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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