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Arslan Bozdag L, Inan S, Elif Gultekin S. Microsatellite Instability and Loss of Heterozygosity as Prognostic Markers in Oral Squamous Cell Carcinoma: Molecular Mechanisms, Detection Techniques, and Therapeutic Strategies. Genes Chromosomes Cancer 2024; 63:e70002. [PMID: 39470253 DOI: 10.1002/gcc.70002] [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: 10/01/2024] [Accepted: 10/05/2024] [Indexed: 10/30/2024] Open
Abstract
The aim of this study was to conduct a systematic review of research investigating the potential role of microsatellite instability (MSI) and loss of heterozygosity (LOH) in oral squamous cell carcinoma (OSCC), with a focus on molecular mechanisms, detection methods, and therapeutic approaches. Search for articles involved the PubMed and Scopus. Previous retrospective and prospective studies identified variations between oral cancers that exhibit microsatellite stability and LOH. In this search, 294 articles were initially retrieved. Of these, 70 were excluded due to duplication, 106 were identified as ineligible by automated tools, and 24 were excluded as they were published in languages other than English. An additional 94 articles were excluded, 32 of which focused on head and neck cancers broadly, and 8 could not be accessed due to withdrawal. Ultimately, a systematic review was conducted based on 54 selected articles. Among the chromosomes analyzed for MSI and LOH, the highest frequency of LOH was observed on chromosome 9p. The MSI subtype is particularly susceptible to immunotherapeutic methods, such as the use of anti-PD-L1 and anti-CTLA4 antibodies, owing to its strong immunogenicity and ubiquitous expression of immune checkpoint ligands. Given the distinct characteristics and clinical behavior of oral cancer with MSI compared to microsatellite stable disease, it is advisable to incorporate MSI testing into the diagnostic process for all stages of tumor development. This ensured that each patient had received precise and effective treatment.
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Affiliation(s)
- Leyla Arslan Bozdag
- Faculty of Science, Department of Biology, Gazi University, Ankara, Turkey
- Faculty of Dentistry, Department of Oral Pathology, Gazi University, Ankara, Turkey
| | - Sevinç Inan
- Tepebasi Oral Dental Health Centre, Ankara, Turkey
| | - Sibel Elif Gultekin
- Faculty of Dentistry, Department of Oral Pathology, Gazi University, Ankara, Turkey
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Ait‐Oudhia S, Jaworowicz D, Hu Z, Bihorel S, Hu S, Balasubrahmanyam B, Mistry B, de Oliveira Pena J, Wenning L, Gheyas F. Population pharmacokinetic modeling of sotatercept in healthy participants and patients with pulmonary arterial hypertension. CPT Pharmacometrics Syst Pharmacol 2024; 13:1380-1393. [PMID: 38812074 PMCID: PMC11330185 DOI: 10.1002/psp4.13166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/31/2024] Open
Abstract
Sotatercept is a breakthrough, first-in-class biologic, that is FDA-approved for the treatment of pulmonary arterial hypertension (PAH). A population pharmacokinetic (PopPK) model was developed using data from two phase 1 studies in healthy participants, and two phase 2 studies and one phase 3 study in participants with PAH. The pooled sotatercept PK data encompassed single intravenous (IV) or subcutaneous (SC) doses ranging from 0.01 to 3.0 mg/kg, as well as multiple SC doses ranging from 0.03 to 1.0 mg/kg, with PK samples collected up to a maximum of ~150 weeks following Q3W and Q4W dosing regimens. The final PopPK analysis included 350 participants, with 30 and 320 participants receiving sotatercept IV and SC, respectively. A two-compartment model with a first-order absorption rate constant and a linear disposition from central compartment well-described sotatercept PK. The estimated bioavailability is ~66%; bioavailability, clearance (CL), and central volume (VC) have low to moderate inter-individual variability. Time-varying body weight and baseline albumin concentration were statistically significant predictors of PK; CL and VC were predicted to increase with increasing body weight, while CL was predicted to decrease with increasing baseline albumin concentration. However, the magnitude of covariate effects is not predicted to meaningfully alter the disposition of sotatercept. Altogether, the PopPK modeling results demonstrate favorable PK characteristics (low to moderate variability and typical bioavailability), supporting sotatercept as a SC biological agent for the treatment of patients with PAH.
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Affiliation(s)
| | | | - Ziheng Hu
- Merck & Co., Inc.RahwayNew JerseyUSA
| | | | - Shuai Hu
- Merck & Co., Inc.RahwayNew JerseyUSA
| | | | - Bipin Mistry
- Acceleron Pharma, a subsidiary of Merck & Co., Inc.RahwayNew JerseyUSA
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Understanding Inter-Individual Variability in Monoclonal Antibody Disposition. Antibodies (Basel) 2019; 8:antib8040056. [PMID: 31817205 PMCID: PMC6963779 DOI: 10.3390/antib8040056] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/22/2019] [Accepted: 11/27/2019] [Indexed: 12/29/2022] Open
Abstract
Monoclonal antibodies (mAbs) are currently the largest and most dominant class of therapeutic proteins. Inter-individual variability has been observed for several mAbs; however, an understanding of the underlying mechanisms and factors contributing to inter-subject differences in mAb disposition is still lacking. In this review, we analyze the mechanisms of antibody disposition and the putative mechanistic determinants of inter-individual variability. Results from in vitro, preclinical, and clinical studies were reviewed evaluate the role of the neonatal Fc receptor and Fc gamma receptors (expression and polymorphism), target properties (expression, shedding, turnover, internalization, heterogeneity, polymorphism), and the influence of anti-drug antibodies. Particular attention is given to the influence of co-administered drugs and disease, and to the physiological relevance of covariates identified by population pharmacokinetic modeling, as determinants of variability in mAb pharmacokinetics.
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Prognostic impact of intra-field heterogeneity in oral squamous cell carcinoma. Virchows Arch 2019; 476:585-595. [PMID: 31468114 DOI: 10.1007/s00428-019-02656-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/29/2019] [Accepted: 08/22/2019] [Indexed: 01/02/2023]
Abstract
Genetic heterogeneity displayed by tumour cells (intratumoural heterogeneity, ITH) represents a diagnostic challenge when assessing tumour mutational profile. In oral squamous cell carcinoma (OSCC), ITH may be found both in tumour cells and in adjacent mucosa. Genetic heterogeneity of the adjacent mucosa can be interpreted as evidence of the field cancerization (field heterogeneity, FH). The aim of the study was to investigate the impact of intratumoural and intrafield heterogeneity on locoregional control. Ten OSCC patients (5 recurrent and 5 nonrecurrent) were studied. Multiple areas were sampled from the bulk of the tumour and the adjacent nonneoplastic mucosa. A panel of 10 tumour-specific OSCC driver genes was analysed for each sample and was used to calculate heterogeneity. Values were compared among recurrent and nonrecurrent OSCC. Mutational analysis highlighted that a single tumour sample has limited accuracy in assessing the genetic profiles of tumours. High values of ITH considering shared mutations between specimens were found in both recurrent and non-recurrent OSCC (p = 0.095). On the contrary, the intrafield genetic heterogeneity was significantly less frequently in the non-recurrent OSCC group (p = 0.032). Heterogeneity within each specimen calculated with variant allele frequency confirmed that there was better discrimination between recurrent and nonrecurrent groups using nonneoplastic adjacent mucosa than tumour tissue (p value 0.0006 and 0.0048 respectively). In agreement with the theory of field cancerization, intrafield genetic heterogeneity correlates with a higher risk of developing loco-regional recurrences and second primaries. In order to reduce the ITH effects, analysis of multiple tumour areas should be encouraged.
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Zhong L, Liu Y, Wang K, He Z, Gong Z, Zhao Z, Yang Y, Gao X, Li F, Wu H, Zhang S, Chen L. Biomarkers: paving stones on the road towards the personalized precision medicine for oral squamous cell carcinoma. BMC Cancer 2018; 18:911. [PMID: 30241505 PMCID: PMC6151070 DOI: 10.1186/s12885-018-4806-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 09/06/2018] [Indexed: 12/20/2022] Open
Abstract
Traditional therapeutics have encountered a bottleneck caused by diagnosis delay and subjective and unreliable assessment. Biomarkers can overcome this bottleneck and guide us toward personalized precision medicine for oral squamous cell carcinoma. To achieve this, it is important to efficiently and accurately screen out specific biomarkers from among the huge number of molecules. Progress in omics-based high-throughput technology has laid a solid foundation for biomarker discovery. With credible and systemic biomarker models, more precise and personalized diagnosis and assessment would be achieved and patients would be more likely to be cured and have a higher quality of life. However, this is not straightforward owing to the complexity of molecules involved in tumorigenesis. In this context, there is a need to focus on tumor heterogeneity and homogeneity, which are discussed in detail. In this review, we aim to provide an understanding of biomarker discovery and application for precision medicine of oral squamous cell carcinoma, and have a strong belief that biomarker will pave the road toward future precision medicine.
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Affiliation(s)
- Liang Zhong
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Yutong Liu
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Kai Wang
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Zhijing He
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Zhaojian Gong
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Zhili Zhao
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Yaocheng Yang
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Xiaofei Gao
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Fangjie Li
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Hanjiang Wu
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Sheng Zhang
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China.
| | - Lin Chen
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China.
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Thennavan A, Sharma M, Chandrashekar C, Hunter K, Radhakrishnan R. Exploring the potential of laser capture microdissection technology in integrated oral biosciences. Oral Dis 2016; 23:737-748. [DOI: 10.1111/odi.12578] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 08/10/2016] [Accepted: 08/24/2016] [Indexed: 12/19/2022]
Affiliation(s)
- A Thennavan
- Department of Oral Pathology; Manipal College of Dental Sciences; Manipal Karnataka India
| | - M Sharma
- Pacific Academy of Higher Education and Research (PAHER) University; Udaipur Rajasthan India
- Department of Oral Pathology; ITS Dental College; Hospital and Research Center; Greater Noida India
| | - C Chandrashekar
- Department of Oral Pathology; Manipal College of Dental Sciences; Manipal Karnataka India
| | - K Hunter
- School of Clinical Dentistry; The University of Sheffield; Sheffield UK
| | - R Radhakrishnan
- Department of Oral Pathology; Manipal College of Dental Sciences; Manipal Karnataka India
- School of Clinical Dentistry; The University of Sheffield; Sheffield UK
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Intratumor molecular heterogeneity in pleomorphic adenoma of the salivary glands. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121:158-63. [DOI: 10.1016/j.oooo.2015.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 09/03/2015] [Accepted: 09/07/2015] [Indexed: 02/06/2023]
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Caldeira PC, de Andrade Sousa A, de Aguiar MCF. Differential infiltration of neutrophils in T1-T2 versus T3-T4 oral squamous cell carcinomas: a preliminary study. BMC Res Notes 2015; 8:569. [PMID: 26467671 PMCID: PMC4607015 DOI: 10.1186/s13104-015-1541-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 10/05/2015] [Indexed: 12/17/2022] Open
Abstract
Background Recent studies have pointed towards a role of tumour-infiltrating neutrophils in cancer biology. Investigations on oral squamous cell carcinoma have indicated a possible association with clinical characteristics. This study aimed to evaluate neutrophil infiltration and the neutrophil/lymphocyte ratio in the central areas and invasive front of oral squamous cell carcinomas at different T stages, and their association with clinicopathological features and patient outcome. Methods Clinical information was retrieved from the charts of patients who had undergone surgical treatment. Samples of the excised tumours were subjected to immunohistochemical analysis for CD66b and CD3. Semi-quantitative analysis was performed in the intratumoural region and in the invasive front. Appropriate statistical tests were used for evaluating the data, including Kaplan–Meier survival analysis and the log-rank test. A p value of less than 0.05 was considered significant. Results T3–T4 tumours presented higher CD66b infiltration in the intratumoural region and higher CD66b/CD3 ratios in the invasive front than T1–T2 lesions (p < 0.05). There was a strong inverse correlation between CD66b and CD3 in the invasive front of T3–T4 tumours (r = −0.712, p < 0.05). Comparisons of CD66b and the CD66b/CD3 ratio according to N status, tumour location, recurrence, inflammation grade, and histological grade did not reach statistical significance. Survival analysis also did not show any significant differences. Conclusions The present study showed different degrees of neutrophil infiltration between T1–T2 and T3–T4 oral cancers, with higher indexes in the advanced lesions. However, there was no association with clinicopathological features or with time to recurrence. Electronic supplementary material The online version of this article (doi:10.1186/s13104-015-1541-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Patrícia Carlos Caldeira
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, CEP: 31.270-901, Belo Horizonte, MG, Brazil.
| | - Alexandre de Andrade Sousa
- Department of Surgery of the School of Medicine and Head and Neck Surgery, Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Maria Cássia Ferreira de Aguiar
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, CEP: 31.270-901, Belo Horizonte, MG, Brazil.
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Inter- and intra-lesional molecular heterogeneity of oral leukoplakia. Oral Oncol 2014; 51:178-81. [PMID: 25467776 DOI: 10.1016/j.oraloncology.2014.11.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 10/28/2014] [Accepted: 11/02/2014] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Oral leukoplakia (OL) is the most common potentially malignant lesion of the oral cavity, and OL diagnosis is a risk factor for developing subsequent oral squamous cell carcinomas (OSCC). Notably, loss of heterozygosity (LOH) profiles have been validated as risk predictors of malignant transformation of OL. Similar to other solid malignant tumors, OSCC exhibit molecular heterogeneity. However, if and to what extent tumor heterogeneity is present in premalignant lesions of the oral cavity has not been addressed. As LOH analysis is currently being used to stratify OL patients at risk for OSCC development in chemoprevention studies, insight into the issue of molecular heterogeneity of OL is of clinical significance. MATERIALS AND METHODS To address this issue, 11 polymorphic microsatellite markers localizing to chromosomes 3, 9, 11 and 17 were used to detect LOH in 28 samples of 14 OL patients, by capillary electrophoresis analysis. These samples were either clinically recurrent lesions, or two anatomically distinct biopsies from the same lesion, or even two different OL lesions located at distinct intraoral sites. RESULTS In all but one of the biopsies pairs, distinct LOH patterns were displayed regardless of histopathological grade. These data provide evidence for inter- and intra-lesional molecular heterogeneity in OL. CONCLUSIONS On the basis of these findings, molecular heterogeneity needs to be addressed in subsequent studies targeting specific carcinogenic pathways/genes in chemoprevention of malignant transformation of OL.
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MutSα and MutLα immunoexpression analysis in diagnostic grading of oral epithelial dysplasia and squamous cell carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 119:74-82. [PMID: 25446502 DOI: 10.1016/j.oooo.2014.06.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 06/02/2014] [Accepted: 06/15/2014] [Indexed: 01/17/2023]
Abstract
OBJECTIVES This study explored the expression of DNA mismatch repair (MMR) proteins in a range of oral biopsies. We further evaluated the significance of MMR protein expression combined with basic demographic data in differentiating grades of oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC). STUDY DESIGN Immunohistochemical expression of MutSα (hMLH1 and hPMS2) and MutLα (hMSH2 and hMSH6) were compared in 98 formalin-fixed paraffin embedded oral biopsies: 21 normal, 24 mild-dysplasia (MD), 8 moderate-to-severe-dysplasia (SD), and 45 OSCC. RESULTS Expression of hMLH1, hPMS2, and hMSH2 was reduced in MD, SD, and OSCC compared with the normal. Reduced hMSH2 immunoreactivity discriminated poorly differentiated OSCC from well-differentiated OSCC. The diagnostic model correctly classified 71.4% of cases and revealed that hPMS2-negative biopsies were more likely to be cancerous (odds ratio [OR], 0.11; 95% confidence interval [CI], 0.000-0.813; P = .040). CONCLUSION The results suggested a diagnostic role for MMR proteins in OED and OSCC.
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Neoangiogenesis. Assessment in Esophageal Adenocarcinomas. Indian J Surg 2014; 77:971-6. [PMID: 27011493 DOI: 10.1007/s12262-014-1091-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 04/23/2014] [Indexed: 12/18/2022] Open
Abstract
Esophageal cancer has always been subject of research for various studies. According to some authors, esophageal cancer represents the 10th leading cause of cancer in the world with a 5-year survival of 10 %. In terms of anatomopathological form of the esophageal neoplasia, the literature mainly describes two major pathological types: adenocarcinoma and esophageal squamous cell carcinoma. Lately there has been an increased incidence of esophageal adenocarcinoma. The aim of the present work was to study neoangiogenesis in esophageal adenocarcinomas. The study was conducted on 40 cases diagnosed and surgically treated. Subsequently, fragment processing was performed using various immunohistochemical staining and marking with CD34 and p53 antigen. Later, quantitative measurements were performed, and images were taken using a microscope imaging system. In the end of the procedures, the professional program PRODIT 5.2. was applied. The study of the vascular system in the esophageal epithelial tumors revealed an axis consisting of three elements which have a mutual induction process: inflammatory infiltrate-neoangiogenesis-fibrosis, with significant differences between the three degrees of differentiation. A significant increase in tumor micro vascular density was present together with the increasing of the histological grading, with an inverse correlation with the degree of differentiation and directly proportional to the risk of malignancy.
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Sarmento DJDS, de Almeida WL, Miguel MCDC, Queiroz LMG, Godoy GP, da Cruz MCFN, da Silveira EJD. Immunohistochemical analysis of mismatch proteins in carcinogenesis of the lower lip. Histopathology 2013; 63:371-7. [PMID: 23865379 DOI: 10.1111/his.12197] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 05/23/2013] [Indexed: 11/27/2022]
Abstract
AIM This study investigated the immunohistochemical expression of hMLH1 and hMSH2 proteins in lower lip squamous cell carcinoma (SCC) and actinic cheilitis (AC), to contribute to the understanding of the development of lower lip cancer. METHODS AND RESULTS Forty cases of lower lip AC and SCC were studied. Quantitative immunohistochemical analysis was undertaken by counting 1000 cells (positive and negative) in each lesion. Statistical evaluation included Student's t-test and one-way ANOVA. For SCC and AC, the mean number of hMLH1- and hMSH2-positive cells decreased with advanced stage of the lesion. The largest mean number of immunostained cells was observed in AC cases without dysplasia or with mild dysplasia (hMLH1: 721.23 ± 88.116; hMHS2: 781.50 ± 156.93). Intermediate values were obtained for AC with moderate or severe dysplasia (hMLH1: 532.86 ± 197.72; hMHS2: 611.14 ± 172.48). Lower lip SSCs presented the smallest number of positive cells (hMLH1: 255.03 ± 199.47; hMHS2: 518.38 ± 265.68). A statistically significant difference was observed between groups (P < 0.001). CONCLUSIONS The results support the hypothesis that changes in the immunoexpression of these mismatch proteins are related to the process of carcinogenesis of the lower lip.
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Tong CCL, Kao J, Sikora AG. Recognizing and reversing the immunosuppressive tumor microenvironment of head and neck cancer. Immunol Res 2013; 54:266-74. [PMID: 22454102 DOI: 10.1007/s12026-012-8306-6] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The estimated annual incidence of oral cavity and pharyngeal cancer is 39,000 in the United States and 260,000 cases worldwide. Despite significant advances in surgery, chemotherapy and radiotherapy, the 5-year survival rate for locally advanced head and neck tumors remains at 50 %. With further intensification of existing treatment limited by the already significant morbidity of multi-modality treatment, there is a clear need for novel therapeutic strategies [1]. Accumulating evidence suggests that the tumor microenvironment of head and neck squamous cell carcinoma (HNSCC) is highly immunosuppressive, mediated by soluble and cell-associated inhibitory mediators and recruitment of host immunosuppressive cells. Thus, understanding and reversing the specific mechanisms underlying tumor-mediated immunosuppression in HNSCC is an important approach to generating an effective antitumor immune response, either as a component of immune-based therapy or as a complement to conventional treatment approaches. This article outlines significant immune-suppressive mechanisms in the HNSCC tumor microenvironment and potential approaches to enhancing the antitumor immune response.
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Affiliation(s)
- Charles C L Tong
- Department of Otolaryngology, Head and Neck Surgery, The Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1189, New York, NY, USA
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A CD44high/EGFRlow subpopulation within head and neck cancer cell lines shows an epithelial-mesenchymal transition phenotype and resistance to treatment. PLoS One 2012; 7:e44071. [PMID: 23049743 PMCID: PMC3458050 DOI: 10.1371/journal.pone.0044071] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 08/01/2012] [Indexed: 01/08/2023] Open
Abstract
Mortality in head and neck squamous cell carcinoma (HNSCC) is high due to emergence of therapy resistance which results in local and regional recurrences that may have their origin in resistant cancer stem cells (CSCs) or cells with an epithelial-mesenchymal transition (EMT) phenotype. In the present study, we investigate the possibility of using the cell surface expression of CD44 and epidermal growth factor receptor (EGFR), both of which have been used as stem cell markers, to identify subpopulations within HNSCC cell lines that differ with respect to phenotype and treatment sensitivity. Three subpopulations, consisting of CD44high/EGFRlow, CD44high/EGFRhigh and CD44low cells, respectively, were collected by fluorescence-activated cell sorting. The CD44high/EGFRlow population showed a spindle-shaped EMT-like morphology, while the CD44low population was dominated by cobblestone-shaped cells. The CD44high/EGFRlow population was enriched with cells in G0/G1 and showed a relatively low proliferation rate and a high plating efficiency. Using a real time PCR array, 27 genes, of which 14 were related to an EMT phenotype and two with stemness, were found to be differentially expressed in CD44high/EGFRlow cells in comparison to CD44low cells. Moreover, CD44high/EGFRlow cells showed a low sensitivity to radiation, cisplatin, cetuximab and gefitinib, and a high sensitivity to dasatinib relative to its CD44high/EGFRhigh and CD44low counterparts. In conclusion, our results show that the combination of CD44 (high) and EGFR (low) cell surface expression can be used to identify a treatment resistant subpopulation with an EMT phenotype in HNSCC cell lines.
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Heterogeneity of KRAS status may explain the subset of discordant KRAS status between primary and metastatic colorectal cancer. Dis Colon Rectum 2011; 54:1170-8. [PMID: 21825899 DOI: 10.1097/dcr.0b013e31821d37a3] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND KRAS status is a useful predictive marker for anti-epidermal growth factor receptor antibody therapy. OBJECTIVE This study aimed to examine the concordance rate of KRAS mutation status between corresponding primary and metastatic colorectal cancer lesions, and also among multiple metastatic tumors. Furthermore, we examined the heterogeneity of KRAS mutations with respect to discordant KRAS status between primary and metastatic tumors. DESIGN AND SETTINGS This study was retrospective in design. PATIENTS Forty-three patients with primary tumors and 113 metastatic tumors were studied. MAIN OUTCOME MEASURES The KRAS mutational status was determined by the peptide nucleic acid clamp real-time polymerase chain reaction TaqMan assay. We also performed sequencing analysis to validate the KRAS mutational status. When KRAS status differed between primary and metastatic tumors, we examined the heterogeneity of KRAS status within individual primary tumors by microdissecting multiple samples in each patient. RESULTS The frequency of KRAS mutations in primary tumors was 34.9%. A high concordance rate of KRAS (88.4-91.7%) mutations was observed between primary and metastatic tumors. All 5 cases (11.6%) with discordant KRAS status had heterogeneous KRAS status in primary tumors. However, in 10 concordant cases all microdissected areas showed an identical KRAS mutational status within each patient. The KRAS mutational statuses in all multiple liver and/or lung metastatic tumors were the same as those of the primary tumor. LIMITATIONS We could not validate KRAS status in microdissected samples by the direct sequence method that was used in the present study, because the quantity of DNA was not sufficient to perform direct sequencing. CONCLUSION KRAS status in a primary site may be used for selecting patients who would benefit from anti-epidermal growth factor receptor therapy. However, KRAS status can be heterogeneous within a primary tumor, and thus different parts of such tumors should be examined for KRAS status to correctly predict the KRAS status in metastatic lesions.
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Liao YM, Kim C, Yen Y. Mammalian target of rapamycin and head and neck squamous cell carcinoma. HEAD & NECK ONCOLOGY 2011; 3:22. [PMID: 21513566 PMCID: PMC3108931 DOI: 10.1186/1758-3284-3-22] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2011] [Accepted: 04/24/2011] [Indexed: 12/26/2022]
Abstract
Head and neck squamous cell carcinoma (HNSCC), a significant cause of cancer deaths worldwide, has multiple stepwise malignant evolutions. Mammalian target of rapamycin (mTOR) plays a critical role in tumor development, invasion, metastasis and angiogenesis that impact local recurrence and survival. mTOR can also act as a biomarker for personalized adjuvant therapy. In in vivo and in vitro studies, mTOR inhibitor suppresses tumor growth and sensitizes HNSCC to radiation, cytotoxic agents and epidermoid growth factor receptor inhibitors. We have reviewed the pathogenesis of HNSCC, mTOR pathway, mTOR inhibitor and the role of mTOR in HNSCC.
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Affiliation(s)
- Yu-Min Liao
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, 404, Taiwan
| | - Charles Kim
- Department of Molecular Pharmacology, Beckman Research Institute, City of Hope Comprehensive Cancer, Duarte, CA 91010, USA
| | - Yun Yen
- Department of Molecular Pharmacology, Beckman Research Institute, City of Hope Comprehensive Cancer, Duarte, CA 91010, USA
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Ganci F, Conti S, Fontemaggi G, Manciocco V, Donzelli S, Covello R, Muti P, Strano S, Blandino G, Spriano G. Allelic expression imbalance of TP53 mutated and polymorphic alleles in head and neck tumors. OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2011; 15:375-81. [PMID: 21348641 DOI: 10.1089/omi.2010.0142] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
TP53 is the most widely mutated gene across all cancer types. In head and neck cancer, approximately half of the tumors are found to contain TP53 mutations, which are correlated to an increased risk for locoregional recurrence and poor outcomes. In this study a mutational profiling of TP53 exons 5-8 was performed on tumor, peritumor and normal tissues from 57 HNSCC patients by direct sequencing of genomic DNA and cDNA. Cloning/sequencing in tumors carrying multiple TP53 mutations and semiquantitative SNaPShot mutation assay was performed in order to assess eventual allelic expression imbalances (AEI). We identified 24 out of 57 HNSCC patients (42%) carrying TP53 mutations and 5 patients carrying the R213R polymorphism. Cloning of the genomic DNA encompassing TP53 exons 5-8 from tumors with multiple TP53 mutations revealed that alleles carrying different types of TP53 mutations are present in these tumors. TP53 missense and nonsense mutations exhibit higher and lower TP53 transcript abundance compared to wild-type TP53 allele, respectively. Interestingly, three out of four patients with the R213R polymorphism analyzed were found positive for TP53 loss of heterozygosity (LOH) and also presented higher transcript abundance than the wild-type counterpart, specifically, in the tumor tissue and not in peritumor or normal tissues. HNSCC tumors present heterogenic cell populations carrying different TP53 mutations. All HNSCC samples analyzed show an alteration in the expression of mutated TP53 mRNA compared to the wild-type allele, most likely independently from the TP53 hemizygous status. The higher expression of R213R TP53 polymorphic allele in cancer tissue compared to normal tissue demonstrates a noninherited variation in allelic expression, independently from its mutation status for exons 5-8, suggesting a potential contribution to TP53 expression in HNSCC disease.
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Affiliation(s)
- Federica Ganci
- Translational Oncogenomics Unit, Regina Elena Cancer Institute, Rome, Italy
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Wu JC, Sun BS, Ren N, Ye QH, Qin LX. Genomic aberrations in hepatocellular carcinoma related to osteopontin expression detected by array-CGH. J Cancer Res Clin Oncol 2010; 136:595-601. [PMID: 19834740 DOI: 10.1007/s00432-009-0695-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Accepted: 01/22/2009] [Indexed: 12/13/2022]
Abstract
PURPOSE We have demonstrated that overexpression of osteopontin (OPN) could contribute to metastasis in hepatocellular carcinoma (HCC), and that OPN-positive cancer cells are often localized in the periphery of cancer nodules adjacent to stromal cells. This study was to identify the difference of intratumor genomic aberrations between OPN-positive and OPN-negative HCC cells. METHODS Immunohistochemical staining for OPN was performed in both archival and fresh HCC tumor tissues. Seven cases of OPN-positive HCC were chosen for laser capture microdissection. The OPN-positive and OPN-negative cancer cells were captured separately from serial frozen sections. Genomic DNA was extracted and quantified. Microarray-based comparative genomic hybridization (array-CGH) was used to achieve high-resolution analysis of whole-genome-wide aberrations. RESULTS The OPN expression level in HCC tissues was significantly associated with vascular or bile duct invasion (P = 0.003), Edmondson's grade (P = 0.047), and intrahepatic spreading (P = 0.011). When compared with the OPN-negative cancer cells, much more amplifications of chromosomal regions, including 4q13.1-q13.3, 4q21.23-q22.1, and 13q32.1-q32.3, were found in OPN-positive HCC cells. Some candidate tumor-related genes, such as SMR3B, MUC7, EPHA5, SPP1, and CLDN10 were detected with over 1.5-fold amplification. CONCLUSIONS There is a significant intratumor genomic heterogeneity between the OPN-positive and negative HCC cells, and OPN-positive HCC cells play a more important role in the development of HCC malignancy than their OPN-negative counterparts.
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Affiliation(s)
- Jin-Cai Wu
- Liver Cancer Institute and Zhongshan Hospital, Institutes of Biomedical Sciences, Fudan University, 180 Feng Lin Road, 200032, Shanghai, People's Republic of China
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The cancer stem cell concept in progression of head and neck cancer. JOURNAL OF ONCOLOGY 2009; 2009:894064. [PMID: 20052382 PMCID: PMC2800367 DOI: 10.1155/2009/894064] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Accepted: 09/14/2009] [Indexed: 01/06/2023]
Abstract
Human head and neck cancer (HNC) is a highly heterogeneous disease. Understanding the biology of HNC progression is necessary for the development of novel approaches to its prevention, early detection, and treatment. A current evolutional progression model has limitations in explaining the heterogeneity observed in a single tumor nest. Accumulating evidence supports the existence of cancer stem cells (CSCs) as small subpopulations in solid tumors, including HNC. These CSCs can be selected by appropriate cell surface markers, which are cancer type specific and have been confirmed by unique in vitro and in vivo assays. Selected CSC populations maintain a self-renewal capability and show aggressive behaviors, such as chemoresistance and metastasis. In addition to introducing the CSC concept in solid tumors, this short review summarizes current publications in HNC CSC and the prospective development and application of the CSC concept to HNC in the clinic.
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Sasahira T, Oue N, Kirita T, Luo Y, Bhawal UK, Fujii K, Yasui W, Kuniyasu H. Reg IV expression is associated with cell growth and prognosis of adenoid cystic carcinoma in the salivary gland. Histopathology 2009; 53:667-75. [PMID: 19076683 DOI: 10.1111/j.1365-2559.2008.03188.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS Regenerating islet-derived family, member 4 (Reg IV) is associated with the progression of various cancers. The aim was to examine Reg IV expression in adenoid cystic carcinomas (ACCs) in salivary glands. METHODS AND RESULTS Reg IV expression was detected by immunohistochemistry and compared with clinicopathological parameters. Expression of phosphorylated epidermal growth factor receptor (pEGFR), phosphorylated AKT (pAKT) and MUC2 was examined by immunohistochemistry. Reg IV function was assessed with Reg IV antisense S-oligodeoxynucleotides (AS) in ACC3 human ACC cells. Reg IV was expressed by salivary duct epithelia and acinus myoepithelia, but not in squamous epithelia. Reg IV expression was found in 41% (17/41) of ACCs, but in none of 40 oral squamous cell carcinomas (OSCCs) and was associated with nodal metastasis (P = 0.047) and poor prognosis (P = 0.012) in ACCs. Reg IV expression was associated with pEGFR (14/17, 82%) in Reg IV+ ACCs, but had no relationship with pAKT or MUC2 expression in ACCs. Cell growth was inhibited by AS treatment in Reg IV+ ACC3 cells, but not in HSC-4 OSCC cells, whereas in vitro invasion of neither cell types was affected by AS treatment. CONCLUSIONS These results suggest that Reg IV might accelerate cell growth and disease progression of ACCs.
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Affiliation(s)
- T Sasahira
- Department of Molecular Pathology, Nara Medical University, Kashihara, Nara, Japan
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21
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Affiliation(s)
- Robert I Haddad
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
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22
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Fernandes AM, Ramos-Jorge ML, Cardoso SV, Loyola AM, Mesquita RA, Aguiar MCF. Immunoexpression of hMSH2 and hMLH1 in oral squamous cell carcinoma and its relationship to histological grades of malignancy. J Oral Pathol Med 2008; 37:543-8. [DOI: 10.1111/j.1600-0714.2008.00658.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Xu C, Houck JR, Fan W, Wang P, Chen Y, Upton M, Futran ND, Schwartz SM, Zhao LP, Chen C, Mendez E. Simultaneous isolation of DNA and RNA from the same cell population obtained by laser capture microdissection for genome and transcriptome profiling. J Mol Diagn 2008; 10:129-34. [PMID: 18258925 DOI: 10.2353/jmoldx.2008.070131] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Laser capture microdissection (LCM) is used extensively for genome and transcriptome profiling. Traditionally, however, DNA and RNA are purified from separate populations of LCM-harvested cells, limiting the strength of inferences about the relationship between gene expression and gene sequence variation. There have been no published protocols for the simultaneous isolation of DNA and RNA from the same cells that are obtained by LCM of patient tissue specimens. Here we report an adaptation of the Qiagen AllPrep method that allows the purification of DNA and RNA from the same LCM-harvested cells. We compared DNA and RNA purified by the QIAamp DNA Micro kit and the PicoPure RNA Isolation kit, respectively, from LCM-collected cells from adjacent tissue sections of the same specimen. The adapted method yields 90% of DNA and 38% of RNA compared with the individual methods. When tested with the GeneChip 250K Nsp Array, the concordance rate of the single nucleotide polymorphism heterozygosity calls was 98%. When tested with the GeneChip U133 Plus 2.0 Array, the correlation coefficient of the raw gene expression was 97%. Thus, we developed a method to obtain both DNA and RNA material from a single population of LCM-harvested cells and herein discuss the strengths and limitations of this methodology.
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Affiliation(s)
- Chang Xu
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, WA, USA
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O-Sullivan I, Chopra A, Kim TS, Magnuson S, Falduto MT, Huang J, Cohen EP. New strategy for the identification of squamous carcinoma antigens that induce therapeutic immune responses in tumor-bearing mice. Cancer Gene Ther 2007; 14:389-98. [PMID: 17273183 DOI: 10.1038/sj.cgt.7701023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This study describes a new strategy for the identification of squamous carcinoma antigens tumor-associated antigens (TAA). The antigens were discovered by comparing microarrays of squamous carcinoma vaccines highly enriched for immunotherapeutic cells with non-enriched vaccines. The vaccines were prepared by transferring sheared genomic DNA fragments (25 kb) from KLN205 cells, a squamous carcinoma cell line (DBA/2 mouse origin (H-2(d)) into LM fibroblasts (C3H/He origin, H-2(k)). The transferred tumor DNA segments integrate spontaneously into the genome of the recipient cells, replicate as the cells divide and are expressed. As only a small proportion of the transfected cell population was expected to have incorporated DNA segments that included genes specifying TAA (the vast majority specify normal cellular constituents), a novel strategy was employed to enrich the vaccine for TAA-positive cells. Microarrays were used to compare genes expressed by enriched and non-enriched vaccines. Seventy-five genes were overexpressed in cells from the enriched vaccine. One, the gene for Cytochrome P450 (family 2, subfamily e, polypeptide 1) (Cyp2e1), was overexpressed in the enriched but not the non-enriched vaccine. A vaccine for squamous carcinoma was prepared by transfer of a 357 bp fragment of the gene for Cyp2e1 into the fibroblast cell line. Robust immunity, sufficient to result in indefinite survival, was induced in tumor-bearing mice immunized with cells transfected with this gene fragment.
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Affiliation(s)
- I O-Sullivan
- Department of Microbiology and Immunology, University of Illinois College of Medicine, Chicago, IL 60615, USA
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Abstract
This paper reviews the main papers related to oral squamous cell carcinoma published in 2006 in oral oncology - an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, and all other scientific articles relating to the aetiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck, and orofacial disease in patients with malignant disease.
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Affiliation(s)
- Crispian Scully
- Eastman Dental Institute, University College London, 256 Gray's Inn Road, London WC1X 8LD, UK.
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