关于头颈肿瘤的Biomarker及其他进展

Head and neck tumors include three major categories: neck tumors, otolaryngology tumors, and oral and maxillofacial tumors. Neck tumors belong to general surgery in general hospitals, and the most common ones are thyroid tumors. Therefore, tumors occurring in the head and neck have many primary sites and pathological types, ranking first among all tumors in the body. More than 90% of head and neck tumors are squamous cell carcinoma. The global incidence of squamous cell carcinoma of the head and neck (SCCHN) has increased significantly in the past decade, especially among women.

Today we will continue to learn about Biomarkers and other developments in head and neck tumors.

Improving the TNM staging system for Epstein-Barr virus-related nasopharyngeal carcinoma: a multicenter cohort study

This study retrospectively selected patients from Zhongshan Cancer Control Center and Foshan First People's Hospital. A total of 2,354 patients with non-metastatic nasopharyngeal carcinoma who received radiotherapy or chemotherapy from January 2008 to December 2016, of which 1,372 patients from Zhongshan Cancer Control Center were used as the training set. The OS and PFS of EBV DNA status and TNM stage were analyzed and compared, using recursive partitioning analysis. analysis, RPA) combined with clustering to obtain prognostic groupings, and compare the PFS of different clinical stages under different EDV DNA status.

RPA recursive segmentation analysis is a widely recognized method for establishing prognostic stages of cancer. In terms of Partitioning Clustering, it selects the best clusters and generates the final RPA-based staging.

Different EBV DNA statuses have different prognostic effects under TNM staging, and the prognostic difference between TNM staging is not significant enough for different EBV DNA statuses.

The staging of EBV DNA-negative patients is underestimated in the current TNM staging system. Patients with T4 or N3 are the highest risk subgroup. This RPA staging may help with prognosis prediction and trial design.

This study established and validated the RPA staging system, which combines TNM staging and EBV DNA status to evaluate the prognosis of patients with Epstein-Barr virus-related, non-metastatic NPC. This RPA staging system is superior to the AJCC 8th edition and other two published RPA staging systems, and may help prognosis prediction and trial design.

Gene expression profiling differentiates short-term and long-term survival in head and neck cancer patients

Only a small proportion of R/M HNSCC patients treated with immune checkpoint inhibitors achieve long-term survival. Uncovering the dominant populations of immune benefit and the molecular mechanisms underlying immunotherapy ineffectiveness is an unmet clinical need. To identify predictive factors for prognosis, the researchers evaluated the gene expression profiles of patients with R/M HNSCC with relatively polarized overall survival (OS) after ICI treatment.

The results showed that long-term survival LTS was positively correlated with the CI6 subtype score, while short-survival STS was negatively correlated with the CI6 subtype score. The accuracy of ROC analysis reaches significance. CI5 and CI6 have a certain positive correlation and have similar results in predicting prognosis. There are potential gene expression profile differences between LTS and STS.

Survival prediction table for locally advanced HNSCC receiving radical chemoradiotherapy: secondary analysis of NRG/RTOG 0129, 0522, and 1016 studies

The impact of HP positivity on the prognosis of HNSCC patients is gradually changing the current treatment pattern of platinum-based concurrent chemoradiotherapy. Recent studies have also provided new evidence to analyze prognostic factors. The purpose of this study is to discover survival prognostic factors for HNSCC patients, evaluate survival outcomes of different genders, and generate prediction tables using data from three randomized controlled clinical trials.

RTOG 0522/1016 was used as a training set to generate 3 models, and different analysis methods were used to perform cross-validation on overall survival and progression-free survival (PFS). The model with the highest C-index (prediction accuracy) was the Cox proportional hazards (CPH) model, which was then externally validated using data from RTOG 0129.

The analysis results showed that there was no significant difference in the OS and PFS of patients of different genders in the three studies using the CPH model, and gender may have nothing to do with OS/PFS.

Real-world efficacy of immunotherapy in patients with R/M HNSCC and subsequent treatment after immune failure

Immune checkpoint inhibitors (CPI) are the standard treatment after failure of platinum-based chemotherapy in r/m SCCHN, but the optimal treatment strategy for CPI has not yet been determined. This study evaluated the overall clinical efficacy of CPI monotherapy in two real-world cohorts and evaluated the impact of subsequent treatment on clinical outcomes after CPI monotherapy in one real-world cohort.

CPI monotherapy has some efficacy in an unselected real-world population of r/m SCCHN, disease control (CR/PR/SD) after CPI monotherapy may be a predictor of long-term survival, and taxane-based treatment regimens may be the most promising treatment strategy after failure of CPI and platinum-based treatments.

Impact of recurrence site on survival of patients treated with immunotherapy for R/M HNSCC

Immune checkpoint inhibitors have certain anti-tumor activity in patients with R/M HNSCC. However, the majority of patients remain unresponsive. The impact of site of recurrence on immunotherapy outcomes has not been studied. Therefore, the researchers sought to evaluate the efficacy of immunotherapy based on the site of relapse at baseline treatment.

The study, conducted between 2013 and 2019 at the Oncopole Cancer Institute of the University of Toulouse, retrospectively looked at all patients with R/M HNSCC who received immunotherapy as part of a clinical trial or as an EMA-approved indication.

Compared with patients with local recurrence, patients with simple distant recurrence have twice the OS benefit of immunotherapy. In future clinical studies of immunotherapy for HNSCC, recurrence sites should be divided into local and distant categories. In addition, local recurrence may exhibit different biological characteristics, and the response to ICI depends on the history of radiotherapy and the site of recurrence (in-field, margin, or out-field).