167, Germany
| | - Karl Hörmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty of Mannheim, University of Heidelberg, Mannheim D-68167, Germany
| | - Johannes David Schultz
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty of Mannheim, University of Heidelberg, Mannheim D-68167, Germany
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Sivadas VP, George NA, Kattoor J, Kannan S. Novel mutations and expression alterations inSMAD3/TGFBR2genes in oral carcinoma correlate with poor prognosis. Genes Chromosomes Cancer 2013; 52:1042-52. [DOI: 10.1002/gcc.22099] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 07/10/2013] [Indexed: 01/10/2023] Open
Affiliation(s)
- Vadakke Peringode Sivadas
- Laboratory of Cell Cycle Regulation & Molecular Oncology, Division of Cancer Research, Regional Cancer Centre; Thiruvananthapuram 695 011 Kerala India
| | - Nebu Abraham George
- Division of Surgical Oncology, Regional Cancer Centre; Thiruvananthapuram 695 011 Kerala India
| | - Jayasree Kattoor
- Division of Cytopathology, Regional Cancer Centre; Thiruvananthapuram 695 011 Kerala India
| | - S. Kannan
- Laboratory of Cell Cycle Regulation & Molecular Oncology, Division of Cancer Research, Regional Cancer Centre; Thiruvananthapuram 695 011 Kerala India
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Schuler PJ, Hoffmann TK, Gauler TC, Bergmann C, Brandau S, Lang S. [Immunotherapy of head and neck cancer. Current developments]. HNO 2012; 61:559-72. [PMID: 23247754 DOI: 10.1007/s00106-012-2635-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
In order to improve the prognosis for patients with head and neck squamous cell cancer (HNSCC) the introduction of new therapeutic strategies is necessary. The concept of immunotherapy has been applied and improved for several years and recent studies have used tumor-specific antigens which facilitates targeted oncologic therapy. However, immunotherapy is hampered by the fact that immunosuppressive mechanisms are pronounced and relevant effector cells are suppressed, especially in patients with HNSCC. Successful immunotherapy could induce an antitumor immune response by restitution of these cell populations. Current anti-tumor immunotherapy includes unspecific immune stimulation, genetic modification of tumor and immune cells, the use of monoclonal antibodies, e.g. cetuximab, adoptive cell transfer and tumor vaccination. In the future, these biologic therapies alone or in combination with conventional therapeutic regimens could present a valuable therapeutic option for HNSCC patients.
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Affiliation(s)
- P J Schuler
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, Universität Duisburg-Essen.
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