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Kende P, Mathur Y, Varte V, Tayal S, Patyal N, Landge J. The efficacy of neoadjuvant chemotherapy as compared to upfront surgery for the management of oral squamous cell carcinoma: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2024; 53:1-10. [PMID: 37088590 DOI: 10.1016/j.ijom.2023.03.007] [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: 10/21/2021] [Revised: 03/12/2023] [Accepted: 03/15/2023] [Indexed: 04/25/2023]
Abstract
The efficacy of neoadjuvant chemotherapy in the field of head and neck oncology has always been debated. The aim of this study was to determine the efficacy of neoadjuvant chemotherapy followed by surgery in patients with oral squamous cell carcinoma (OSCC) by comparison to upfront surgery, in terms of overall survival, disease-free survival, response rates, positive surgical margins, loco-regional recurrence, distant metastasis, and toxicity. Prospective and retrospective studies were identified from a search of the PubMed, PubMed Central, and Cochrane Library databases (publication date between January 1, 1995 and January 1, 2022), as well as hand searches. Three randomized clinical trials and five retrospective studies reporting a total of 1373 patients were retrieved (493 treated with NACT, 880 treated with upfront surgery). All statistical analyses were done using RevMan 5.4. There was no statistically significant difference between the treatment groups for all outcomes (overall survival P = 0.41, disease-free survival P = 0.91, loco-regional recurrence P = 0.12, distant metastasis P = 0.23), except positive margins (P = 0.007); a reduced risk of positive margins was observed for neoadjuvant chemotherapy. The pooled proportion of patients with a complete pathological response (17%) was inadequate to obtain an improvement in survival. The lower margin positivity rate, leading to resectability with clear margins, may be a benefit of neoadjuvant chemotherapy in locally advanced OSCC; however, this treatment failed to provide a benefit in terms of survival and the response rate.
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Affiliation(s)
- P Kende
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Mumbai, India.
| | - Y Mathur
- Department of Surgical Oncology, HCG Cancer Centre, Mumbai, India.
| | - V Varte
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Mumbai, India.
| | - S Tayal
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Mumbai, India.
| | - N Patyal
- SCB Government Dental College and Hospital, Cuttack, Odisha, India.
| | - J Landge
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Mumbai, India.
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Ulusan M, Bireller S, Ertugrul B, Kasarci G, Atas MN, Aydemir L, Ergen A, Cakmakoglu B. What if amoxicillin/clavulanic acid reduces the cisplatin anticancer impact on oral cancer treatment? JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101502. [PMID: 37192700 DOI: 10.1016/j.jormas.2023.101502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 05/13/2023] [Indexed: 05/18/2023]
Abstract
Antibiotics-chemotherapeutics combination have become on the table for many cancer treatments. For this reason, we thought that further progress and development of studies to support chemotherapeutic approaches with the use of antibiotics may be beneficial in the clinical field. Cell lines (SCC-15, HTB-41, and MRC-5) were treated with 5-100 μM/ml concentrations of cisplatin (cisp) and amoxicillin/clavulanic acid (amx/cla) with combination (amx/cla-cisp) and alone in three different incubation periods. The all-cells viability was examined with WST-1 and apoptotic activity of the drugs were investigated via cell death ELISA assay kit. The cytotoxic impact of the 100 μM amx/cla-cisp combination was found to be reduced by up to 21.8%, which was significant given that the cytotoxic effect of only cisplatin therapy was 86.1%. Because our findings demonstrated that solo amx/cla therapy have almost no impact on proliferation or death, we focused on the amx/cla-cisp combination effect. It was found that the amx/cla-cisp combination has reduced the apoptotic fragment when comparing with the solely cisp-treated cells. Due to amx/cla-cisp combination on both cells but significantly on SCC-15 recovered the sole cisplatin effect, we believe that there might be a second thought when prescribing antibiotics while treating cancer patients. Not only the antibiotic's type but also the cancer type might interact to lessen the chemotherapeutic agent's impact which is clinically a dilemma to focus on.
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Affiliation(s)
- Murat Ulusan
- Department of Otolaryngology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sinem Bireller
- Department of Biochemistry, Faculty of Pharmacy, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Baris Ertugrul
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey; Graduate School of Health Sciences, Istanbul University, Istanbul, Turkey
| | - Goksu Kasarci
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey; Graduate School of Health Sciences, Istanbul University, Istanbul, Turkey
| | - Merve Nur Atas
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey; Graduate School of Health Sciences, Istanbul University, Istanbul, Turkey
| | - Levent Aydemir
- Department of Otolaryngology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Arzu Ergen
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Bedia Cakmakoglu
- Department of Molecular Medicine, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey.
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Xu Q, Huang S, Yang K. Combination immunochemotherapy for recurrent or metastatic head and neck squamous cell carcinoma: a systematic review and meta-analysis. BMJ Open 2023; 13:e069047. [PMID: 37311638 DOI: 10.1136/bmjopen-2022-069047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
OBJECTIVE To evaluate the efficacy and safety of combination immunochemotherapy regimens for the treatment of recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). DESIGN Meta-analysis and systematic review. DATA SOURCES PubMed, Embase, Web of Science and Cochrane library and the Clinicaltrials.gov clinical trials registry were searched up to 14 March 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included randomised controlled trials that compared combination immunochemotherapy with conventional chemotherapy for R/M HNSCC. Primary outcomes of interest were overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and adverse effects (AEs). DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted data and assessed the risk of bias of the included studies. The HR and its 95% CI were used as the effect analysis statistic for survival analysis, while the OR and its 95% CI were used as the effect analysis statistic for dichotomous variables. These statistics were extracted by the reviewers and aggregated using a fixed-effects model to synthesise the data. RESULTS A total of 1214 relevant papers were obtained after the initial search, and five papers that met the inclusion criteria were included; these studies included a total of 1856 patients with R/M HNSCC. Meta-analysis showed that the OS and PFS of patients with R/M HNSCC in the combination immunochemotherapy group were significantly longer than those in the conventional chemotherapy group (HR=0.84; 95% CI 0.76, 0.94; p=0.002; HR=0.67; 95% CI 0.61, 0.75; p<0.0001), and the ORR was significantly higher (OR=1.90; 95% CI 1.54, 2.34; p<0.00001). The analysis of AEs showed that there was no significant difference in the overall incidence rate of AEs between two groups (OR=0.80; 95% CI 0.18, 3.58; p=0.77), but the rate of grade III and IV AEs was significantly higher in patients in the combination immunochemotherapy group (OR=1.39; 95% CI 1.12, 1.73; p=0.003). CONCLUSIONS Combination immunochemotherapy prolonged OS and PFS in patients with R/M HNSCC and improved the ORR; while this approach did not increase the overall incidence of AEs in patients, it increased the rate of grade III and IV AEs. PROSPERO REGISTRATION NUMBER CRD42022344166.
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Affiliation(s)
- Qiudong Xu
- Department of Oral and Maxillofacial Surgery, Wuxi Stomatology Hospital, Wuxi, China
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shuang Huang
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Kai Yang
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Soni S, Anand P, Swarnkar MK, Patial V, Tirpude NV, Padwad YS. MAPKAPK2-centric transcriptome profiling reveals its major role in governing molecular crosstalk of IGFBP2, MUC4, and PRKAR2B during HNSCC pathogenesis. Comput Struct Biotechnol J 2023; 21:1292-1311. [PMID: 36817960 PMCID: PMC9929207 DOI: 10.1016/j.csbj.2023.01.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 02/07/2023] Open
Abstract
Transcriptome analysis of head and neck squamous cell carcinoma (HNSCC) has been pivotal to comprehending the convoluted biology of HNSCC tumors. MAPKAPK2 or MK2 is a critical modulator of the mRNA turnover of crucial genes involved in HNSCC progression. However, MK2-centric transcriptome profiles of tumors are not well known. This study delves into HNSCC progression with MK2 at the nexus to delineate the biological relevance and intricate crosstalk of MK2 in the tumor milieu. We performed next-generation sequencing-based transcriptome profiling of HNSCC cells and xenograft tumors to ascertain mRNA expression profiles in MK2-wild type and MK2-knockdown conditions. The findings were validated using gene expression assays, immunohistochemistry, and transcript turnover studies. Here, we identified a pool of crucial MK2-regulated candidate genes by annotation and differential gene expression analyses. Regulatory network and pathway enrichment revealed their significance and involvement in the HNSCC pathogenesis. Additionally, 3'-UTR-based filtering recognized important MK2-regulated downstream target genes and validated them by nCounter gene expression assays. Finally, immunohistochemistry and transcript stability studies revealed the putative role of MK2 in regulating the transcript turnover of IGFBP2, MUC4, and PRKAR2B in HNSCC. Conclusively, MK2-regulated candidate genes were identified in this study, and their plausible involvement in HNSCC pathogenesis was elucidated. These genes possess investigative values as targets for diagnosis and therapeutic interventions for HNSCC.
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Key Words
- 3'-UTR
- 3′-UTR, 3′-untranslated region
- AREs, Adenylate-uridylate-rich element(s)
- ATCC, American Type Culture Collection
- ActD, Actinomycin D
- CISBP, Catalog of Inferred Sequence Binding Preferences
- Ct, Cycle Threshold
- DAP3, Death associated protein 3
- DEGs, Differentially expressed gene(s)
- Differentially expressed genes
- EHBP1, EH domain binding protein 1
- FC, Fold change
- FDR, False discovery rate
- FPKM, Fragments per kilobase of transcript per million mapped
- GFP, Green fluorescent protein
- GO, Gene Ontology
- HKG, House-keeping genes
- HNSCC
- HNSCCs, Head and neck squamous cell carcinoma(s)
- HQ, High quality
- IAEC, Institutional animal ethics committee
- IFN, Interferon
- IGFBP2, Insulin-like growth factor-binding protein 2
- IHC, Immunohistochemistry
- IP6K2, Inositol hexakisphosphate kinase 2
- KD, Knockdown
- KEGG, Kyoto encyclopedia of genes and genomics
- MAPK, Mitogen-Activated Protein Kinase
- MAPKAPK2
- MAPKAPK2 or MK2, Mitogen-activated protein kinase-activated protein kinase 2
- MELK, Maternal embryonic leucine zipper kinase
- MK2KD, MK2-knockdown
- MK2WT, MK2 wild-type
- MKP-1, Mitogen-activated protein kinase phosphatase-1
- MUC4, Mucin 4
- NGS, Next generation sequencing
- NOD/SCID, Non-obese diabetic/severe combined immunodeficient
- PRKAR2B, Protein kinase CAMP-dependent type II regulatory subunit beta
- QC, Quality control
- RBPs, RNA-binding protein(s)
- RIN, RNA integrity number
- RNA-seq, Ribose Nucleic Acid -sequencing
- RNA-sequencing
- RT-qPCR, Real-time quantitative polymerase chain reaction
- RUNX1, Runt-related transcription factor 1
- SLF2, SMC5-SMC6 complex localization factor 2
- TCGA, The cancer genome atlas
- TNF-α, Tumor necrosis factor-alpha
- TTP, Tristetraprolin
- Transcriptome
- VEGF, Vascular endothelial growth factor
- WB, Western blotting
- WT, Wild type
- ZNF662, Zinc finger protein 662
- p27, Cyclin-dependent kinase inhibitor 1B
- shRNA, Short hairpin RNA
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Affiliation(s)
- Sourabh Soni
- Pharmacology and Toxicology Laboratory, CSIR-Institute of Himalayan Bioresource Technology (CSIR-IHBT), Palampur 176061, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Prince Anand
- Pharmacology and Toxicology Laboratory, CSIR-Institute of Himalayan Bioresource Technology (CSIR-IHBT), Palampur 176061, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Mohit Kumar Swarnkar
- Biotechnology Division, CSIR-Institute of Himalayan Bioresource Technology (CSIR-IHBT), Palampur 176061, India
| | - Vikram Patial
- Pharmacology and Toxicology Laboratory, CSIR-Institute of Himalayan Bioresource Technology (CSIR-IHBT), Palampur 176061, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Narendra V. Tirpude
- Pharmacology and Toxicology Laboratory, CSIR-Institute of Himalayan Bioresource Technology (CSIR-IHBT), Palampur 176061, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Yogendra S. Padwad
- Pharmacology and Toxicology Laboratory, CSIR-Institute of Himalayan Bioresource Technology (CSIR-IHBT), Palampur 176061, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
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Abdulla M, Belal AA, Sakr A, El Arab LE, Mokhtar M, Allahloubi N, Ghali R, Hashem T, Arafat W. Eligibility criteria to cisplatin in head and neck squamous cell carcinoma: Egyptian expert opinion. Health Sci Rep 2023; 6:e1037. [PMID: 36698712 PMCID: PMC9847398 DOI: 10.1002/hsr2.1037] [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: 05/18/2022] [Revised: 11/29/2022] [Accepted: 12/16/2022] [Indexed: 01/19/2023] Open
Abstract
Introduction The use of cisplatin in clinical practice in the management of head and neck squamous cell carcinoma (HNSCC) is limited by its toxicity and acquired resistance, which makes the decision-making process of its prescription multifactorial. Methods An Egyptian expert panel (comprising nine Egyptian oncologists) meeting was held after a comprehensive literature review on the use of cisplatin in HNSCC. The panel aimed to develop a consensus on evidence-based recommendations for receiving cisplatin in the chemoradiotherapy management of HNSCC in Egyptian clinical practice. Results The panel indicated that an Eastern Cooperative Oncology Group Performance Status (ECOG PS) > 2, creatinine clearance (CCR) < 50 ml/min, neuropathy grade ≥ 2, pre-existing hearing loss or tinnitus ≥2, hematological problems (platelets < 100,000/mm3, neutrophils < 1500/mm, and hemoglobin < 9 g/dl), and heart failure of New York Heart Association Classes III or IV (even if cardiovascular therapy is optimized); are all absolute contraindications to receiving cisplatin. On the other hand, relative contraindications to cisplatin according to the panel were an ECOG PS of 2, age more than 70 years, CCR between 50 and 60 ml/min, grade 1 neuropathy, grade 1 hearing loss, involuntary weight loss of ≥20% of body weight, Child-Pugh Scores B and C, previous induction chemotherapy, and heart failure of New York Heart Association Classes I or II with left ventricular ejection fraction ≤50%. The panel agreed that the socioeconomic status of patients should be considered when prescribing cisplatin to HNSCC patients. Conclusion Our discussion resulted in a set of evidence-based recommendations for cisplatin eligibility criteria in patients of HNSCC in Egypt.
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Affiliation(s)
- Mohamed Abdulla
- Department of Oncology, Kasr Al‐Aini School of MedicineCairo UniversityCairoEgypt
| | - Abdel Aziz Belal
- Department of Oncology, Faculty of MedicineAlexandria UniversityAlexandriaEgypt
| | - Amr Sakr
- Department of Oncology, Kasr Al‐Aini School of MedicineCairo UniversityCairoEgypt
| | - Lobna E. El Arab
- Department of Clinical Oncology, Faculty of MedicineAin Shams UniversityCairoEgypt
| | - Mohsen Mokhtar
- Department of Oncology, Kasr Al‐Aini School of MedicineCairo UniversityCairoEgypt
| | - Nasr Allahloubi
- Department of Medical Oncology, National Cancer InstituteCairo UniversityCairoEgypt
| | - Ramy Ghali
- Department of Clinical Oncology, Faculty of MedicineAin Shams UniversityCairoEgypt
| | - Tarek Hashem
- Department of Clinical Oncology, Faculty of MedicineMenoufia UniversityMenoufiaEgypt
| | - Waleed Arafat
- Department of Oncology, Faculty of MedicineAlexandria UniversityAlexandriaEgypt
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6
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Gül D, Schweitzer A, Khamis A, Knauer SK, Ding GB, Freudelsperger L, Karampinis I, Strieth S, Hagemann J, Stauber RH. Impact of Secretion-Active Osteoblast-Specific Factor 2 in Promoting Progression and Metastasis of Head and Neck Cancer. Cancers (Basel) 2022; 14:2337. [PMID: 35565465 PMCID: PMC9106029 DOI: 10.3390/cancers14092337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/28/2022] [Accepted: 05/05/2022] [Indexed: 11/16/2022] Open
Abstract
Treatment success of head and neck cancer (HNC) is still hampered by tumor relapse due to metastases. Our study aimed to identify biomarkers by exploiting transcriptomics profiles of patient-matched metastases, primary tumors, and normal tissue mucosa as well as the TCGA HNC cohort data sets. Analyses identified osteoblast-specific factor 2 (OSF-2) as significantly overexpressed in lymph node metastases and primary tumors compared to normal tissue. High OSF-2 levels correlate with metastatic disease and reduced overall survival of predominantly HPV-negative HNC patients. No significant correlation was observed with tumor localization or therapy response. These findings were supported by the fact that OSF-2 expression was not elevated in cisplatin-resistant HNC cell lines. OSF-2 was strongly expressed in tumor-associated fibroblasts, suggesting a tumor microenvironment-promoting function. Molecular cloning and expression studies of OSF-2 variants from patients identified an evolutionary conserved bona fide protein secretion signal (1MIPFLPMFSLLLLLIVNPINA21). OSF-2 enhanced cell migration and cellular survival under stress conditions, which could be mimicked by the extracellular administration of recombinant protein. Here, OSF-2 executes its functions via ß1 integrin, resulting in the phosphorylation of PI3K and activation of the Akt/PKB signaling pathway. Collectively, we suggest OSF-2 as a potential prognostic biomarker and drug target, promoting metastases by supporting the tumor microenvironment and lymph node metastases survival rather than by enhancing primary tumor proliferation or therapy resistance.
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Affiliation(s)
- Désirée Gül
- Department of Otorhinolaryngology, Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, 55131 Mainz, Germany; (A.S.); (A.K.); (L.F.); (J.H.)
| | - Andrea Schweitzer
- Department of Otorhinolaryngology, Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, 55131 Mainz, Germany; (A.S.); (A.K.); (L.F.); (J.H.)
| | - Aya Khamis
- Department of Otorhinolaryngology, Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, 55131 Mainz, Germany; (A.S.); (A.K.); (L.F.); (J.H.)
- Oral Pathology Department, Faculty of Dentistry, Alexandria University, El Azareta, Alexandria, Egypt
| | - Shirley K. Knauer
- Institute for Molecular Biology, Centre for Medical Biotechnology (ZMB), University Duisburg-Essen, Universitätsstraße, 45117 Essen, Germany;
| | - Guo-Bin Ding
- Institute of Biotechnology, The Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education, Shanxi University, Taiyuan 030006, China;
| | - Laura Freudelsperger
- Department of Otorhinolaryngology, Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, 55131 Mainz, Germany; (A.S.); (A.K.); (L.F.); (J.H.)
| | - Ioannis Karampinis
- Academic Thoracic Center, University Medical Center Mainz, Johannes Gutenberg University Mainz, 55131 Mainz, Germany;
| | - Sebastian Strieth
- Department of Otorhinolaryngology, University Medical Center Bonn, 53127 Bonn, Germany;
| | - Jan Hagemann
- Department of Otorhinolaryngology, Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, 55131 Mainz, Germany; (A.S.); (A.K.); (L.F.); (J.H.)
| | - Roland H. Stauber
- Department of Otorhinolaryngology, Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, 55131 Mainz, Germany; (A.S.); (A.K.); (L.F.); (J.H.)
- Institute of Biotechnology, The Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education, Shanxi University, Taiyuan 030006, China;
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Hung TKW, Ho AL, Pfister DG. Therapeutic strategies for systemic therapies of human papillomavirus-related oropharyngeal cancer. J Surg Oncol 2021; 124:952-961. [PMID: 34585389 PMCID: PMC8500927 DOI: 10.1002/jso.26688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 09/11/2021] [Indexed: 12/18/2022]
Abstract
Our understanding of human papillomavirus (HPV)-related oropharyngeal cancer (OPC) and its molecular basis continues to evolve and produce important insights into customized therapeutic strategies. Novel therapeutics exploiting HPV-related targets are being evaluated in the incurable setting, while the favorable prognosis of locoregionally advanced disease has stimulated investigation into de-escalation strategies. There is much opportunity for better personalization of standard therapy according to HPV status. This review discusses both current and investigational therapeutic strategies for HPV-related OPC.
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Affiliation(s)
- Tony K W Hung
- From the Section of Head and Neck Oncology, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Alan L Ho
- From the Section of Head and Neck Oncology, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - David G Pfister
- From the Section of Head and Neck Oncology, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Medicine, Weill Cornell Medical College, New York, New York, USA
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Wang H, Zhao Q, Zhang Y, Wei J, Wang B, Zheng Z, Liu S, Liu Z, Meng L, Xin Y, Jiang X. Efficacy and safety of systemic treatments for patients with recurrent/metastatic head and neck squamous cell carcinoma: A systematic review and network meta-analysis. Pharmacol Res 2021; 173:105866. [PMID: 34474103 DOI: 10.1016/j.phrs.2021.105866] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/17/2021] [Accepted: 08/28/2021] [Indexed: 12/24/2022]
Abstract
A variety of systemic chemotherapy regimens have been used for recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). However, most guidelines have been derived from a single clinical trial, and no studies have comprehensively compared their efficacy and safety. We systematically searched PubMed, Embase, Web of Science, and Cochrane Library databases. Eligible studies reported overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and ≥ 3 adverse events rate (AEs). Eighteen eligible trials involving 4930 patients and 15 treatment regimens were included. The results suggest that patients with R/M HNSCC exhibit better tumor response with the cetuximab/platinum/5-FU, pembrolizumab/platinum/5-FU or pembrolizumab alone, accompanied by a low AE rate. Nivolumab also showed better efficacy than other single agents. Immunotherapy has achieved better efficacy.
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Affiliation(s)
- Huanhuan Wang
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun 130021, China; Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun 130021, China; NHC Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun 130021, China.
| | - Qin Zhao
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun 130021, China; Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun 130021, China; NHC Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun 130021, China.
| | - Yangyu Zhang
- Division of Clinical Research, The First Hospital of Jilin University, Changchun 130021, China.
| | - Jinlong Wei
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun 130021, China; Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun 130021, China; NHC Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun 130021, China.
| | - Bin Wang
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun 130021, China; Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun 130021, China; NHC Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun 130021, China.
| | - Zhuangzhuang Zheng
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun 130021, China; Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun 130021, China; NHC Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun 130021, China.
| | - Shiyu Liu
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun 130021, China; Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun 130021, China; NHC Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun 130021, China.
| | - Zijing Liu
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun 130021, China; Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun 130021, China; NHC Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun 130021, China.
| | - Lingbin Meng
- Department of Hematology and Medical Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA.
| | - Ying Xin
- Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun 130021, China.
| | - Xin Jiang
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun 130021, China; Jilin Provincial Key Laboratory of Radiation Oncology & Therapy, The First Hospital of Jilin University, Changchun 130021, China; NHC Key Laboratory of Radiobiology, School of Public Health, Jilin University, Changchun 130021, China.
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Gül D, Habtemichael N, Dietrich D, Dietrich J, Gößwein D, Khamis A, Deuss E, Künzel J, Schneider G, Strieth S, Stauber RH. Identification of cytokeratin24 as a tumor suppressor for the management of head and neck cancer. Biol Chem 2021; 403:869-890. [PMID: 34450690 DOI: 10.1515/hsz-2021-0287] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/28/2021] [Indexed: 12/19/2022]
Abstract
To improve management of head and neck squamous cell carcinoma patients, we need to increase our understanding of carcinogenesis, to identify biomarkers, and drug targets. This study aimed to identify novel biomarkers by providing transcriptomics profiles of matched primary tumors, lymph node metastasis, and non-malignant tissue of 20 HNSCC patients as well as by bioinformatic analyses of a TCGA HNSCC cohort, comprising 554 patients. We provide cancer cell signaling networks differentially expressed in tumors versus metastases, such as mesenchymal-epithelial transition, and structural integrity networks. As a proof of principle study, we exploited the data sets and performed functional analyses of a novel cytokeratin, cytokeratin24 (cKRT24), which had not been described as biomarker for tumors before. Survival analysis revealed that low cKRT24 expression correlated with poor overall survival in HNSCC. Experimentally, downregulation of cKRT24 in primary tumors, metastases, and HNSCC cell lines was verified on mRNA and protein level. Cloning and ectopic overexpression of cKRT24 not only affected viability and growth of HNSSC cell lines, but also inhibited tumor growth in murine xenograft studies. We conclude that cKRT24 functions as a tumor suppressor in HNSCC, and may serve as an additional prognostic biomarker and novel target to support current HNSCC treatments.
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Affiliation(s)
- Désirée Gül
- Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, D-55131Mainz, Germany
| | - Negusse Habtemichael
- Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, D-55131Mainz, Germany
| | - Dimo Dietrich
- Department of Otorhinolaryngology,University Medical Center Bonn, D-53127Bonn, Germany
| | - Jörn Dietrich
- Department of Otorhinolaryngology,University Medical Center Bonn, D-53127Bonn, Germany
| | - Dorothee Gößwein
- Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, D-55131Mainz, Germany
| | - Aya Khamis
- Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, D-55131Mainz, Germany
| | - Eric Deuss
- Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, D-55131Mainz, Germany.,Department of Otorhinolaryngology Head and Neck Surgery, University Hospital, D-45147Essen, Germany
| | - Julian Künzel
- Ear, Nose and Throat Department, University Hospital, D-93053Regensburg, Germany
| | - Günter Schneider
- Ear, Nose and Throat Department, University Hospital, D-93053Regensburg, Germany
| | - Sebastian Strieth
- Department of Otorhinolaryngology,University Medical Center Bonn, D-53127Bonn, Germany
| | - Roland H Stauber
- Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, D-55131Mainz, Germany
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10
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Shaikh H, Karivedu V, Wise-Draper TM. Managing Recurrent Metastatic Head and Neck Cancer. Hematol Oncol Clin North Am 2021; 35:1009-1020. [PMID: 34226077 DOI: 10.1016/j.hoc.2021.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Head and neck squamous cell carcinoma (HNSCC) treatment is often associated with high morbidity especially in the recurrent and/or metastatic (R/M) setting, limiting effective treatment options. Local disease control is important. Therefore, local therapies including reirradiation and salvage surgery, either alone or in combination with systemic treatment, may be used for selected patients with R/M HNSCC. Although chemotherapy and targeted agents have modest efficacy in HNSCC, the advent of immunotherapy has revolutionized the treatment paradigm of R/M HNSCC. Multiple trials have resulted in the past 5 years advocating for its use alone or in combination with chemotherapy.
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Affiliation(s)
- Hira Shaikh
- Division of Hematology/Oncology, University of Cincinnati, 3125 Eden Avenue, Cincinnati, OH 45267-0562, USA
| | - Vidhya Karivedu
- Division of Medical Oncology, The Ohio State University, 1335 Lincoln Tower, 1800 Cannon Drive, Columbus, OH 43210, USA
| | - Trisha M Wise-Draper
- Division of Hematology/Oncology, University of Cincinnati, 3125 Eden Avenue, Cincinnati, OH 45267-0562, USA.
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11
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Riestra-Ayora J, Sánchez-Rodríguez C, Palao-Suay R, Yanes-Díaz J, Martín-Hita A, Aguilar MR, Sanz-Fernández R. Paclitaxel-loaded polymeric nanoparticles based on α-tocopheryl succinate for the treatment of head and neck squamous cell carcinoma: in vivo murine model. Drug Deliv 2021; 28:1376-1388. [PMID: 34180747 PMCID: PMC8245075 DOI: 10.1080/10717544.2021.1923863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The prognosis of patients with recurrent or metastatic head and neck squamous cell cancer (HNSCC) is generally poor. New treatments are required to supplement the current standard of care. Paclitaxel (PTX), an effective chemotherapeutic for HNSCC, has serious side effects. A polymeric nanocarrier system was developed for the delivery of PTX to improve HNSCC treatment. This study aimed to evaluate the antitumor efficacy of PTX-loaded polymeric nanoparticles based on α-TOS (PTX-NPs) administered by direct intratumoral injection into a Hypopharynx carcinoma squamous cells (FaDu) tumor xenograft mouse model. The nanocarrier system based on block copolymers of polyethylene glycol (PEG) and a methacrylic derivative of α-TOS was synthesized and PTX was loaded into the delivery system. Tumor volume was measured to evaluate the antitumor effect of the PTX-NPs. The relative mechanisms of apoptosis, cell proliferation, growth, angiogenesis, and oxidative and nitrosative stress were detected by Western blotting, fluorescent probes, and immunohistochemical analysis. The antitumor activity results showed that compared to free PTX, PTX-NPs exhibited much higher antitumor efficacy and apoptosis-inducing in a FaDu mouse xenograft model and demonstrated an improved safety profile. Ki-67, EGFR, and angiogenesis markers (Factor VIII, CD31, and CD34) expression were significantly lower in the PTX-NPs group compared with other groups (p < .05). Also, PTX-NPs induced oxidative and nitrosative stress in tumor tissue. Direct administration of PTX-loaded polymeric nanoparticles based on α-Tocopheryl Succinate at the tumor sites, proved to be promising for HNSCC therapy.
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Affiliation(s)
- Juan Riestra-Ayora
- Department otolaryngology, Hospital Universitario de Getafe, Getafe (Madrid), Carretera de Toledo, km 12.500, Getafe, Madrid, Spain.,Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Carolina Sánchez-Rodríguez
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Raquel Palao-Suay
- Department of Polymeric Nanomaterials and Biomaterials Institute of Polymer Science and Technology CSIC, Networking Biomedical Research Centre in Bioengineering Biomaterials, and Nanomedicine CIBER-BBN, C/Juan de la Cierva, 3, Madrid, Spain
| | - Joaquín Yanes-Díaz
- Department otolaryngology, Hospital Universitario de Getafe, Getafe (Madrid), Carretera de Toledo, km 12.500, Getafe, Madrid, Spain.,Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Ana Martín-Hita
- Department Pathology, Hospital, Universitario de Getafe, Getafe (Madrid), Carretera de Toledo, km 12.500, Getafe, Madrid, Spain
| | - María Rosa Aguilar
- Department of Polymeric Nanomaterials and Biomaterials Institute of Polymer Science and Technology CSIC, Networking Biomedical Research Centre in Bioengineering Biomaterials, and Nanomedicine CIBER-BBN, C/Juan de la Cierva, 3, Madrid, Spain
| | - Ricardo Sanz-Fernández
- Department otolaryngology, Hospital Universitario de Getafe, Getafe (Madrid), Carretera de Toledo, km 12.500, Getafe, Madrid, Spain.,Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
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12
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Espinosa ML, Abad C, Kurtzman Y, Abdulla FR. Dermatologic Toxicities of Targeted Therapy and Immunotherapy in Head and Neck Cancers. Front Oncol 2021; 11:605941. [PMID: 34123780 PMCID: PMC8190330 DOI: 10.3389/fonc.2021.605941] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 05/05/2021] [Indexed: 11/23/2022] Open
Abstract
Treatment of head and neck cancers requires multidisciplinary collaboration to reduce morbidity and mortality associated with the tumor burden, as well as to preserve function of organs and structures. With the use of various new targeted therapies come new adverse events including dermatologic toxicities, which may consist of xerosis, nail and hair changes, morbilliform or papulopustular rashes, to more severe eruptions such as Stevens–Johnson syndrome. We describe the dermatologic toxicities and corresponding grades of severity and associated pathophysiology resulting from seven therapeutics used to treat head and neck cancers: cetuximab, trastuzumab, pembrolizumab, nivolumab, lentatinib, larotrectinib, and entrectinib. Being familiar with these dermatologic toxicities allows clinicians to provide comprehensive counseling for patients, encourage preventative measures, and to know when it is appropriate to hold therapy or permanently stop treatment.
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Affiliation(s)
- Maria L Espinosa
- Department of Dermatology, University of Chicago Pritzker School of Medicine, Chicago, IL, United States
| | - Chelsea Abad
- Department of Dermatology, City of Hope Los Angeles, Duarte, CA, United States
| | - Yaira Kurtzman
- Department of Dermatology, City of Hope Los Angeles, Duarte, CA, United States
| | - Farah R Abdulla
- Department of Dermatology, City of Hope Los Angeles, Duarte, CA, United States
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13
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Quek LHH, Lim MY, Cheo T, Teo HL, Pua U. Percutaneous Management of Recurrent Head and Neck Cancer: Current Role and Evolving Principles in the Multidisciplinary Setting. Curr Oncol Rep 2021; 23:52. [PMID: 33754244 DOI: 10.1007/s11912-021-01045-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE OF REVIEW In this review, we will outline the role of percutaneous interventional radiological management of recurrent head and neck (H&N) cancer in the context of a multidisciplinary setting which consists of surgery, radiation therapy, as well as established and evolving systemic therapies that may impact current practice. RECENT FINDINGS Management of recurrent H&N cancer is complex, with attention to the preservation of function and minimal treatment-related morbidity. The favored treatment modalities in local recurrence previously treated with radiotherapy are surgical resection, and if unresectable, for chemotherapy as definitive treatment, or as a prelude to resection if there is good tumor response. Unfortunately, some of these patients are too frail for major surgery or to withstand the toxicity of chemotherapy. There is a gap for effective local therapy without the morbidity of surgery, toxicity of re-irradiation, and systemic side effects of chemotherapy. Percutaneous interventions have the potential to bridge that gap as well as provide palliative symptomatic treatment for patients that have exhausted all treatment options. In the multidisciplinary setting involving the treatment of complex recurrent H&N cancer, percutaneous management now plays a viable and effective role with a foothold in this team-based approach.
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Affiliation(s)
- Lawrence Han Hwee Quek
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Basement 1, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore. .,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
| | - Ming Yann Lim
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Otorhinolaryngology and Head and Neck Surgery, Tan Tock Seng Hospital, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Timothy Cheo
- Department of Radiation Oncology, Tan Tock Seng Hospital, Singapore, Singapore.,Department of Radiation Oncology, National University Health System, Singapore, Singapore
| | - Hui Lin Teo
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Medical Oncology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Uei Pua
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Basement 1, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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14
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Cui P, Jing P, Liu X, Xu W. Prognostic Significance of PD-L1 Expression and Its Tumor-Intrinsic Functions in Hypopharyngeal Squamous Cell Carcinoma. Cancer Manag Res 2020; 12:5893-5902. [PMID: 32765090 PMCID: PMC7373417 DOI: 10.2147/cmar.s257299] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 07/06/2020] [Indexed: 12/21/2022] Open
Abstract
Purpose The expression of programmed death-ligand 1 (PD-L1) is common in various solid human cancers and it is an important therapeutic target. However, the expression pattern, clinical significance and potential mechanism of PD-L1 in hypopharyngeal squamous cell carcinoma (HSCC) are still lacking. Methods PD-L1 expression in HSCC tumor tissues and paired adjacent hypopharyngeal mucosal tissues was detected using immunohistochemistry assay, and the clinical significance of PD-L1 in HSCC was characterized. In vitro assays including cell viability assays, migration assays, invasion assays as well as Western blot assays were performed to illuminate the biological functions and underlying molecular mechanisms of PD-L1 in HSCC development. Results PD-L1 expression was detected in HSCC samples but we found no positive expression in matched normal hypopharyngeal mucosal tissues. The levels of PD-L1 expression were significantly correlated with advanced clinical progression and poor patient survival. Multivariable analysis of Cox model showed that PD-L1 expression was an independent predictor for the prognosis of HSCC patients. Functional experiments showed that the ectopic expression of PD-L1 markedly influenced the proliferation, migration and invasion of FaDu cells in vitro. Mechanistically, investigations demonstrated that PD-L1 could promote the epithelial–mesenchymal transition of FaDu cells. Meanwhile, PD-L1 knockdown inhibited, while PD-L1 overexpression activated the Akt-mTOR signaling pathway in FaDu cells. The EMT induced by PD-L1 overexpression could be reversed by the Akt inhibitor. Conclusion In summary, the expression of PD-L1 can act as a significant biomarker for the adverse clinicopathological features and poor prognosis of patients with HSCC. PD-L1 can promote the proliferation, migration and invasion of FaDu cells and consequently enhance the aggressiveness. Moreover, PD-L1 induces EMT through AKT-mTOR signaling pathway. These suggest that PD-L1 has important tumor-intrinsic functions independent of its immunopathogenic effects.
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Affiliation(s)
- Peng Cui
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Peihang Jing
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Xiuxiu Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Wei Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
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15
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Fewer tumour-specific PD-1 +CD8 + TILs in high-risk "Infiltrating" HPV - HNSCC. Br J Cancer 2020; 123:932-941. [PMID: 32616847 PMCID: PMC7492364 DOI: 10.1038/s41416-020-0966-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 05/24/2020] [Accepted: 06/12/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The prognosis of HPV- HNSCC was worse than that of HPV+ HNSCC. Analysis of tumours and tumour-infiltrating lymphocytes (TILs) may provide insight into the progression of HPV- HNSCC. METHODS The tumour and TIL phenotypic characteristics of 134 HNSCC specimens (HPV- tumours were classified into "Infiltrating" and "Pushing" subtypes based on their different tumour nest configuration and prognosis) were retrospectively analysed. HNSCC data from the Cancer Genome Atlas (n = 263) were analysed for CD8α, HPV and overall survival (OS). A murine HNSCC model was used to verify the antitumour role of PD-1+CD8+ TILs. RESULTS The "Infiltrating" HPV- subtype showed shorter OS than the "Pushing" subtype. Moreover, there is a tendency from "Pushing" to "Infiltrating" subtype from the primary to the recurrent lesion. Different from total CD8+ TILs, tumour-specific PD-1+CD8+ TILs were fewer in invasive margin (IM) of "Infiltrating" HPV- tumours. PD-1+CD8+ TILs recognised autologous HNSCC cells and showed stronger inhibition of tumour growth in a murine HNSCC model resistant to PD-1 blockade. CONCLUSIONS Coevolution of HPV- HNSCC and TILs is characterised by an "Infiltrating" phenotype and less tumour-specific PD-1+CD8+ TILs, which may provide a framework for further translational studies and patient stratification.
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16
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The Synergistic Anti-Cancer Effects of NVP-BEZ235 and Regorafenib in Hepatocellular Carcinoma. Molecules 2020; 25:molecules25102454. [PMID: 32466169 PMCID: PMC7287658 DOI: 10.3390/molecules25102454] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/18/2020] [Accepted: 05/24/2020] [Indexed: 12/19/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common type of liver cancer worldwide. Regorafenib is a multi-kinase inhibitor and the second-line treatment for HCC. Since the PI3K/Akt/mTOR signaling pathway is dysregulated in HCC, we evaluated the therapeutic effects of regorafenib combined with a dual PI3K/mTOR inhibitor BEZ235 in the human HCC cell lines (n = 3). The combined treatment with BEZ235 and regorafenib enhanced the inhibition of cell proliferation and increased the expression of cleaved caspase-3 and cleaved PARP in HCC cells. Moreover, the combined treatment suppressed HCC cell migration and invasion in the transwell assay. Further, the Western blot analyses confirmed the involvement of epithelial-mesenchymal transition (EMT)-related genes such as slug, vimentin, and matrix metalloproteinase (MMP)-9/-2. Additionally, the proteinase activity of MMP-9/-2 was analyzed using gelatin zymography. Furthermore, the inhibition of phosphorylation of the Akt, mTOR, p70S6K, and 4EBP1 after combined treatment was validated using Western blot analysis. Therefore, these results suggest that the combined treatment with BEZ235 and regorafenib benefits patients with HCC.
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17
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18
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Hirata-Nozaki Y, Ohkuri T, Ohara K, Kumai T, Nagata M, Harabuchi S, Kosaka A, Nagato T, Ishibashi K, Oikawa K, Aoki N, Ohara M, Harabuchi Y, Uno Y, Takei H, Celis E, Kobayashi H. PD-L1-specific helper T-cells exhibit effective antitumor responses: new strategy of cancer immunotherapy targeting PD-L1 in head and neck squamous cell carcinoma. J Transl Med 2019; 17:207. [PMID: 31221178 PMCID: PMC6585001 DOI: 10.1186/s12967-019-1957-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 06/13/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Head and neck squamous cell carcinoma (HNSCC) originates from squamous epithelium of the upper aerodigestive tract and is the most common malignancy in the head and neck region. Among HNSCCs, oropharynx squamous cell carcinoma (OSCC) has a unique profile and is associated with human papillomavirus infection. Recently, anti-programmed cell death-1 monoclonal antibody has yielded good clinical responses in recurrent and/or metastatic HNSCC patients. Therefore, programmed death-ligand 1 (PD-L1) may be a favorable target molecule for cancer immunotherapy. Although PD-L1-expressing malignant cells could be targeted by PD-L1-specific CD8+ cytotoxic T lymphocytes, it remains unclear whether CD4+ helper T lymphocytes (HTLs) recognize and kill tumor cells in a PD-L1-specific manner. METHODS The expression levels of PD-L1 and HLA-DR were evaluated using immunohistochemical analyses. MHC class II-binding peptides for PD-L1 were designed based on computer algorithm analyses and added into in vitro culture of HTLs with antigen-presenting cells to evaluate their stimulatory activity. RESULTS We found that seven of 24 cases of OSCC showed positive for both PD-L1 and HLA-DR and that PD-L1241-265 peptide efficiently activates HTLs, which showed not only cytokine production but also cytotoxicity against tumor cells in a PD-L1-dependent manner. Also, an adoptive transfer of the PD-L1-specific HTLs significantly inhibited growth of PD-L1-expressing human tumor cell lines in an immunodeficient mouse model. Importantly, T cell responses specific for the PD-L1241-265 peptide were detected in the HNSCC patients. CONCLUSIONS The cancer immunotherapy targeting PD-L1 as a helper T-cell antigen would be a rational strategy for HNSCC patients.
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Affiliation(s)
- Yui Hirata-Nozaki
- Department of Pathology, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan.,Department of Otolaryngology, Head and Neck Surgery, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan
| | - Takayuki Ohkuri
- Department of Pathology, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan.
| | - Kenzo Ohara
- Department of Pathology, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan.,Department of Otolaryngology, Head and Neck Surgery, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan
| | - Takumi Kumai
- Department of Otolaryngology, Head and Neck Surgery, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan
| | - Marino Nagata
- Department of Pathology, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan
| | - Shohei Harabuchi
- Department of Pathology, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan.,Department of Otolaryngology, Head and Neck Surgery, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan
| | - Akemi Kosaka
- Department of Pathology, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan
| | - Toshihiro Nagato
- Department of Pathology, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan.,Department of Otolaryngology, Head and Neck Surgery, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan
| | - Kei Ishibashi
- Respiratory and Breast Center, Asahikawa Medical University Hospital, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan
| | - Kensuke Oikawa
- Department of Pathology, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan
| | - Naoko Aoki
- Department of Pathology, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan
| | - Mizuho Ohara
- Department of Pathology, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan
| | - Yasuaki Harabuchi
- Department of Otolaryngology, Head and Neck Surgery, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan
| | - Yuji Uno
- Department of Pathology, Asahikawa Medical University Hospital, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan
| | - Hidehiro Takei
- Department of Pathology, Asahikawa Medical University Hospital, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan
| | - Esteban Celis
- Cancer Immunology, Inflammation and Tolerance Program, Augusta University Georgia Cancer Center, 1120 15th Street, Augusta, GA, 30912, USA
| | - Hiroya Kobayashi
- Department of Pathology, Asahikawa Medical University, Midorigaoka-Higashi 2-1-1, Asahikawa, 078-8510, Japan.
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19
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Sola AM, Johnson DE, Grandis JR. Investigational multitargeted kinase inhibitors in development for head and neck neoplasms. Expert Opin Investig Drugs 2019; 28:351-363. [PMID: 30753792 DOI: 10.1080/13543784.2019.1581172] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Despite advances in treatment, head and neck squamous cell carcinoma (HNSCC) survival rates remain stagnant. Current treatment is associated with significant toxicities and includes chemotherapy, radiation, surgery, and few targeted treatments. Targeted treatments, epidermal growth factor receptor (EGFR)-targeted agent, cetuximab, and immune checkpoint inhibitors, pembrolizumab and nivolumab, show improved toxicity profiles and modestly improved survival in select patients. An urgent need remains to identify novel targeted treatments for single-agent or combined therapy use. AREAS COVERED Multitargeted kinase inhibitors are small molecule inhibitors with limited toxicity. This review will focus on early-stage investigations of multitargeted tyrosine kinase inhibitors (m-TKIs) (those that target at least two tyrosine kinases) for HNSCC. Preclinical and early trials investigating m-TKIs for various disease settings of HNSCC will be evaluated for efficacy, identification of significant biomarkers and potential for combination therapy. EXPERT OPINION Few single agent m-TKIs have demonstrated efficacy in unselected HNSCC populations. The most promising clinical results have been obtained when m-TKIs are tested in combination with other therapies, including immunotherapy, or in mutation-defined subgroups of patients. The future success of m-TKIs will rely on identification, in preclinical models and clinical trials, of predictive biomarkers of response and mechanisms of innate and acquired resistance.
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Affiliation(s)
- Ana Marija Sola
- a Department of Otolaryngology - Head and Neck Surgery , University of California , San Francisco , CA , USA
| | - Daniel E Johnson
- a Department of Otolaryngology - Head and Neck Surgery , University of California , San Francisco , CA , USA
| | - Jennifer R Grandis
- a Department of Otolaryngology - Head and Neck Surgery , University of California , San Francisco , CA , USA
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20
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Bahig H, Aubin F, Stagg J, Gologan O, Ballivy O, Bissada E, Nguyen-Tan FP, Soulières D, Guertin L, Filion E, Christopoulos A, Lambert L, Tehfe M, Ayad T, Charpentier D, Jamal R, Wong P. Phase I/II trial of Durvalumab plus Tremelimumab and stereotactic body radiotherapy for metastatic head and neck carcinoma. BMC Cancer 2019; 19:68. [PMID: 30642290 PMCID: PMC6332607 DOI: 10.1186/s12885-019-5266-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/02/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The efficacy of immunotherapy targeting the PD-1/PD-L1 pathway has previously been demonstrated in metastatic head and neck squamous cell carcinoma (HNSCC). Stereotactic Body Radiotherapy (SBRT) aims at ablating metastatic lesions and may play a synergistic role with immunotherapy. The purpose of this study is to assess the safety and efficacy of triple treatment combination (TTC) consisting of the administration of durvalumab and tremelimumab in combination with SBRT in metastatic HNSCC. METHOD This is a phase I/II single arm study that will include 35 patients with 2-10 extracranial metastatic lesions. Patients will receive durvalumab (1500 mg IV every 4 weeks (Q4W)) and tremelimumab (75 mg IV Q4W for a total of 4 doses) until progression, unacceptable toxicity or patient withdrawal. SBRT to 2-5 metastases will be administered between cycles 2 and 3 of immunotherapy. The safety of the treatment combination will be evaluated through assessment of TTC-related toxicities, defined as grade 3-5 toxicities based on Common Terminology Criteria for Adverse Events (v 4.03), occurring within 6 weeks from SBRT start, and that are definitely, probably or possibly related to the combination of all treatments. We hypothesize that dual targeting of PD-L1 and CTLA-4 pathways combined with SBRT will lead to < 35% grade 3-5 acute toxicities related to TTC. Progression free survival (PFS) will be the primary endpoint of the phase II portion of this study and will be assessed with radiological exams every 8 weeks using the RECIST version 1.1 criteria. DISCUSSION The combination of synergistic dual checkpoints inhibition along with ablative radiation may significantly potentiate the local and systemic disease control. This study constitutes the first clinical trial combining effects of SBRT with dual checkpoint blockade with durvalumab and tremelimumab in the treatment of metastatic HNSCC. If positive, this study would lead to a phase III trial testing this treatment combination against standard of care in metastatic HNSCC. TRIAL REGISTRATION NCT03283605 . Registration date: September 14, 2017; version 1.
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Affiliation(s)
- Houda Bahig
- Department of Radiation Oncology, Centre Hospitalier de l’Université de Montréal, 1051 Sanguinet Street, Montreal, QC H2X 3E4 Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada
| | - Francine Aubin
- Department of Medical Oncology, Centre Hospitalier de l’Université de Montréal, Montreal, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada
| | - John Stagg
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada
| | - Olguta Gologan
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada
- Pathology Department, Centre Hospitalier de l’Université de Montréal, Montreal, Canada
| | - Olivier Ballivy
- Department of Radiation Oncology, Centre Hospitalier de l’Université de Montréal, 1051 Sanguinet Street, Montreal, QC H2X 3E4 Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada
| | - Eric Bissada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada
- Department of Otorhinolaryngology, Centre Hospitalier de l’Université de Montréal, Montreal, Canada
| | - Felix-Phuc Nguyen-Tan
- Department of Radiation Oncology, Centre Hospitalier de l’Université de Montréal, 1051 Sanguinet Street, Montreal, QC H2X 3E4 Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada
| | - Denis Soulières
- Department of Medical Oncology, Centre Hospitalier de l’Université de Montréal, Montreal, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada
| | - Louis Guertin
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada
- Department of Otorhinolaryngology, Centre Hospitalier de l’Université de Montréal, Montreal, Canada
| | - Edith Filion
- Department of Radiation Oncology, Centre Hospitalier de l’Université de Montréal, 1051 Sanguinet Street, Montreal, QC H2X 3E4 Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada
| | - Apostolos Christopoulos
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada
- Department of Otorhinolaryngology, Centre Hospitalier de l’Université de Montréal, Montreal, Canada
| | - Louise Lambert
- Department of Radiation Oncology, Centre Hospitalier de l’Université de Montréal, 1051 Sanguinet Street, Montreal, QC H2X 3E4 Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada
| | - Mustapha Tehfe
- Department of Medical Oncology, Centre Hospitalier de l’Université de Montréal, Montreal, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada
| | - Tareck Ayad
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada
- Department of Otorhinolaryngology, Centre Hospitalier de l’Université de Montréal, Montreal, Canada
| | - Danielle Charpentier
- Department of Medical Oncology, Centre Hospitalier de l’Université de Montréal, Montreal, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada
| | - Rahima Jamal
- Department of Medical Oncology, Centre Hospitalier de l’Université de Montréal, Montreal, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada
| | - Philip Wong
- Department of Radiation Oncology, Centre Hospitalier de l’Université de Montréal, 1051 Sanguinet Street, Montreal, QC H2X 3E4 Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada
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NVP-BEZ235 Attenuated Cell Proliferation and Migration in the Squamous Cell Carcinoma of Oral Cavities and p70S6K Inhibition Mimics its Effect. Int J Mol Sci 2018; 19:ijms19113546. [PMID: 30423811 PMCID: PMC6274880 DOI: 10.3390/ijms19113546] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/08/2018] [Accepted: 11/08/2018] [Indexed: 11/19/2022] Open
Abstract
NVP-BEZ235 or BEZ235 is a dual inhibitor of adenosine triphosphate (ATP)-competitive phosphoinositide 3-kinase (PI3K)/mammalian-target-of-rapamycin (mTOR) and is promising for cancer treatment. Because it targets more than one downstream effector, a dual approach is promising for cancer treatment. The aim of this study was to evaluate the efficacy of NVP-BEZ235 in treating oral cavity squamous cell carcinoma (OSCC). Two human OSCC cell lines, SCC-4 and SCC-25, were used in this study. PI3K-AKT signaling, proliferation, and cell migratory and invasion capabilities of OSCC cells were examined. In NVP-BEZ235-treated SCC-4 and SCC-25 cells, the phosphorylation of 70-kDa ribosomal S6 kinase (p70S6K), but not mTOR, decreased within 24 h. NVP-BEZ235 inhibited OSCC-cell proliferation, migration, and invasion possibly by directly deregulating the phosphorylation of p70S6K. The phospho-p70S6K inhibitor mimicked the effects of NVP-BEZ235 for preventing proliferation and weakening the migratory and invasion abilities of SCC-4 and SCC-25 cells. This study further confirmed the effect of NVP-BEZ235 on OSCC cells and provided a new strategy for controlling the proliferation, migration, and invasion of OSCC cells using the phopho-p70S6K inhibitor.
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Gazzah A, Boni V, Soria JC, Calles A, Even C, Doger B, Mahjoubi L, Bahleda R, Ould-Kaci M, Esler A, Nazabadioko S, Calvo E. A phase 1b study of afatinib in combination with standard-dose cetuximab in patients with advanced solid tumours. Eur J Cancer 2018; 104:1-8. [PMID: 30278378 DOI: 10.1016/j.ejca.2018.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 07/12/2018] [Indexed: 12/29/2022]
Abstract
This phase 1b, open-label trial assessed the combination of afatinib, an ErbB family blocker, with cetuximab, an epidermal growth factor receptor (EGFR) monoclonal antibody, in heavily pretreated patients with unselected/EGFR wild-type, advanced solid tumours. In Part A, the maximum tolerated dose (MTD) of afatinib + cetuximab was evaluated using a 3 + 3 dose-escalation design; the starting dose was afatinib 30 mg/day plus cetuximab 250 mg/m2/week (after cetuximab 400 mg/m2 loading dose), escalating to afatinib 40 mg/day. Part B further evaluated safety and tolerability at the MTD and preliminary anti-tumour activity in three patient cohorts with squamous non-small cell lung cancer (NSCLC), head and neck squamous cell carcinoma (HNSCC) and other solid tumours. Nine patients were treated in Part A; the MTD and recommended dose was determined as afatinib 40 mg/day plus cetuximab 250 mg/m2/week. In Part B, 49 patients were treated at the recommended dose (12 with squamous NSCLC, 15 with HNSCC and 22 with other tumours). The most common treatment-related adverse events (AEs) across all 58 patients were diarrhoea (63.8%) and acneiform dermatitis (43.1%). Overall, the best confirmed response was stable disease (SD; 53.4%); mean duration of disease control was 4.5 months; median progression-free survival was 2.6 months. In Part B, 55.1% of patients had SD (squamous NSCLC, 75.0%; HNSCC, 66.7%; other tumours; 36.4%). In conclusion, the recommended phase 2 dose was determined as afatinib 40 mg/day plus cetuximab 250 mg/m2/week. AEs were predictable and manageable, and anti-tumour activity was observed in some patients, particularly in those with squamous NSCLC and HNSCC. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT02020577.
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Affiliation(s)
- Anas Gazzah
- Drug Development Department, Gustave Roussy Cancer Campus, 114 Rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
| | - Valentina Boni
- Medical Oncology Division, START Madrid Centro Integral Oncológico Clara Campal, Calle de Oña, 10, 28050, Madrid, Spain.
| | - Jean-Charles Soria
- Drug Development Department, Gustave Roussy Cancer Campus, 114 Rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
| | - Antonio Calles
- Medical Oncology Division, START Madrid Centro Integral Oncológico Clara Campal, Calle de Oña, 10, 28050, Madrid, Spain; Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Calle Del Dr. Esquerdo, 46, 28007 Madrid, Spain.
| | - Caroline Even
- Department of Head and Neck Cancer, Gustave Roussy Cancer Campus, 114 Rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
| | - Bernard Doger
- Medical Oncology Phase I Unit, START Madrid Fundación Jiménez Díaz, Av. Reyes Católicos, 2, 28040 Madrid, Spain.
| | - Linda Mahjoubi
- Drug Development Department, Gustave Roussy Cancer Campus, 114 Rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
| | - Rastislav Bahleda
- Drug Development Department, Gustave Roussy Cancer Campus, 114 Rue Édouard-Vaillant, 94805 Villejuif Cedex, France.
| | - Mahmoud Ould-Kaci
- Clinical Development and Medical Affairs, Boehringer Ingelheim Pharmaceuticals, Inc., 900 Ridgebury Road, Ridgefield, CT 06877, USA.
| | - Anne Esler
- Statistics, Syneos Health, 3201 Beechleaf Court, Raleigh, NC 27604, USA.
| | - Serge Nazabadioko
- Medical Department, Boehringer Ingelheim, 12 Rue André Huet, 51721 Reims, France.
| | - Emiliano Calvo
- Medical Oncology Division, START Madrid Centro Integral Oncológico Clara Campal, Calle de Oña, 10, 28050, Madrid, Spain.
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Effectiveness Outcomes in Patients With Recurrent or Refractory Head and Neck Cancers: Retrospective Analysis of Data From a Community Oncology Database. Clin Ther 2018; 40:1522-1537. [PMID: 30150077 DOI: 10.1016/j.clinthera.2018.07.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 07/18/2018] [Accepted: 07/19/2018] [Indexed: 12/21/2022]
Abstract
PURPOSE The purpose of this study was to provide an understanding of the effectiveness of existing therapies in patients with advanced head and neck cancer (HNC), particularly in clinical practice. METHODS Data from the electronic medical records of adult patients diagnosed with locally advanced or metastatic (Stage III-IVc) HNC between January 1, 2007, and October 1, 2015, were retrospectively collected from a network of community oncology practices in the United States. Eligible patients experienced disease progression despite having received prior systemic therapy. Kaplan-Meier and Cox regression analyses of progression-free survival (PFS) and overall survival (OS) were conducted. Patient-reported outcomes were also collected. FINDINGS The study included 462 patients (median age 61.0 years; 80.7% male; 77.1% white). Most patients had a history of tobacco use (41.8% current, 41.8% past), and human papillomavirus testing was infrequent overall (11.0%). The median overall duration of follow-up was 16.4 months (range, 2.3-85.2 months). Median PFS values were 8.45 months with first-line treatment and 5.33 months with second-line treatment. PFS with first-line treatment was significantly associated with primary tumor location, performance status, and tobacco use. Performance status was a predictor of PFS in second-line treatment. Median OS values were 21.04 and 9.53 months from the start of the first and second lines of therapy, respectively. Abuse/excessive use of alcohol, older age, and impaired performance status were associated with a significantly increased risk for death in outcomes analyses. Outcomes were worse among patients initially diagnosed with Stage IVc disease versus those who progressed to Stage IVc. Past tobacco use and alcohol abuse were associated with worse patient-reported symptoms such as dry mouth and sore throat (smoking) and trouble swallowing (alcohol). IMPLICATIONS This study of data from clinical practice shows that there remains a large unmet need for effective therapeutic options in advanced HNC. Patients' characteristics such as alcohol use and performance status were statistically significant predictors of PFS and OS in Stage III-IVc HNC.
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Fisher MD, Fernandes AW, Olufade TO, Miller PJ, Walker MS, Fenton M. Patient Characteristics and Costs in Recurrent or Refractory Head and Neck Cancer: Retrospective Analysis of a Community Oncology Database. Clin Ther 2018. [PMID: 29530457 DOI: 10.1016/j.clinthera.2018.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE The goal of this study was to describe patient characteristics, health resource utilization (HRU), and costs associated with treating recurrent or refractory head and neck cancer (HNC) among patients with disease progression in the community oncology setting. METHODS This retrospective observational study was conducted by using data from the Vector Oncology Data Warehouse. Patients had been diagnosed with locally advanced or metastatic (stage III-IVc) HNC between January 1, 2007, and October 1, 2015. Patients also had evidence of at least 1 systemic anticancer therapy regimen following the diagnosis of advanced HNC, with at least 1 disease progression. Costs, treatment patterns, and HRU were evaluated beginning with diagnosis of advanced HNC through 3 lines of therapy. Costs of surgery or radiation were not available for inclusion in the analysis. Total cost for the study period and cost per month were analyzed by using a generalized linear regression model. FINDINGS The study included 462 patients (median age, 61 years; range, 26-99 years); of these, 81% were male, 77% were white, and 21% were black. At initial diagnosis, the most frequent tumor locations were the hypopharynx/larynx (31%) and the oropharynx (31%). Human papilloma virus testing was most frequent among the oropharynx group (22% tested, 52% positive). Overall, 42% were current tobacco users and 22% were current or past alcohol abusers/excessive users. Platinum-based combination therapies were the most frequently administered chemotherapy in both first (42%) and second (40%) lines of treatment. Through the overall study period (mean, 20.5 months), 74% of patients were hospitalized, 19% had an emergency department visit, and 100% had an office visit. The overall mean (SD) duration of hospital stay was 12.6 days, and the median number of office visits per patient was 35. The mean monthly health care cost for the overall study period was $14,391 (95% CI, 12,739-16,044). Hospitalization costs represented ~57% of the total expenditures. Statistically significant predictors of higher overall cost included primary tumor location in the oral cavity, history of alcohol abuse/excess use, use of cetuximab, and higher comorbidity index. Older age and being stage IV versus other stages of disease at diagnosis were associated with lower overall cost. IMPLICATIONS These data suggest that costs of care in patients with recurrent or refractory HNC are related to patient characteristics and treatment patterns. Identification of factors contributing to the costs of care in HNC may provide a useful foundation for developing strategies to control rising costs.
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Tahara M, Muro K, Hasegawa Y, Chung HC, Lin C, Keam B, Takahashi K, Cheng JD, Bang Y. Pembrolizumab in Asia-Pacific patients with advanced head and neck squamous cell carcinoma: Analyses from KEYNOTE-012. Cancer Sci 2018; 109:771-776. [PMID: 29284202 PMCID: PMC5834807 DOI: 10.1111/cas.13480] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 12/12/2017] [Accepted: 12/19/2017] [Indexed: 12/30/2022] Open
Abstract
KEYNOTE-012 was a phase Ib, multicohort study designed to investigate efficacy and safety of pembrolizumab in advanced solid tumors. Results from the subset of patients with recurrent/metastatic head and neck squamous cell carcinoma (HNSCC) from the Asia-Pacific region are reported. Patients with recurrent/metastatic HNSCC, measurable disease (RECIST version 1.1), and ECOG performance status (PS) 0-1 were eligible for enrollment in the HNSCC expansion cohort. Patients received pembrolizumab 200 mg every 3 weeks. Response was assessed every 8 weeks. Co-primary end-points were safety and overall response rate (RECIST version 1.1, central review). Secondary end-points included overall survival and response duration. Patients enrolled at any of the five centers throughout the Asia-Pacific region were included in these analyses. Twenty-six patients with HNSCC from the Asia-Pacific region received pembrolizumab. The median age was 62 years, 65% of patients had ECOG PS 1, and 62% had received two or more prior therapies for recurrent/metastatic disease. Sixteen (62%) patients experienced a treatment-related adverse event of any grade, including two (8%) patients who experienced one or more events of grade 3 severity. No treatment-related deaths occurred. The overall response rate was 19% (95% confidence interval, 7%-39%). After a median follow-up of 12 months (range, 2-21 months), a median response duration was not reached (range, 6 to 17+ months); four of five responses lasted ≥6 months. Median overall survival was 11.6 months (95% confidence interval, 4.7-17.7 months). Pembrolizumab was well tolerated and had durable antitumor activity in patients with HNSCC from the Asia-Pacific region. (Trial registration no. NCT01848834.).
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Affiliation(s)
| | - Kei Muro
- Aichi Cancer Center HospitalNagoyaJapan
| | | | | | | | - Bhumsuk Keam
- Seoul National University College of MedicineSeoulKorea
| | | | | | - Yung‐Jue Bang
- Seoul National University College of MedicineSeoulKorea
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Is Lipidomic the Answer to the Search of a Biomarker for Organ Preservation Protocol in Head and Neck Squamous Cell Carcinoma? Pathol Oncol Res 2017; 24:931-935. [PMID: 29130149 DOI: 10.1007/s12253-017-0336-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 10/20/2017] [Indexed: 12/13/2022]
Abstract
In the last decade organ preservation protocols based on chemoradiotherapy (CRT) has been showing the possibility of preserving function without jeopardizing survival for locally advanced head and neck squamous cell carcinoma (HNSCC). Still, only a percentage of the patients will benefit from this approach and, to date, no biomarkers are known to correctly predict these patients. More recently, modern mass spectrometry method has been used to determine metabolic profiles, and lipidomics, in particular, emerged as a new field of study in oncology and other diseases. This study aimed to analyze the lipid profile on saliva from patients undergoing to a prospective, single center, open-label, non-randomized phase II trial for organ preservation on HNSCC. The lipid analysis was performed using matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS). Multivariate statistical analyses based on principal component analysis and orthogonal partial least square-discriminant analysis were applied to MALDI-TOF-MS data to visualize differences between the lipid profiles and identify potential biomarkers. The results assisted on distinguishing complete responders from non-responders to the treatment protocol. In conclusion, we demonstrated that a group of lipids is differentially abundant in saliva from HNSCC patients submitted to an organ preservation protocol, being able to differentiate responders from non-responders. These results suggest the potential use of lipid biomarkers to identify patients who may benefit from this treatment. Also, we showed that saliva testing might be routinely used in clinical practice, for being a non-invasive alternative to blood testing, besides inexpensive and easy to obtain.
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Gribko A, Hahlbrock A, Strieth S, Becker S, Hagemann J, Deichelbohrer M, Hildebrandt A, Habtemichael N, Wünsch D. Disease-relevant signalling-pathways in head and neck cancer: Taspase1's proteolytic activity fine-tunes TFIIA function. Sci Rep 2017; 7:14937. [PMID: 29097782 PMCID: PMC5668323 DOI: 10.1038/s41598-017-14814-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 10/16/2017] [Indexed: 12/23/2022] Open
Abstract
Head and neck cancer (HNC) is the seventh most common malignancy in the world and its prevailing form, the head and neck squamous cell carcinoma (HNSCC), is characterized as aggressive and invasive cancer type. The transcription factor II A (TFIIA), initially described as general regulator of RNA polymerase II-dependent transcription, is part of complex transcriptional networks also controlling mammalian head morphogenesis. Posttranslational cleavage of the TFIIA precursor by the oncologically relevant protease Taspase1 is crucial in this process. In contrast, the relevance of Taspase1-mediated TFIIA cleavage during oncogenesis of HNSCC is not characterized yet. Here, we performed genome-wide expression profiling of HNSCC which revealed significant downregulation of the TFIIA downstream target CDKN2A. To identify potential regulatory mechanisms of TFIIA on cellular level, we characterized nuclear-cytoplasmic transport and Taspase1-mediated cleavage of TFIIA variants. Unexpectedly, we identified an evolutionary conserved nuclear export signal (NES) counteracting nuclear localization and thus, transcriptional activity of TFIIA. Notably, proteolytic processing of TFIIA by Taspase1 was found to mask the NES, thereby promoting nuclear localization and transcriptional activation of TFIIA target genes, such as CDKN2A. Collectively, we here describe a hitherto unknown mechanism how cellular localization and Taspase1 cleavage fine-tunes transcriptional activity of TFIIA in HNSCC.
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Affiliation(s)
- Alena Gribko
- Department of Otorhinolaryngology, Molecular and Cellular Oncology, University Hospital of Mainz, Langenbeckstrasse 1, Mainz, 55101, Germany
| | - Angelina Hahlbrock
- Department of Otorhinolaryngology, Molecular and Cellular Oncology, University Hospital of Mainz, Langenbeckstrasse 1, Mainz, 55101, Germany
| | - Sebastian Strieth
- Department of Otorhinolaryngology, Molecular and Cellular Oncology, University Hospital of Mainz, Langenbeckstrasse 1, Mainz, 55101, Germany
| | - Sven Becker
- Department of Otorhinolaryngology, Molecular and Cellular Oncology, University Hospital of Mainz, Langenbeckstrasse 1, Mainz, 55101, Germany
| | - Jan Hagemann
- Department of Otorhinolaryngology, Molecular and Cellular Oncology, University Hospital of Mainz, Langenbeckstrasse 1, Mainz, 55101, Germany
| | - Max Deichelbohrer
- Department of Otorhinolaryngology, Molecular and Cellular Oncology, University Hospital of Mainz, Langenbeckstrasse 1, Mainz, 55101, Germany
| | - Andreas Hildebrandt
- Scientific Computing and Bioinformatics, Johannes Gutenberg University, Staudingerweg 9, Mainz, 55128, Germany
| | - Negusse Habtemichael
- Department of Otorhinolaryngology, Molecular and Cellular Oncology, University Hospital of Mainz, Langenbeckstrasse 1, Mainz, 55101, Germany
| | - D Wünsch
- Department of Otorhinolaryngology, Molecular and Cellular Oncology, University Hospital of Mainz, Langenbeckstrasse 1, Mainz, 55101, Germany.
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Hartwig S, Raguse JD, Pfitzner D, Preissner R, Paris S, Preissner S. Volatile Organic Compounds in the Breath of Oral Squamous Cell Carcinoma Patients: A Pilot Study. Otolaryngol Head Neck Surg 2017; 157:981-987. [DOI: 10.1177/0194599817711411] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective To assess the feasibility of detecting signature volatile organic compounds in the breath of patients with oral squamous cell carcinoma. Study Design Prospective cohort pilot study. Setting University hospital. Subjects and Methods Using gas chromatography and mass spectrometry, emitted volatile organic compounds in the breath of patients before and after curative surgery (n = 10) were compared with those of healthy subjects (n = 4). It was hypothesized that certain volatile organic compounds disappear after surgical therapy. A characteristic signature of these compounds for diseased patients was compiled and validated. Results Breath analyses revealed 125 volatile organic compounds in patients with oral cancer. A signature of 8 compounds that were characteristic for patients with oral cancer could be detected: 3 from this group presented were absent after surgery. Conclusion The presented results confirmed the hypothesis of an absence of cancer-associated volatile organic compounds in the breath after therapy. In this pilot study, we proved the feasibility of this test approach. Further studies should be initiated to establish protocols for usage in a clinical setting.
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Affiliation(s)
- Stefan Hartwig
- Department of Oral and Maxillofacial Surgery/Clinical Navigation, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Jan D. Raguse
- Department of Oral and Maxillofacial Surgery/Clinical Navigation, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Dorothee Pfitzner
- Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Robert Preissner
- Institute of Physiology, Structural Bioinformatics Group, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Sebastian Paris
- Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Saskia Preissner
- Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin Berlin, Berlin, Germany
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Schröck A, Leisse A, de Vos L, Gevensleben H, Dröge F, Franzen A, Wachendörfer M, Schröck F, Ellinger J, Teschke M, Wilhelm-Buchstab T, Landsberg J, Holdenrieder S, Hartmann G, Field JK, Bootz F, Kristiansen G, Dietrich D. Free-Circulating Methylated DNA in Blood for Diagnosis, Staging, Prognosis, and Monitoring of Head and Neck Squamous Cell Carcinoma Patients: An Observational Prospective Cohort Study. Clin Chem 2017; 63:1288-1296. [PMID: 28515105 DOI: 10.1373/clinchem.2016.270207] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 03/21/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Circulating cell-free DNA methylation testing in blood has recently received regulatory approval for screening of colorectal cancer. Its application in other clinical settings, including staging, prognosis, prediction, and recurrence monitoring is highly promising, and of particular interest in head and neck squamous cell carcinomas (HNSCCs) that represent a heterogeneous group of cancers with unsatisfactory treatment guidelines. METHODS Short stature homeobox 2 (SHOX2) and septin 9 (SEPT9) DNA methylation in plasma from 649 prospectively enrolled patients (training study: 284 HNSCC/122 control patients; testing study: 141 HNSCC/102 control patients) was quantified before treatment and longitudinally during surveillance. RESULTS In the training study, 59% of HNSCC patients were methylation-positive at 96% specificity. Methylation levels correlated with tumor and nodal category (P < 0.001). Initially increased methylation levels were associated with a higher risk of death [SEPT9: hazard ratio (HR) = 5.27, P = 0.001; SHOX2: HR = 2.32, P = 0.024]. Disease recurrence/metastases were detected in 47% of patients up to 377 days earlier compared to current clinical practice. The onset of second cancers was detected up to 343 days earlier. In the testing study, sensitivity (52%), specificity (95%), prediction of overall survival (SEPT9: HR = 2.78, P = 0.022; SHOX2: HR = 2.50, P = 0.026), and correlation with tumor and nodal category (P <0.001) were successfully validated. CONCLUSIONS Methylation testing in plasma is a powerful diagnostic tool for molecular disease staging, risk stratification, and disease monitoring. Patients with initially high biomarker levels might benefit from intensified treatment and posttherapeutic surveillance. The early detection of a recurrent/metastatic disease or a second malignancy could lead to an earlier consecutive treatment, thereby improving patients' outcomes.
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Affiliation(s)
- Andreas Schröck
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Bonn, Bonn, Germany
| | - Annette Leisse
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Bonn, Bonn, Germany.,Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | - Luka de Vos
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Bonn, Bonn, Germany
| | | | - Freya Dröge
- Ear, Nose and Throat Clinic, University Hospital Essen, Essen, Germany
| | - Alina Franzen
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Bonn, Bonn, Germany
| | - Malin Wachendörfer
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Bonn, Bonn, Germany.,Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | - Friederike Schröck
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Bonn, Bonn, Germany
| | - Joerg Ellinger
- Department of Urology, University Hospital Bonn, Bonn, Germany
| | - Marcus Teschke
- Department of Oral and Maxillofacial Surgery, University Hospital Bonn, Bonn, Germany
| | | | | | | | - Gunther Hartmann
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, Bonn, Germany
| | - John K Field
- University of Liverpool Cancer Research Center, Liverpool, UK
| | - Friedrich Bootz
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Bonn, Bonn, Germany
| | | | - Dimo Dietrich
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Bonn, Bonn, Germany;
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30
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Müller T, Braun M, Dietrich D, Aktekin S, Höft S, Kristiansen G, Göke F, Schröck A, Brägelmann J, Held SAE, Bootz F, Brossart P. PD-L1: a novel prognostic biomarker in head and neck squamous cell carcinoma. Oncotarget 2017; 8:52889-52900. [PMID: 28881780 PMCID: PMC5581079 DOI: 10.18632/oncotarget.17547] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 03/17/2017] [Indexed: 12/31/2022] Open
Abstract
Background The PD-1 receptor and its ligands PD-L1 and PD-L2 are known to be significantly involved in T-cell regulation. Recent studies suggest that PD-L1 expression in malignant tumors contributes to an immunosuppressive microenvironment and disruption of antitumoral immune response. Drugs targeting this pathway are already tested in clinical trials against several tumor entities with promising results. However, until now comprehensive data with regard to PD-L1 and PD-L2 expression in head and neck squamous cell carcinoma (HNSCC) is still lacking. Patients and methods We assessed PD-L1 and PD-L2 expression via immunohistochemistry in two independent cohorts of 293 HNSCC patients. Results A significant subset of HNSCC showed high expression levels of PD-L1. Most remarkable, we detected a strong correlation between PD-L1 expression and overall survival time in both HNSCC cohorts. Further, in multivariate cox proportional hazard models, PD-L1 dominates as the strongest prognostic factor of patient's outcome in HNSCC, leaving even tumor stage and distant metastasis behind. Moreover, strong PD-L1 expression was associated with the presence of distant metastases in a subset of cases. Conclusions In summary, while the significance of PD-L2 in HNSCC seems to minor, we show that PD-L1 expression is common in HNSCC and, more importantly, a both robust and strong prognostic biomarker. In this respect, our results provide hints on further application of therapies targeting the PD-1/PD-L1 pathway in HNSCC. Investigation of response and outcome of patients receiving anti-PD-1/PD-L1 containing therapies in correlation with PD-L1 expression analysis should be an important task for the future. STATEMENT OF TRANSLATIONAL RELEVANCE In spite of improved treatment options and increasing knowledge of molecular alterations in HNSCC, the survival rate has not been dramatically changed in the past decades. Pies are missing in HNSCC. One promising candidate in cancer immune therapy is PD-L1. Drugs targeting PD-L1 or its receptor PD-1 are subject of several clinical studies in different cancer entities. However, comprehensive data about PD-L1 expression in HNSCC and therefore a rational basis for anti PD-L1/PD-1 therapy in HNSCC is lacking. Here, we provide wide-ranging data about PD-L1 expression in HNSCC of all major localizations. We observed a strong correlation between expression of PD-L1 and reduced overall survival time. Furthermore, high PD-L1 expression was identified as a strong prognostic factor of patient's outcome when verified together with recognized prognostic factors.
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Affiliation(s)
- Tim Müller
- Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | - Martin Braun
- Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | - Dimo Dietrich
- Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | - Seher Aktekin
- Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | - Simon Höft
- Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | | | - Friederike Göke
- Department of Otorhinolaryngology/Head and Neck Surgery, University Hospital Bonn, Bonn, Germany
| | - Andreas Schröck
- Department of Otorhinolaryngology/Head and Neck Surgery, University Hospital Bonn, Bonn, Germany
| | - Johannes Brägelmann
- Department of Oncology, Hematology and Rheumatology, University Hospital Bonn, Bonn, Germany
| | - Stefanie A E Held
- Department of Oncology, Hematology and Rheumatology, University Hospital Bonn, Bonn, Germany
| | - Friedrich Bootz
- Department of Otorhinolaryngology/Head and Neck Surgery, University Hospital Bonn, Bonn, Germany
| | - Peter Brossart
- Department of Oncology, Hematology and Rheumatology, University Hospital Bonn, Bonn, Germany
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Tuttle TR, Takiar V, Kumar B, Kumar P, Ben-Jonathan N. Soluble guanylate cyclase stimulators increase sensitivity to cisplatin in head and neck squamous cell carcinoma cells. Cancer Lett 2016; 389:33-40. [PMID: 28025101 DOI: 10.1016/j.canlet.2016.12.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 12/16/2016] [Accepted: 12/16/2016] [Indexed: 01/02/2023]
Abstract
Head and neck squamous cell carcinoma (HNSCC) is an aggressive and often fatal disease. Cisplatin is the most common chemotherapeutic drug in the treatment of HNSCC, but intrinsic and acquired resistance are frequent, and severe side effects occur at high doses. The second messenger cyclic GMP (cGMP) is produced by soluble guanylate cyclase (sGC). We previously reported that activation of the cGMP signaling cascade caused apoptosis in HNSCC cells, while others found that this pathway enhances cisplatin efficacy in some cell types. Here we found that sGC stimulators reduced HNSCC cell viability synergistically with cisplatin, and enhanced apoptosis by cisplatin. Moreover, the sGC stimulators effectively reduced viability in cells with acquired cisplatin resistance, and were synergistic with cisplatin. The sGC stimulator BAY 41-2272 reduced expression of the survival proteins EGFR and β-catenin, and increased pro-apoptotic Bax, suggesting a potential mechanism for the anti-tumorigenic effects of these drugs. The sGC stimulator Riociguat is FDA-approved to treat pulmonary hypertension, and others are being studied for therapeutic use in several diseases. These drugs could provide valuable addition or alternative to cisplatin in the treatment of HNSCC.
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Affiliation(s)
- Traci R Tuttle
- Department of Cancer Biology, University of Cincinnati School of Medicine, Cincinnati, OH 45267, USA
| | - Vinita Takiar
- Department of Radiation Oncology, University of Cincinnati School of Medicine, Cincinnati, OH 45267, USA
| | - Bhavna Kumar
- Department of Otolaryngology-Head and Neck Surgery, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Pawan Kumar
- Department of Otolaryngology-Head and Neck Surgery, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Nira Ben-Jonathan
- Department of Cancer Biology, University of Cincinnati School of Medicine, Cincinnati, OH 45267, USA.
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Arnold CR, Kloss F, Singh S, Vasiljevic D, Stigler R, Auberger T, Wenzel V, Klima G, Lukas P, Lepperdinger G, Gassner R. A domestic porcine model for studying the effects of radiation on head and neck cancers. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 123:536-543. [PMID: 28130028 DOI: 10.1016/j.oooo.2016.11.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/11/2016] [Accepted: 11/25/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND Radiation therapy (RT) of the head and neck region is often accompanied by serious side effects. Research in this area is needed to improve treatment outcomes and ameliorate therapy tolerance. Laboratory rodents are barely matching today's clinical standards in RT research. Yet domestic swine (Sus scrofa domestica) have previously proved suitable for various advanced tests in clinical research and training. We therefore investigated whether S. scrofa domestica is also appropriate for irradiation of the mandible. STUDY DESIGN A common scheme for irradiation treatment of S. scrofa domestica mandibles in a split-mouth design was acquired by applying computed tomography (CT) scanning under sedation. Basing on close anatomic resemblance, a standard treatment plan comprising 2 opposed irradiation fields could be accomplished. RESULTS RT was carried out in a clinical environment with 2 × 9 Gy. The resulting operating procedure facilitated complication-free sedation, transport, positioning, CT scanning, and effective irradiation. CONCLUSION Based on common standards applied for RT in humans, domestic pigs can be employed to progress RT clinical research. Due to their human-like anatomy, physiology, size, and weight, the swine model is expedient for advancing experimental RT of the head and neck area.
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Affiliation(s)
- Christoph R Arnold
- Department of Therapeutic Radiology and Oncology, Innsbruck Medical University, Innsbruck, Austria.
| | - Frank Kloss
- Department of Maxillofacial Surgery, Innsbruck Medical University, Innsbruck, Austria
| | | | - Danijela Vasiljevic
- Department of Therapeutic Radiology and Oncology, Innsbruck Medical University, Innsbruck, Austria
| | - Robert Stigler
- Department of Maxillofacial Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - Thomas Auberger
- Department of Radiotherapy-Radiooncology, Hospital Traunstein, Traunstein, Germany
| | - Volker Wenzel
- Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria
| | - Günter Klima
- Division of Histology and Embryology, Innsbruck Medical University, Innsbruck, Austria
| | - Peter Lukas
- Department of Therapeutic Radiology and Oncology, Innsbruck Medical University, Innsbruck, Austria
| | - Günter Lepperdinger
- Institute for Biomedical Aging Research, Innsbruck, Austria; Department of Cell Biology, University Salzburg, Salzburg, Austria
| | - Robert Gassner
- Department of Maxillofacial Surgery, Innsbruck Medical University, Innsbruck, Austria
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Percutaneous Image-Guided Cryoablation of Head and Neck Tumors for Local Control, Preservation of Functional Status, and Pain Relief. AJR Am J Roentgenol 2016; 208:453-458. [PMID: 27845860 DOI: 10.2214/ajr.16.16446] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We report nine consecutive percutaneous image-guided cryoablation procedures of head and neck tumors in seven patients (four men and three women; mean age, 68 years; age range, 50-78 years). Ablation of the entire tumor for local control or ablation of a region of tumor for pain relief or preservation of function was achieved in eight of nine procedures. One patient experienced intraprocedural bradycardia, and another developed a neopharyngeal abscess. There were no deaths, permanent neurologic or functional deficits, vascular complications, or adverse cosmetic sequelae due to the procedures. CONCLUSION Percutaneous image-guided cryoablation offers a potentially less morbid minimally invasive treatment option than salvage head and neck surgery. The complications that we encountered may be avoidable with increased experience. Further work is needed to continue improving the safety and efficacy of cryoablation of head and neck tumors and to continue expanding the use of cryoablation in patients with head and neck tumors that cannot be treated surgically.
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Schmidt H, Kulasinghe A, Kenny L, Punyadeera C. The development of a liquid biopsy for head and neck cancers. Oral Oncol 2016; 61:8-11. [DOI: 10.1016/j.oraloncology.2016.07.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 07/12/2016] [Indexed: 10/21/2022]
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35
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Chow LQM, Haddad R, Gupta S, Mahipal A, Mehra R, Tahara M, Berger R, Eder JP, Burtness B, Lee SH, Keam B, Kang H, Muro K, Weiss J, Geva R, Lin CC, Chung HC, Meister A, Dolled-Filhart M, Pathiraja K, Cheng JD, Seiwert TY. Antitumor Activity of Pembrolizumab in Biomarker-Unselected Patients With Recurrent and/or Metastatic Head and Neck Squamous Cell Carcinoma: Results From the Phase Ib KEYNOTE-012 Expansion Cohort. J Clin Oncol 2016; 34:3838-3845. [PMID: 27646946 PMCID: PMC6804896 DOI: 10.1200/jco.2016.68.1478] [Citation(s) in RCA: 607] [Impact Index Per Article: 75.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose Treatment with pembrolizumab, an anti–programmed death-1 antibody, at 10 mg/kg administered once every 2 weeks, displayed durable antitumor activity in programmed death-ligand 1 (PD-L1) –positive recurrent and/or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) in the KEYNOTE-012 trial. Results from the expansion cohort, in which patients with HNSCC, irrespective of biomarker status, received a fixed dose of pembrolizumab at a less frequent dosing schedule, are reported. Patients and Methods Patients with R/M HNSCC, irrespective of PD-L1 or human papillomavirus status, received pembrolizumab 200 mg intravenously once every 3 weeks. Imaging was performed every 8 weeks. Primary end points were overall response rate (ORR) per central imaging vendor (Response Evaluation Criteria in Solid Tumors v1.1) and safety. Secondary end points included progression-free survival, overall survival, and association of response and PD-L1 expression. Patients who received one or more doses of pembrolizumab were included in analyses. Results Of 132 patients enrolled, median age was 60 years (range, 25 to 84 years), 83% were male, and 57% received two or more lines of therapy for R/M disease. ORR was 18% (95% CI, 12 to 26) by central imaging vendor and 20% (95% CI, 13 to 28) by investigator review. Median duration of response was not reached (range, ≥ 2 to ≥ 11 months). Six-month progression-free survival and overall survival rates were 23% and 59%, respectively. By using tumor and immune cells, a statistically significant increase in ORR was observed for PD-L1–positive versus –negative patients (22% v 4%; P = .021). Treatment-related adverse events of any grade and grade ≥ 3 events occurred in 62% and 9% of patients, respectively. Conclusion Fixed-dose pembrolizumab 200 mg administered once every 3 weeks was well tolerated and yielded a clinically meaningful ORR with evidence of durable responses, which supports further development of this regimen in patients with advanced HNSCC.
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Affiliation(s)
- Laura Q M Chow
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Robert Haddad
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Shilpa Gupta
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Amit Mahipal
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Ranee Mehra
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Makoto Tahara
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Raanan Berger
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Joseph Paul Eder
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Barbara Burtness
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Se-Hoon Lee
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Bhumsuk Keam
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Hyunseok Kang
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Kei Muro
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Jared Weiss
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Ravit Geva
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Chi Lin
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Hyun Cheol Chung
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Amy Meister
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Marisa Dolled-Filhart
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Kumudu Pathiraja
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Jonathan D Cheng
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
| | - Tanguy Y Seiwert
- Laura Q.M. Chow, University of Washington, Seattle Cancer Care Alliance, Seattle, WA; Robert Haddad, Dana-Farber Cancer Institute, Boston, MA; Shilpa Gupta and Amit Mahipal, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Ranee Mehra, Fox Chase Cancer Center, Philadelphia, PA; Joseph Paul Eder and Barbara Burtness, Yale University Cancer Center, New Haven, CT; Hyunseok Kang, Johns Hopkins University, Baltimore, MD; Jared Weiss, Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, NC; Amy Meister, Marisa Dolled-Filhart, Kumudu Pathiraja, and Jonathan D. Cheng, Merck, Kenilworth, NJ; Tanguy Y. Seiwert, The University of Chicago, Chicago, IL; Makoto Tahara, National Cancer Center Hospital East, Kashiwa; Kei Muro, Aichi Cancer Center Hospital, Nagoya, Japan; Raanan Berger, Sheba Medical Center, Tel Hashomer; Ravit Geva, Sourasky Medical Center, Tel-Aviv, Israel; Se-Hoon Lee and Bhumsuk Keam, Seoul National University Hospital; Hyun Cheol Chung, Yonsei University College of Medicine, Seoul, Korea; and Chia-Chi Lin, National Taiwan University Hospital, Taipei, Taiwan
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36
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Jung AC, Ray AM, Ramolu L, Macabre C, Simon F, Noulet F, Blandin AF, Renner G, Lehmann M, Choulier L, Kessler H, Abecassis J, Dontenwill M, Martin S. Caveolin-1-negative head and neck squamous cell carcinoma primary tumors display increased epithelial to mesenchymal transition and prometastatic properties. Oncotarget 2016; 6:41884-901. [PMID: 26474461 PMCID: PMC4747196 DOI: 10.18632/oncotarget.6099] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 09/17/2015] [Indexed: 12/17/2022] Open
Abstract
Distant metastases arise in 20-30% of patients with squamous cell carcinoma of the head and neck (HNSCC) in the 2 years following treatment. Therapeutic options are limited and the outcome of the patients is poor. The identification of predictive biomarkers of patient at risk for distant metastasis and therapies are urgently needed. We previously identified a clinical subgroup, called "R1" characterized by high propensity for rapid distant metastasis. Here, we showed that "R1" patients do not or at very low level express caveolin-1 (Cav1). Low or no expression of Cav1 is of bad prognosis. Disappearance of Cav1 enables cells to undergo epithelial-mesenchymal transition (EMT). EMT is associated with enhanced migration and invasion. Our study uncovered a new target, α5β1 integrin. Targeting α5β1 integrins might not only prevent metastasis of HNSCC but also delay the development of the primary tumor by reducing tumor cell viability. Cav1 detection might be taken into consideration in the future in the clinic not only to identify patients at high risk of metastasis but also to select patient who might benefit from an anti-integrin therapy.
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Affiliation(s)
- Alain C Jung
- Laboratoire de Biologie Tumorale, EA 3430 Université de Strasbourg, CRLC Paul Strauss, Strasbourg, France
| | - Anne-Marie Ray
- Université de Strasbourg, LBP, CNRS UMR 7213, Illkirch, France
| | - Ludivine Ramolu
- Laboratoire de Biologie Tumorale, EA 3430 Université de Strasbourg, CRLC Paul Strauss, Strasbourg, France
| | - Christine Macabre
- Laboratoire de Biologie Tumorale, EA 3430 Université de Strasbourg, CRLC Paul Strauss, Strasbourg, France
| | - Florian Simon
- Université de Strasbourg, LBP, CNRS UMR 7213, Illkirch, France
| | - Fanny Noulet
- Université de Strasbourg, LBP, CNRS UMR 7213, Illkirch, France
| | | | | | - Maxime Lehmann
- Université de Strasbourg, LBP, CNRS UMR 7213, Illkirch, France
| | | | - Horst Kessler
- Institute for Advanced Study and Center of Integrated Protein Studies, Technische Universität München, Department Chemie, Garching, Germany
| | - Joseph Abecassis
- Laboratoire de Biologie Tumorale, EA 3430 Université de Strasbourg, CRLC Paul Strauss, Strasbourg, France
| | | | - Sophie Martin
- Université de Strasbourg, LBP, CNRS UMR 7213, Illkirch, France
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37
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Tachibana H, Sho R, Takeda Y, Zhang X, Yoshida Y, Narimatsu H, Otani K, Ishikawa S, Fukao A, Asao H, Iino M. Circulating miR-223 in Oral Cancer: Its Potential as a Novel Diagnostic Biomarker and Therapeutic Target. PLoS One 2016; 11:e0159693. [PMID: 27441818 PMCID: PMC4956265 DOI: 10.1371/journal.pone.0159693] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 07/05/2016] [Indexed: 12/12/2022] Open
Abstract
Circulating microRNAs (miRNAs) have been detected in various types of cancer and have been proposed as novel biomarkers for diagnosis and treatment. Until recently, however, no studies had comprehensively examined circulating miRNAs in oral cancer. The current study used an ultra-sensitive genome-wide miRNA array to investigate changes in circulating miRNAs in plasma from five patients with oral cancer and ten healthy individuals. Results indicated that there were only a few circulating miRNAs, including miR-223, miR-26a, miR-126, and miR-21, that were up-regulated in patients with oral cancer. A subsequent validation test indicated that circulating miR-223 levels were significantly higher (~2-fold, P< 0.05) in patients with oral cancer (n = 31) than in those without cancer (n = 31). Moreover, miR-223 was found to be up-regulated in tumor-adjacent normal tissue compared to tumor tissue from patients with oral cancer. A gain-of-function assay was performed to explore the potential roles of circulating miR-223 in the development of oral cancer. Results revealed that miR-223 functions as a tumor suppressor by inhibiting cell proliferation and inducing apoptosis. In conclusion, this study suggested that circulating miR-223 may serve as a potential biomarker for diagnosis and that it may represent a novel therapeutic target for treatment of oral cancer.
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Affiliation(s)
- Hirohiko Tachibana
- Department of Dentistry and Oral and Maxillofacial Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Ri Sho
- Department of Public Health, Yamagata University Faculty of Medicine, Yamagata, Japan
- * E-mail:
| | - Yuji Takeda
- Department of Immunology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Xuhong Zhang
- Department of Biochemistry and Molecular Biology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Yukie Yoshida
- Department of Dentistry and Oral and Maxillofacial Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Hiroto Narimatsu
- Department of Public Health, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Katsumi Otani
- Department of Public Health, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Shigeo Ishikawa
- Department of Dentistry and Oral and Maxillofacial Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Akira Fukao
- Department of Public Health, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Hironobu Asao
- Department of Immunology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Mitsuyoshi Iino
- Department of Dentistry and Oral and Maxillofacial Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
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38
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Umbreit C, Erben P, Faber A, Hofheinz RD, Schultz JD, Hoermann K, Wenzel A. Lapatinib-induced mesenchymal-epithelial transition in squamous cell carcinoma cells correlates with unexpected alteration of β-catenin expression. Oncol Lett 2016; 11:2715-2724. [PMID: 27073542 PMCID: PMC4812316 DOI: 10.3892/ol.2016.4293] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 10/14/2015] [Indexed: 11/06/2022] Open
Abstract
The epithelial-mesenchymal transition (EMT) is a key developmental program that is often activated during cancer progression, and may promote resistance of cancer cells to therapy. Inhibiting EMT appears to be crucial to inhibit drug resistance. The mesenchymal-epithelial transition (MET), which is the reverse program of EMT in metastases, is characterized by the upregulation of epithelial adhesive proteins such as E-cadherin, and downregulation of mesenchymal proteins such as vimentin. The sensitivity of cancer cells to epithelial growth factor receptor (EGFR) inhibitor may be increased by inducing MET in these cells. Therefore, it is of clinical importance to specify the phenotype of cancer cells in order to overcome the phenomenon of drug resistance. The aim of the present study was to investigate the expression pattern of specific markers in squamous cell carcinoma (SCC) cells following stimulation with lapatinib and gefitinib. For this purpose, the head and neck (HN) SCC cell lines HNSCC22B and HNSCC11A were incubated with 0.5 and 2 µg/ml lapatinib and gefitinib, and the levels of E-cadherin, vimentin, matrix metalloproteinase-14, c-kit and β-catenin were detected by immunocytochemistry and enzyme-linked immunosorbent assay at 5, 24 and 96 h post-incubation. The results indicated that, compared with HNSCC22B cells, the protein expression levels of vimentin increased, whereas those of E-cadherin reduced, in non-stimulated HNSCC11A cells. In addition, the protein expression levels of β-catenin were altered in the epithelial- and mesenchymal-associated SCC cell lines following treatment with lapatinib and gefitinib. Furthermore, lapatinib induced the downregulation of vimentin and upregulation of E-cadherin in HNSCC11A cells in a time-dependent manner. This suggests that the sensitivity of cancer cells to lapatinib may be improved by inducing MET in these cells. In summary, the results of the present study demonstrated that lapatinib-induced MET led to an unexpected alteration of the protein expression levels of β-catenin in SCC cells. Further studies on the mechanistic role of MET are required in order to increase the sensitivity of cancer cells to EGFR inhibitor and block the EMT process in these cells.
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Affiliation(s)
- Claudia Umbreit
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, D-68167 Mannheim, Germany
| | - Philipp Erben
- Department of Urology, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, D-68167 Mannheim, Germany
| | - Anne Faber
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, D-68167 Mannheim, Germany
| | - Ralf-Dieter Hofheinz
- Department of Hematology and Oncology, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, D-68167 Mannheim, Germany
| | - Johannes David Schultz
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, D-68167 Mannheim, Germany
| | - Karl Hoermann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, D-68167 Mannheim, Germany
| | - Angela Wenzel
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, D-68167 Mannheim, Germany
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De Cecco L, Nicolau M, Giannoccaro M, Daidone MG, Bossi P, Locati L, Licitra L, Canevari S. Head and neck cancer subtypes with biological and clinical relevance: Meta-analysis of gene-expression data. Oncotarget 2016; 6:9627-42. [PMID: 25821127 PMCID: PMC4496244 DOI: 10.18632/oncotarget.3301] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 02/08/2015] [Indexed: 02/04/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a disease with heterogeneous clinical behavior and response to therapies. Despite the introduction of multimodality treatment, 40–50% of patients with advanced disease recur. Therefore, there is an urgent need to improve the classification beyond the current parameters in clinical use to better stratify patients and the therapeutic approaches. Following a meta-analysis approach we built a large training set to whom we applied a Disease-Specific Genomic Analysis (DSGA) to identify the disease component embedded into the tumor data. Eleven independent microarray datasets were used as validation sets. Six different HNSCC subtypes that summarize the aberrant alterations occurring during tumor progression were identified. Based on their main biological characteristics and de-regulated signaling pathways, the subtypes were designed as immunoreactive, inflammatory, human papilloma virus (HPV)-like, classical, hypoxia associated, and mesenchymal. Our findings highlighted a more aggressive behavior for mesenchymal and hypoxia-associated subtypes. The Genomics Drug Sensitivity Project was used to identify potential associations with drug sensitivity and significant differences were observed among the six subtypes. To conclude, we report a robust molecularly defined subtype classification in HNSCC that can improve patient selection and pave the way to the development of appropriate therapeutic strategies.
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Affiliation(s)
- Loris De Cecco
- Functional Genomics and Bioinformatics, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Monica Nicolau
- Department of Mathematics, Stanford University, Stanford, CA, USA
| | - Marco Giannoccaro
- Functional Genomics and Bioinformatics, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Maria Grazia Daidone
- Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paolo Bossi
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Laura Locati
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lisa Licitra
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Silvana Canevari
- Functional Genomics and Bioinformatics, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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40
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Schmidt H, Kulasinghe A, Perry C, Nelson C, Punyadeera C. A liquid biopsy for head and neck cancers. Expert Rev Mol Diagn 2016; 16:165-72. [DOI: 10.1586/14737159.2016.1127758] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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41
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Vanderveken OM, Szturz P, Specenier P, Merlano MC, Benasso M, Van Gestel D, Wouters K, Van Laer C, Van den Weyngaert D, Peeters M, Vermorken J. Gemcitabine-Based Chemoradiation in the Treatment of Locally Advanced Head and Neck Cancer: Systematic Review of Literature and Meta-Analysis. Oncologist 2015; 21:59-71. [PMID: 26712958 DOI: 10.1634/theoncologist.2015-0246] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 08/18/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Platinum-based concurrent chemoradiation (CCRT) improves locoregional control and overall survival of locoregionally advanced (LA) squamous cell carcinoma of the head and neck (SCCHN) when compared to radiotherapy alone, but this approach is hampered by significant toxicity. Therefore, alternative ways to enhance the radiation effects are worth investigating. Gemcitabine (2',2'-difluorodeoxycytidine), in addition to its activity against a variety of solid tumors, including SCCHN, is one of the most potent radiosensitizers, and it has an overall favorable safety profile. In this paper, the clinical experience with gemcitabine-based chemoradiation in the treatment of patients with LA-SCCHN is reviewed. METHODS We conducted a review of the literature on the clinical experience with radiotherapy combined with either single-agent gemcitabine or gemcitabine/cisplatin-based polychemotherapy for the treatment of patients with LA-SCCHN. We also searched abstracts in databases of major international oncology meetings from the last 20 years. A meta-analysis was performed to calculate pooled proportions with 95% confidence intervals (CIs) for complete response rate and grade 3-4 acute mucositis rate. RESULTS A total of 13 papers were eligible for the literature review. For schedules using a gemcitabine dose intensity (DI) below 50 mg/m(2) per week, the complete response rate was 86% (95% CI, 74%-93%) with grade 3-4 acute mucositis rate of 38% (95% CI, 27%-50%) and acceptable late toxicity. In one of the studies employing such low DIs, survival data were provided showing a 3-year overall survival of 50%. Compared with DI ≥50 mg/m(2) per week, there was no difference in the complete response rate (71%; 95% CI, 55%-83%; p = .087) but a significantly higher (p < .001) grade 3-4 acute mucositis rate of 74% (95% CI, 62%-83%), often leading to treatment interruptions (survival data provided in 8 studies; 3-year overall survival, 27%-63%). Late toxicity comprising mainly dysphagia was generally underreported, whereas information about xerostomia and skin fibrosis was scarce. CONCLUSION This review highlights the radiosensitizing potential of gemcitabine and suggests that even very low dosages (less than 50 mg/m(2) per week) provide a sufficient therapeutic ratio and therefore should be further investigated. Refinements in radiation schemes, including intensity-modulated radiation therapy, in combination with low-dose gemcitabine and targeted agents, such as cetuximab, are currently being investigated. IMPLICATIONS FOR PRACTICE Cisplatin-based concurrent chemoradiation (CCRT) has become the standard treatment of locally advanced head and neck cancer (LAHNC). This approach is hampered by significant toxicity. This paper reviews the studies using gemcitabine as an alternative radio-sensitizer for CCRT in patients with LAHNC. In this capacity, despite its mild intrinsic toxicity, gemcitabine comes with high rates of severe mucositis when used in dosages exceeding 50 mg/m(2) per week. CCRT with low-dose gemcitabine provides a sufficient therapeutic ratio, combining clinical activity, similar to the higher-dose regimens, with lower toxicity. Further investigation is warranted.
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Affiliation(s)
- Olivier M Vanderveken
- Department of Otolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Antwerp, Belgium Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Petr Szturz
- Department of Medical Oncology, Antwerp University Hospital, Edegem, Antwerp, Belgium Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Brno, Czech Republic School of Medicine, Masaryk University, Brno, Czech Republic
| | - Pol Specenier
- Department of Medical Oncology, Antwerp University Hospital, Edegem, Antwerp, Belgium Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Marco C Merlano
- Department of Oncology, Santa Croce e Carle General Hospital, Cuneo, Italy
| | - Marco Benasso
- Department of Oncology, San Paolo Hospital, Savona, Italy
| | - Dirk Van Gestel
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium Department of Radiotherapy, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Kristien Wouters
- Scientific Coordination and Biostatistics, Antwerp University Hospital, Edegem, Antwerp, Belgium
| | - Carl Van Laer
- Department of Otolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Antwerp, Belgium Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Danielle Van den Weyngaert
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium Department of Radiotherapy, Ziekenhuis Netwerk Antwerpen (ZNA), Antwerp, Belgium
| | - Marc Peeters
- Department of Medical Oncology, Antwerp University Hospital, Edegem, Antwerp, Belgium Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Jan Vermorken
- Department of Medical Oncology, Antwerp University Hospital, Edegem, Antwerp, Belgium Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Marta GN, William WN, Feher O, Carvalho AL, Kowalski LP. Induction chemotherapy for oral cavity cancer patients: Current status and future perspectives. Oral Oncol 2015; 51:1069-75. [DOI: 10.1016/j.oraloncology.2015.10.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 10/05/2015] [Accepted: 10/13/2015] [Indexed: 12/26/2022]
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Welz C, Emmert S, Canis M, Becker S, Baumeister P, Shimizu T, Morfill GE, Harréus U, Zimmermann JL. Cold Atmospheric Plasma: A Promising Complementary Therapy for Squamous Head and Neck Cancer. PLoS One 2015; 10:e0141827. [PMID: 26588072 PMCID: PMC4654510 DOI: 10.1371/journal.pone.0141827] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 10/13/2015] [Indexed: 12/29/2022] Open
Abstract
Head and neck squamous cell cancer (HNSCC) is the 7th most common cancer worldwide. Despite the development of new therapeutic agents such as monoclonal antibodies, prognosis did not change for the last decades. Cold atmospheric plasma (CAP) presents the most promising new technology in cancer treatment. In this study the efficacy of a surface micro discharging (SMD) plasma device against two head and neck cancer cell lines was proved. Effects on the cell viability, DNA fragmentation and apoptosis induction were evaluated with the MTT assay, alkaline microgel electrophoresis (comet assay) and Annexin-V/PI staining. MTT assay revealed that the CAP treatment markedly decreases the cell viability for all tested treatment times (30, 60, 90, 120 and 180 s). IC 50 was reached within maximal 120 seconds of CAP treatment. Comet assay analysis showed a dose dependent high DNA fragmentation being one of the key players in anti-cancer activity of CAP. Annexin-V/PI staining revealed induction of apoptosis in CAP treated HNSCC cell lines but no significant dose dependency was seen. Thus, we confirmed that SMD Plasma technology is definitely a promising new approach on cancer treatment.
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Affiliation(s)
- Christian Welz
- Department of Otorhinolaryngology, Head & Neck Surgery, Georg-August-University, Göttingen, Germany
| | - Steffen Emmert
- Department of Dermatology, Venereology and Allergology, Georg-August-University, Göttingen, Germany
| | - Martin Canis
- Department of Otorhinolaryngology, Head & Neck Surgery, Georg-August-University, Göttingen, Germany
| | - Sven Becker
- Department of Otolaryngology, Head and Neck Surgery, Johannes Gutenberg-University, Mainz, Germany
| | - Philipp Baumeister
- Department of Otorhinolaryngology, Head & Neck Surgery, Ludwig-Maximilians-University, Munich, Germany
| | | | | | - Uli Harréus
- Department of Otolaryngology, Head and Neck Surgery, evangelical hospital Düsseldorf, Germany
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Tuttle TR, Mierzwa ML, Wells SI, Fox SR, Ben-Jonathan N. The cyclic GMP/protein kinase G pathway as a therapeutic target in head and neck squamous cell carcinoma. Cancer Lett 2015; 370:279-85. [PMID: 26551887 DOI: 10.1016/j.canlet.2015.10.024] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 10/22/2015] [Accepted: 10/23/2015] [Indexed: 01/11/2023]
Abstract
Head and neck squamous cell carcinoma (HNSCC) is an aggressive disease with high mortality. Treatments, which can result in significant morbidity, have not substantially changed in three decades. The second messenger cyclic GMP (cGMP), which targets protein kinase G (PKG), is generated by guanylate cyclases (GCs), and is rapidly hydrolyzed by phosphodiesterases (PDEs). Activation of the cGMP/PKG pathway is antineoplastic in several cancer types, but its impact on HNSCC has not been fully exploited. We found differential expression of critical components of this pathway in four HNSCC cell lines. Several activators of soluble GC (sGC), as well as inhibitors of PDE5, increased intracellular cGMP, reduced cell viability, and induced apoptosis in HNSCC cells. The apoptotic effects of the sGC activator BAY 41-2272 and the PDE5 inhibitor Tadalafil (Cialis) were mediated by PKG. Furthermore, Tadalafil substantially reduced the growth of CAL27-derived tumors in athymic mice. Several drugs which either activate sGC or inhibit PDE5 are approved for treatment of nonmalignant conditions. These drugs could be repurposed as novel and effective therapeutics in patients with head and neck cancer.
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Affiliation(s)
- Traci R Tuttle
- Department of Cancer Biology, University of Cincinnati School of Medicine, Cincinnati, OH 45267, USA
| | - Michelle L Mierzwa
- Department of Radiation Oncology, University of Cincinnati School of Medicine, Cincinnati, OH 45267, USA
| | - Susanne I Wells
- Division of Oncology, Cancer and Blood Diseases Institute, Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Sejal R Fox
- Department of Cancer Biology, University of Cincinnati School of Medicine, Cincinnati, OH 45267, USA
| | - Nira Ben-Jonathan
- Department of Cancer Biology, University of Cincinnati School of Medicine, Cincinnati, OH 45267, USA.
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Abstract
Oral mucositis induced by conventional cytotoxic cancer therapies is a common and significant clinical problem in oncology. Mucositis symptoms, which include severe pain, may lead to dose reductions and unplanned interruptions of chemotherapy and/or radiotherapy, and often affect patients' quality of life. In addition, ulcerative mucositis represents a risk factor for local or systemic infectious complications that may be life-threatening in immunosuppressed patients. The development of biologically based targeted cancer therapies, which aim to block the growth, spread, and survival of tumors by interfering with specific molecular targets, may have reduced mucosal injury, but did not eliminate it. This article will review the epidemiology, pathobiology, and management of oral mucositis associated with conventional cytotoxic therapies for malignant diseases and will briefly summarize emerging information on oral mucosal injury associated with targeted therapies. Considerations for future research aimed at the development of more efficient and effective supportive care approaches will be presented, with emphasis on the contribution of dental researchers and clinicians in these efforts.
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Yu T, Li C, Wang Z, Liu K, Xu C, Yang Q, Tang Y, Wu Y. Non-coding RNAs deregulation in oral squamous cell carcinoma: advances and challenges. Clin Transl Oncol 2015; 18:427-36. [PMID: 26370423 DOI: 10.1007/s12094-015-1404-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 08/31/2015] [Indexed: 12/28/2022]
Abstract
Oral squamous cell carcinoma (OSCC) is a common cause of cancer death. Despite decades of improvements in exploring new treatments and considerable advance in multimodality treatment, satisfactory curative rates have not yet been reached. The difficulty of early diagnosis and the high prevalence of metastasis associated with OSCC contribute to its dismal prognosis. In the last few decades the emerging data from both tumor biology and clinical trials led to growing interest in the research for predictive biomarkers. Non-coding RNAs (ncRNAs) are promising biomarkers. Among numerous kinds of ncRNAs, short ncRNAs, such as microRNAs (miRNAs), have been extensively investigated with regard to their biogenesis, function, and importance in carcinogenesis. In contrast to miRNAs, long non-coding RNAs (lncRNAs) are much less known concerning their functions in human cancers especially in OSCC. The present review highlighted the roles of miRNAs and newly discovered lncRNAs in oral tumorigenesis, metastasis, and their clinical implication.
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Affiliation(s)
- T Yu
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, No. 55, Sec. 4, Renminnan Road, 610041, Chengdu, Sichuan, People's Republic of China.
| | - C Li
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, No. 55, Sec. 4, Renminnan Road, 610041, Chengdu, Sichuan, People's Republic of China
| | - Z Wang
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, No. 55, Sec. 4, Renminnan Road, 610041, Chengdu, Sichuan, People's Republic of China
| | - K Liu
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, No. 55, Sec. 4, Renminnan Road, 610041, Chengdu, Sichuan, People's Republic of China
| | - C Xu
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, No. 55, Sec. 4, Renminnan Road, 610041, Chengdu, Sichuan, People's Republic of China
| | - Q Yang
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, No. 55, Sec. 4, Renminnan Road, 610041, Chengdu, Sichuan, People's Republic of China
| | - Y Tang
- Department of Head and Neck Oncology Surgery, Sichuan Cancer Hospital, No. 55, Sec. 4, Renminnan Road, 610041, Chengdu, Sichuan, People's Republic of China
| | - Y Wu
- State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, No. 14, Sec. 3, Renminnan Road, 610041, Chengdu, Sichuan, People's Republic of China.
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Induction chemotherapy prior to surgery with or without postoperative radiotherapy for oral cavity cancer patients: Systematic review and meta-analysis. Eur J Cancer 2015; 51:2596-603. [PMID: 26318725 DOI: 10.1016/j.ejca.2015.08.007] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 08/12/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND Locoregionally advanced oral cavity cancers are aggressive tumours with high risk of relapse after definitive treatment. This study was performed to assess the effectiveness and safety of induction chemotherapy prior to surgery for untreated oral cavity cancer patients. MATERIAL AND METHODS Only prospective phase III randomised studies comparing induction chemotherapy followed by surgery with or without postoperative radiotherapy (Chemo Group) compared with surgery with or without postoperative radiotherapy (Control Group) were eligible. Two of the authors independently selected and assessed the studies regarding eligibility criteria and risk of bias. RESULTS Two studies were selected. A total of 451 patients were randomly assigned to Chemo Group (n=226) versus Control Group (n=225). Most patients had tumours at clinical stages III/IV (89.1%). Both trials were classified as having low risk of bias. No significant overall benefit in favour of induction chemotherapy was found regarding loco-regional recurrence, disease-free survival and overall survival. A subgroup analysis of individual data from cN2 patients showed statistically significant overall survival benefit in favour of induction chemotherapy. The included studies did not directly compare toxicity between the groups and no statistical analysis was performed regarding safety outcomes. CONCLUSIONS Based on the available studies, induction chemotherapy when administered before surgery with curative intent did not improve clinical outcomes in locoregionally advanced oral cavity cancer patients. Clinically assessed N2 patients might benefit from induction chemotherapy.
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Preliminary Results in Unresectable Head and Neck Cancer Treated by Radiofrequency and Microwave Ablation: Feasibility, Efficacy, and Safety. J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2015.05.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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49
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de Souza Viana L, de Aguiar Silva FC, Andrade Dos Anjos Jacome A, Calheiros Campelo Maia D, Duarte de Mattos M, Arthur Jacinto A, Elias Mamere A, Boldrini Junior D, de Castro Capuzzo R, Roberto Santos C, Lopes Carvalho A. Efficacy and safety of a cisplatin and paclitaxel induction regimen followed by chemoradiotherapy for patients with locally advanced head and neck squamous cell carcinoma. Head Neck 2015; 38 Suppl 1:E970-80. [PMID: 26031625 DOI: 10.1002/hed.24137] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 03/14/2015] [Accepted: 05/21/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The purpose of this phase II trial was to evaluate the tolerability, safety, and efficacy of a non-5-fluorouracil (5-FU)-based induction chemotherapy followed by chemoradiotherapy (CRT) for patients with locally advanced head and neck squamous cell carcinoma (HNSCC). METHODS Sixty patients with stage III to IV HNSCC were treated with induction paclitaxel and cisplatin (TP; paclitaxel 175 mg/m(2) and cisplatin 80 mg/m(2) , 3 cycles) followed by CRT (cisplatin 100 mg/m(2) ; D1, 22, and 43 of radiotherapy). RESULTS Fifty-six patients (93.3%) completed 3 cycles of induction TP (no treatment-related deaths), 52 (86.7%) completed definitive CRT per protocol (adverse event [AE] grade ≥2 in 53.3%). The overall response rate after induction TP was 82.5% for patients with resectable disease and 55.5% for unresectable disease (p = .023), and complete response (CR) rate after CRT was 70.0% for patients with resectable disease and 30.0% for unresectable disease (p = .005). CONCLUSION Induction TP followed by cisplatin based-CRT was well-tolerated, safe, and had high overall response rate in selected patients with locally advanced HNSCC. © 2015 Wiley Periodicals, Inc. Head Neck 38: E970-E980, 2016.
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Affiliation(s)
| | | | | | | | | | | | - Augusto Elias Mamere
- Department of Radiotherapy, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | | | | | - Carlos Roberto Santos
- Department of Head and Neck Surgery, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Andre Lopes Carvalho
- Department of Head and Neck Surgery, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
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Abstract
INTRODUCTION Despite improvements in treatment, survival rates of head and neck squamous cell carcinoma (HNSCC) are stagnant. The existing chemotherapeutic agents are non-selective and associated with toxicities. Combinations of the only the US FDA-approved epidermal growth factor receptor (EGFR)-targeted agent, cetuximab, with chemotherapy or radiation improves overall survival. However, the response rates to cetuximab are modest. Thus, there is an urgent need for new agents that can be safely integrated into current treatment regimens to improve outcome. AREAS COVERED Current EGFR-targeted drugs under clinical development include mAbs and tyrosine kinase inhibitors. The modest efficacy of these drugs implicates intrinsic or acquired resistance. Novel molecular agents inhibiting alternative targets to overcome anti-EGFR resistance in HNSCC are under investigation. Gene therapy and immunotherapy are also promising strategies to improve efficacy and reduce toxicity. EXPERT OPINION To date, only six drugs have been FDA-approved for the treatment of head and neck cancer. Cetuximab is the only approved molecular targeting agent for HNSCC and despite ubiquitous expression of EGFR in HNSCC tumors, clinical responses are limited. Genetic and epigenetic characterization of HNSCC tumors, coupled with improved preclinical models, should facilitate the development of more effective drugs.
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Affiliation(s)
- Yihui Wen
- Sun Yat-Sen University and The First Affiliated Hospital of Sun Yat-Sen University, Department of Otolaryngology, Guangzhou, Guangzhou, PR China
- Sun Yat-Sen University and Otolaryngology Institute of Sun Yat-Sen University, Guangzhou, Guangzhou, PR China
- University of Pittsburgh and University of Pittsburgh School of Medicine, Department of Otolaryngology, Pittsburgh, PA, USA
| | - Jennifer R Grandis
- University of Pittsburgh and University of Pittsburgh School of Medicine, Department of Otolaryngology, Pittsburgh, PA, USA
- University of Pittsburgh and University of Pittsburgh School of Medicine, Department of Pharmacology, Pittsburgh, PA, USA
- Eye and Ear Institute, 200 Lothrop St., Suite 500, Pittsburgh, PA, USA
- University of California, Clinical and Translational Science Institute, Department of Otolaryngology-Head and Neck Surgery, San Francisco, CA, USA
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