EGFR, p16, HPV titer, Bcl-xL and p53, sex, and smoking as indicators of response to therapy and survival in oropharyngeal cancer
Kumar B et al. - In a study to prospectively identify markers of response to therapy and outcome in an organ-sparing trial for advanced oropharyngeal cancer, it was shown that low epidermal growth factor receptor (EGFR) and high p16 (or higher human papillomavirus [HPV] titer) expression are markers of good response to organ-sparing therapy and outcome, whereas high EGFR expression, combined low p53/high Bcl-xL expression, female sex, and smoking are associated with a poor outcome Methods- Pretreatment biopsies were examined for expression of EGFR, p16, Bcl-xL, and p53 as well as for p53 mutation
- These markers were assessed for association with high-risk HPV, response to therapy, and survival
- Pt variables included smoking history, sex, age, primary site, tumor stage, and nodal status
Results- EGFR expression was inversely associated with response to induction chemotherapy (IC), chemotherapy/radiotherapy (CRT), overall survival (OS), and disease-specific survival (DSS) and was directly associated with current smoking, female sex, and lower HPV titer
- HPV titer was significantly associated with p16 expression; p16 was significantly associated with response to IC, CRT, OS, and DSS
- As combined markers, lower HPV titer and high EGFR expression were associated with worse OS and DSS
- In 36 of 42 biopsies, p53 was wild-type, and only 1 HPV-positive tumor had mutant p53
- Combination of low p53 and high Bcl-xL expression was associated with poor OS and DSS
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