Development and characterization of HPV-positive and HPV-negative head and neck squamous cell carcinoma tumorgrafts

PURPOSE

To develop a clinically relevant model system to study head and neck squamous cell carcinoma (HNSCC), we have established and characterized a direct-from-patient tumorgraft model of human papillomavirus (HPV)-positive and HPV-negative cancers.

EXPERIMENTAL DESIGN

Patients with newly diagnosed or recurrent HNSCC were consented for donation of tumor specimens. Surgically obtained tissue was implanted subcutaneously into immunodeficient mice. During subsequent passages, both formalin-fixed/paraffin-embedded as well as flash-frozen tissues were harvested. Tumors were analyzed for a variety of relevant tumor markers. Tumor growth rates and response to radiation, cisplatin, or cetuximab were assessed and early passage cell strains were developed for rapid testing of drug sensitivity.

RESULTS

Tumorgrafts have been established in 22 of 26 patients to date. Significant diversity in tumorgraft tumor differentiation was observed with good agreement in degree of differentiation between patient tumor and tumorgraft (Kappa 0.72). Six tumorgrafts were HPV-positive on the basis of p16 staining. A strong inverse correlation between tumorgraft p16 and p53 or Rb was identified (Spearman correlations P = 0.085 and P = 0.002, respectively). Significant growth inhibition of representative tumorgrafts was shown with cisplatin, cetuximab, or radiation treatment delivered over a two-week period. Early passage cell strains showed high consistency in response to cancer therapy between tumorgraft and cell strain.

CONCLUSIONS

We have established a robust human tumorgraft model system for investigating HPV-positive and HPV-negative HNSCC. These tumorgrafts show strong correlation with the original tumor specimens and provide a powerful resource for investigating mechanisms of therapeutic response as well as preclinical testing.

Abstract 2352: Molecular profiles of head and neck cancer tumorgrafts

Purpose: We have developed a primary tumorgraft system of squamous cell carcinoma of the head and neck with relevance for investigating mechanisms of therapeutic resistance, understanding differential responses to standard therapy in HPV-positive and HPV-negative cancers, and testing novel therapeutics. To better understand the power, limitations and relevance of our tumorgraft system, we have initiated molecular characterization of these tumors. Methods: Patients with newly diagnosed or recurrent HNSCC were consented for donation of tumor at the time of surgery. Tumor tissue was obtained, washed in antibiotic rich media, manually disaggregated, and subcutaneously implanted into mice (NOD.Cg-Prkdc scid Il2rgtm1Wjl/SzJ) for initial tumorgraft establishment. Subsequent mouse-to-mouse passages were performed and formalin-fixed/paraffin embedded as well as flash frozen tissue was harvested for subsequent molecular analyses. Expression of p16(Ink4a), p53, pRB, and EGFR was assessed by immunohistochemistry(IHC). HPV status and subtype was assessed using MY09/MY11 and GP5/GP6 degenerate nested polymerase chain reaction and Sanger sequencing. Transcriptionally active HPV infection was assessed by qRT-PCR for the HPV oncogenes E6 and E7. Mutation status of p53 was assessed by PCR-based exon amplification and Sanger sequencing. Results: To date, thirty primary tumorgrafts have been established with robust growth in eighteen (60%). p16(INK4A) expression was identified in approximately one-third. The majority of HPV-positive tumorgrafts contained HPV-16 and were transcriptionally active by mRNA expression profiling. HPV-positive tumors showed low p53 and RB expression by IHC. As anticipated, mutations in p53 were seen more frequently in HPV-negative tumors. Conclusions: These primary human tumorgrafts represent a diverse range of head and neck cancers. Both HPV-positive tumors and HPV-negative tumors have been successfully propagated with a diverse range of molecular characteristics. These primary tumorgrafts will provide a valuable platform for testing novel therapeutics as well as radiation and chemotherapy response profiles.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2352. doi:1538-7445.AM2012-2352

Sympathetic restraint of muscle blood flow during hypoxic exercise

Control of exercising muscle blood flow is a balance between local vasodilatory factors and the increase in global sympathetic vasoconstrictor outflow. Hypoxia has been shown to potentiate the muscle sympathetic nerve response to exercise, potentially limiting the increase in muscle blood flow. Accordingly, we investigated sympathetic restraint to exercising muscle during whole body exercise in hypoxia. Six dogs chronically instrumented with ascending aortic and hindlimb flow probes and a terminal aortic catheter were studied at rest and mild [2.5 miles/h (mph), 5% grade] and moderate (4.0 mph, 10% grade) exercise while breathing room air or hypoxia (Pa(O(2)) approximately 45 mmHg) in the intact control condition and following systemic alpha-adrenergic blockade (phentolamine). Hypoxia caused an increase in cardiac output (CO), hindlimb flow (Flow(L)), and blood pressure (BP), while total (Cond(T)) and hindlimb conductance (Cond(L)) were unchanged at rest and mild exercise but increased with moderate exercise. During both mild and moderate exercise, alpha-blockade in normoxia resulted in significant vasodilation as evidenced by increases in CO (10%), Flow(L) (17%), Cond(T) (33%), Cond(L) (43%), and a decrease in BP (-18%), with the increase in Cond(L) greater than the increase in Cond(T) during mild exercise. Compared with the normoxic response, alpha-blockade in hypoxia during exercise resulted in a significantly greater increase in Cond(T) (59%) and Cond(L) (74%) and a correspondingly greater decrease in BP (-34%) from baseline. These findings indicate that there is considerable hypoxia-induced sympathetic restraint of muscle blood flow during both mild and moderate exercise, which helps to maintain arterial blood pressure in hypoxia.

Apoptosis: its role in the development of malignancies and its potential as a novel therapeutic target

OBJECTIVE

To review the current literature regarding the role of apoptosis in the development of malignant cells and how the induction of this pathway could be used in cancer therapy.

DATA SOURCE

A MEDLINE search of basic science articles pertinent to the understanding of the normal physiologic process of apoptosis was conducted.

STUDY SELECTION

Because of the rapidly growing literature regarding apoptosis, only articles describing key processes in the biology of the cell and the genetic control of apoptosis were included.

DATA SYNTHESIS

Apoptosis is imperative for host survival since it discards unwanted, damaged, and atypical cells. The process is therefore implicated in the continuous regulation of development, differentiation, and homeostasis. Furthermore, apoptosis is a response to physiologic and pathologic stresses that disrupt the balanced rates of cell generation and elimination. In a disease such as cancer, there is a lack of equilibrium between the rates of cell division and cell death; agents that promote or suppress apoptosis can manipulate these rates, influencing the anomalous accumulation of neoplastic cells. Pharmacologic manipulation of apoptosis can manipulate these rates, influencing the anomalous accumulation represents a novel approach in targeting malignant cells and has far-reaching implications for new directions in cancer therapy.

CONCLUSIONS

Apoptosis is a highly organized physiologic mechanism of destroying injured and abnormal cells as well as maintaining homeostasis in multicellular organisms. Both the activation and inhibition of apoptosis are tightly controlled. Pharmacologic manipulation of this pathway is a novel therapeutic target in cancer therapy.