Biomarker Could Help Determine Aggressiveness of Treatment in Head and Neck Cancer

Scientists have discovered a new biomarker that could predict survival outcomes—and help establish the need for aggressive treatment for a disease that is estimated to kill nearly 10,000 people in the United States in 2016.

According to the American Cancer Society, more than 48,000 people are expected to be diagnosed with head and neck cancer in 2016, a disease that is more common among men than in women. Now, genomic experts at the Loyola University in Chicago, via a retrospective gene expression barcode analysis of genomic data from human papilloma virus (HPV)-negative patients with oral cavity squamous cell carcinoma (OCSCC), have identified a gene that could predict survival in that patient population.

The researchers analyzed information on 54 HPV-negative OCSCC patients and found that tumors that expressed the cytoskeletal protein spectrin, which helps maintain plasma membrane integrity, were 4.6 times likely of dying at any given time, compared with patients who did not express the protein (95% CI, 1.88-11.25; P = .001). Additional analysis of the genomic data found a correlation between advanced disease and survival: individuals diagnosed with late-stage OCSCC were 6.34 times more likely (95% CI, 1.41-28.53; P = .02) to die; however after accounting for spectrin expression, the correlation was no longer significant (P = .07). This provides significant credibility to using this protein as a biomarker in OCSCC.

Staging of disease by physicians can sometimes result in imprecise prognosis—patients with early-stage disease could have worse outcomes that those with a more advanced disease. “Studies have found that patients with oropharynx cancers associated with the HPV tend to have better outcomes. But there is no reliable biomarker to predict outcomes among patients who are HPV negative,” according to Carol Bier-Laning, MD, a head-and-neck cancer surgeon who co-authored the paper that has been published in Otolaryngology - Head and Neck Surgery. Based on the results of this study, patients with early-stage disease who express spectrin could potentially receive more aggressive treatment such as radiation and chemotherapy, in addition to surgery, and vice versa, those with a more advanced disease who do not expres spectrin could safely undergo surgery alone. Additional studies would be necessary to test this hypothesis.

“Our analysis of public genomic data shows promise in identifying biomarkers that may allow clinicians to make more accurate survival predictions. Spectrin is a strong candidate for further biomarker testing,” the authors conclude.

Reference

Yang SF, Bier-Laning CM, Adams W, Zilliox MJ. Candidate biomarkers for HPV-negative head and neck cancer identified via gene expression barcode analysis [published online April 19, 2016]. Otolaryngol Head Neck Surg. 2016. pii: 0194599816642436.