Vascular Endothelial Growth Factor Expression Predicts Outcome after Primary Radiotherapy for Head and Neck Squamous Cell Cancer

A novel molecular classification system for head and neck squamous cell carcinoma: predicting treatment response and metastatic potential through multi-omics analysis

BACKGROUND

Head and neck squamous cell carcinoma (HNSCC) demonstrates significant heterogeneity, necessitating improved molecular classification for precision treatment.

METHODS

We integrated single-cell and bulk RNA sequencing data from 59,376 cells across ten datasets using Scissor and scSTAR packages. Molecular subtyping was performed through ssGSEA and WGCNA analysis, with immune infiltration evaluated using CIBERSORT. We developed a machine learning-based risk prediction model using 54 algorithms.

RESULTS

We identified three molecular subtypes with distinct prognostic implications, showing significant survival differences across independent datasets (TCGA-HNSCC, P < 0.0001; GSE65858, P = 0.018). The C3 subtype showed enhanced immunotherapy response potential, while C2 exhibited the highest genomic alteration rate (97.06%) and TP53 mutations (80%). Macrophages emerged as key players in intercellular communication networks. Our risk prediction model demonstrated robust performance across four validation cohorts.

CONCLUSION

This molecular subtyping framework provides valuable insights for patient stratification and personalized therapeutic strategies in HNSCC, potentially improving clinical outcomes through precise treatment selection.

Treatment of feline oral squamous cell carcinoma with accelerated radiation and carboplatin with and without follow-up toceranib phosphate

ObjectivesOral squamous cell carcinoma (SCC) is the most common oral tumor in cats but treatment options that provide long-term tumor control are limited. Radiation therapy is a reported treatment option, but local tumor control is still difficult to obtain and additional treatment options are needed. Toceranib phosphate recently emerged as having biologic activity against feline oral SCC. This study is a preliminary evaluation of radiation therapy and toceranib phosphate in cats with oral SCC.MethodsThis non-blinded, retrospective, single-institutional study included all patients between 2011 and 2023 that underwent the same treatment with accelerated radiation therapy and concurrent carboplatin as previously described, with the exception of one additional fraction of radiation. Once the early side effects abated, toceranib phosphate was offered as follow-up maintenance therapy. The median survival time (MST) and progression-free interval (PFI) were assessed for the cats that received toceranib after radiation therapy and carboplatin, and were compared with the cats that received the same radiation and carboplatin protocol within the same time period but did not receive follow-up toceranib.ResultsOverall, 47 cats met the criteria for evaluation; of them, 15 received follow-up toceranib. The MST of all cats was 164 days; there was no significant difference in MST or PFI between the cats that did and did not receive adjuvant toceranib (MST 208 days vs 162 days, respectively; P = 0.35). When comparing cats with lingual tumors, the PFI was significantly longer in the cats that received toceranib than those that did not (142 days vs 104 days, respectively; P = 0.045); however, there was no difference in MST (197 days vs 147 days; P = 0.15).Conclusions and relevanceThis study suggests that most cats with oral SCC do not benefit from toceranib after radiation therapy. There may be clinical benefit to administering adjuvant toceranib after radiation in cats with lingual SCCs, but the mechanism remains unclear and additional studies are warranted.

Overcoming radioresistance in head and neck squamous cell carcinoma

Radiation therapy plays an essential role in the treatment of head and neck squamous cell carcinoma (HNSCC), yet therapeutic efficacy is hindered by treatment-associated toxicity and tumor recurrence. In comparison to other cancers, innovation has proved challenging, with the epidermal growth factor receptor (EGFR) antibody cetuximab being the only new radiosensitizing agent approved by the FDA in over half a century. This review examines the physiological mechanisms that contribute to radioresistance in HNSCC as well as preclinical and clinical data regarding novel radiosensitizing agents, with an emphasis on those with highest translational promise.

Psychosocial functioning and vascular endothelial growth factor in patients with head and neck cancer

BACKGROUND

Psychosocial functioning is associated with vascular endothelial growth factor (VEGF) in various patient populations. This study examined whether psychosocial functioning in patients with head and neck squamous cell carcinoma (HNSCC) is associated with tumor VEGF expression, a protein that stimulates angiogenesis and is associated with poor prognosis.

METHODS

Forty-two newly diagnosed patients completed assessments of psychosocial functioning (ie, depressive symptoms, perceived stress, anxiety, social support) before surgery. Tumor samples were obtained for VEGF analysis and human papillomavirus (HPV)-typing.

RESULTS

Poorer psychosocial functioning was associated with greater VEGF expression controlling for disease stage (odds ratio [OR], 4.55; 95% confidence interval [CI], 1.72-12.0; p < .01). When examined by HPV status, the association between psychosocial functioning and VEGF remained significant among patients who were HPV negative (OR, 5.50; 95% CI, 1.68-17.3; p < .01), but not among patients who were HPV positive.

CONCLUSION

These findings inform our understanding of the biobehavioral pathways that may contribute to poor outcomes in non-HPV-associated HNSCCs.

Vascular endothelial growth factor and ki-67 antigen expression in relation to age and gender in oral squamous cell carcinoma

BACKGROUND AND AIMS

Vascular endothelial growth factor (VEGF) and Ki-67 antigen are contributing factors in this process cell proliferation and new blood vessels formation in tumor progression. This study was conducted to examine the relationship between the expression of VEGF and Ki-67 and gender and age of patients with oral squamous cell carcinoma (OSCC).

MATERIALS AND METHODS

Twenty-three archival samples of well-differentiated OSCC were examined immunohisto-chemically and assessed by obtaining Total Score (TS = proportion score × staining index). For statistical analysis, t-test and Pearson's correlation were employed. P≤0.05 was considered statistically significant.

RESULTS

The differences in VEGF expression between males and females (P = 0.43) and different ages (P = 0.88) were not significant. The differences in Ki-67 expression was between males and females (P = 0.67) and different ages (P = 0.88) were also not significant. A positive correlation of VEGF and Ki-67 expression was observed in males and females in addi-tion to ≤ 60 years age group (r = 0.22, r = 0.008, and r = 0.58, respectively; P < 0.05). The expression of VEGF had a nega-tive relation to Ki-67 in > 60 years group (r = -0.48, P < 0.05).

CONCLUSION

The expression of VEGF and Ki-67 between males and females and different ages were not significant among oral squamous cell carcinoma cases evaluated.

BRCA1 tumours correlate with a HIF-1alpha phenotype and have a poor prognosis through modulation of hydroxylase enzyme profile expression

Background:

There are limited data regarding the hypoxia pathway in familial breast cancers. We therefore performed a study of hypoxic factors in BRCA1, BRCA2 and BRCAX breast cancers.

Methods:

Immunoperoxidase staining for HIF-1α, PHD1, PHD2, PHD3, VEGF and FIH was carried out in 125 (38 BRCA1, 33 BRCA2 and 54 BRCAX) breast carcinomas. These were correlated with clinicopathological parameters and the intrinsic breast cancer phenotypes.

Results:

BRCA1 tumours correlated with positivity for HIF-1α (P=0.008) and negativity for PHD3 (P=0.037). HIF-1α positivity (P=0.001), PHD3 negativity (P=0.037) and nuclear FIH negativity (P=0.011) was associated with basal phenotype. HIF-1α expression correlated with high tumour grade (P=0.009), negative oestrogen receptor (ER) status (P=0.001) and the absence of lymph node metastasis (P=0.028). Nuclear FIH expression and PHD3 correlated with positive ER expression (P=0.024 and P=0.035, respectively). BRCA1 cancers with positive HIF-1α or cytoplasmic FIH had a significantly shorter relapse-free survival (P=0.007 and P=0.049, respectively).

Conclusions:

The aggressive nature of BRCA1 and basal-type tumours may be partly explained by an enhanced hypoxic drive and hypoxia driven ER degradation because of suppressed PHD and aberrantly located FIH expression. This may have important implications, as these tumours may respond to compounds directed against HIF-1α or its downstream targets.