Predicting Radiosensitivity and Outcomes in Head and Neck Cancer
Posted: Thursday, April 11, 2019
Patients with head and neck squamous cell carcinoma who are resistant to the effects of radiation or those with human papillomavirus (HPV)/p16-negative disease may benefit from chemotherapy plus anti–PD-1 and anti–PD-L1 therapy, according to findings published in the Journal of Cancer. Qiao Qiao, MD, and colleagues from the First Hospital of China Medical University, Shenyang, found that overexpression of PD-1 and PD-L1 was strongly related to radiosensitivity and that high expression of PD-1 was associated with HPV/p16-positive disease.
“These findings provide insight into radioresistant and HPV-negative tumor treatment, particularly with respect to clinical trials in the future,” the investigators noted.
A total of 517 patients from The Cancer Genome Atlas head and neck squamous cell carcinoma cohort were divided into radioresistant and radiosensitive groups using K-mean clustering. Of the total population, 289 patients (55.9%) received radiotherapy, 158 patients (30.6%) did not receive radiotherapy, and 70 patients (13.5%) had an unknown treatment.
Patients with HPV/p16-positive disease had significantly higher PD-1 expression (P < .0001) than the HPV/p16-negative group. The radiosensitive group had higher PD-1 (P = .0005) and PD-L1 (P < .0001) expression than the radioresistant group.
Among patients treated with radiotherapy, high PD-1 expression was associated with better recurrence-free survival rates than was low PD-1 expression (P = .023). However, overexpression of PD-L1 was associated with lower overall survival than low PD-L1 expression (P = .01). Furthermore, patients in the radioresistant group with HPV/p16-negative disease and high PD-L1 expression exhibited significantly lower overall survival rates than those with low PD-L1 expression. Those with high PD-L1 expression had lower overall survival (P = .01) and recurrence-free survival (P = .02) rates than the radiosensitive group.
Disclosure: The study authors reported no conflicts of interest.