Independent validation of the prognostic value of cancer stem cell marker expression and hypoxia-induced gene expression for patients with locally advanced HNSCC after postoperative radiotherapy

Objective: To validate the impact of HPV status, cancer stem cell (CSC) marker expression and tumour hypoxia status in patients with locally advanced head and neck squamous cell carcinoma (HNSCC), who received postoperative radiotherapy. The results of the exploration cohort have previously been rep...

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Main Authors: Annett Linge, Steffen Löck, Constanze Krenn, Steffen Appold, Fabian Lohaus, Alexander Nowak, Volker Gudziol, Gustavo B. Baretton, Frank Buchholz, Michael Baumann, Mechthild Krause
Format: Article
Language:English
Published: Elsevier 2016-12-01
Series:Clinical and Translational Radiation Oncology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2405630816300064
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author Annett Linge
Steffen Löck
Constanze Krenn
Steffen Appold
Fabian Lohaus
Alexander Nowak
Volker Gudziol
Gustavo B. Baretton
Frank Buchholz
Michael Baumann
Mechthild Krause
author_facet Annett Linge
Steffen Löck
Constanze Krenn
Steffen Appold
Fabian Lohaus
Alexander Nowak
Volker Gudziol
Gustavo B. Baretton
Frank Buchholz
Michael Baumann
Mechthild Krause
author_sort Annett Linge
collection DOAJ
description Objective: To validate the impact of HPV status, cancer stem cell (CSC) marker expression and tumour hypoxia status in patients with locally advanced head and neck squamous cell carcinoma (HNSCC), who received postoperative radiotherapy. The results of the exploration cohort have previously been reported by the German Cancer Consortium Radiation Oncology Group (DKTK-ROG; Lohaus et al., 2014; Linge et al., 2016). Materials and methods: For 152 patients with locally advanced HNSCC the impact of HPV16 DNA status, CSC marker expression and hypoxia-associated gene signatures on outcome of postoperative radiotherapy were retrospectively analysed. Out of them, 40 patients received postoperative radiochemotherapy. Cox models presented in a previous study were validated using the concordance index as a performance measure. The primary endpoint of this study was loco-regional control. Results were compared to those previously reported by DKTK-ROG. Results: Loco-regional control, freedom from distant metastases and overall survival were inferior to the previously reported cohort. Despite of this, the prognostic value of the combination of HPV infection status, CSC marker expression (SLC3A2) and tumour hypoxia status could be validated in univariate analyses using an independent validation cohort. For multivariate models, the concordance index was between 0.58 and 0.69 in validation, indicating a good prognostic performance of the models. The inclusion of CD44 and the 15-gene hypoxia signature moderately improved the performance compared to a baseline model without CSC markers or hypoxia classifiers. Conclusions: The HPV status, CSC marker expression of CD44 and SLC3A2 as well as hypoxia status are potential prognostic biomarkers for patients with locally advanced HNSCC treated by postoperative radiotherapy.
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spelling doaj.art-c78ce09caaf24412bb55102c0325377e2022-12-21T18:31:07ZengElsevierClinical and Translational Radiation Oncology2405-63082016-12-011C192610.1016/j.ctro.2016.10.002Independent validation of the prognostic value of cancer stem cell marker expression and hypoxia-induced gene expression for patients with locally advanced HNSCC after postoperative radiotherapyAnnett Linge0Steffen Löck1Constanze Krenn2Steffen Appold3Fabian Lohaus4Alexander Nowak5Volker Gudziol6Gustavo B. Baretton7Frank Buchholz8Michael Baumann9Mechthild Krause10German Cancer Research Center (DKFZ), Heidelberg and German Cancer Consortium (DKTK), Partner Site Dresden, GermanyGerman Cancer Research Center (DKFZ), Heidelberg and German Cancer Consortium (DKTK), Partner Site Dresden, GermanyOncoRay – National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, GermanyDepartment of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, GermanyGerman Cancer Research Center (DKFZ), Heidelberg and German Cancer Consortium (DKTK), Partner Site Dresden, GermanyNational Center for Tumor Diseases (NCT), Dresden, GermanyNational Center for Tumor Diseases (NCT), Dresden, GermanyGerman Cancer Research Center (DKFZ), Heidelberg and German Cancer Consortium (DKTK), Partner Site Dresden, GermanyGerman Cancer Research Center (DKFZ), Heidelberg and German Cancer Consortium (DKTK), Partner Site Dresden, GermanyGerman Cancer Research Center (DKFZ), Heidelberg and German Cancer Consortium (DKTK), Partner Site Dresden, GermanyGerman Cancer Research Center (DKFZ), Heidelberg and German Cancer Consortium (DKTK), Partner Site Dresden, GermanyObjective: To validate the impact of HPV status, cancer stem cell (CSC) marker expression and tumour hypoxia status in patients with locally advanced head and neck squamous cell carcinoma (HNSCC), who received postoperative radiotherapy. The results of the exploration cohort have previously been reported by the German Cancer Consortium Radiation Oncology Group (DKTK-ROG; Lohaus et al., 2014; Linge et al., 2016). Materials and methods: For 152 patients with locally advanced HNSCC the impact of HPV16 DNA status, CSC marker expression and hypoxia-associated gene signatures on outcome of postoperative radiotherapy were retrospectively analysed. Out of them, 40 patients received postoperative radiochemotherapy. Cox models presented in a previous study were validated using the concordance index as a performance measure. The primary endpoint of this study was loco-regional control. Results were compared to those previously reported by DKTK-ROG. Results: Loco-regional control, freedom from distant metastases and overall survival were inferior to the previously reported cohort. Despite of this, the prognostic value of the combination of HPV infection status, CSC marker expression (SLC3A2) and tumour hypoxia status could be validated in univariate analyses using an independent validation cohort. For multivariate models, the concordance index was between 0.58 and 0.69 in validation, indicating a good prognostic performance of the models. The inclusion of CD44 and the 15-gene hypoxia signature moderately improved the performance compared to a baseline model without CSC markers or hypoxia classifiers. Conclusions: The HPV status, CSC marker expression of CD44 and SLC3A2 as well as hypoxia status are potential prognostic biomarkers for patients with locally advanced HNSCC treated by postoperative radiotherapy.http://www.sciencedirect.com/science/article/pii/S2405630816300064BiomarkerCancer stem cellsHNSCCHPVHypoxiaPostoperative radiochemotherapyValidation
spellingShingle Annett Linge
Steffen Löck
Constanze Krenn
Steffen Appold
Fabian Lohaus
Alexander Nowak
Volker Gudziol
Gustavo B. Baretton
Frank Buchholz
Michael Baumann
Mechthild Krause
Independent validation of the prognostic value of cancer stem cell marker expression and hypoxia-induced gene expression for patients with locally advanced HNSCC after postoperative radiotherapy
Clinical and Translational Radiation Oncology
Biomarker
Cancer stem cells
HNSCC
HPV
Hypoxia
Postoperative radiochemotherapy
Validation
title Independent validation of the prognostic value of cancer stem cell marker expression and hypoxia-induced gene expression for patients with locally advanced HNSCC after postoperative radiotherapy
title_full Independent validation of the prognostic value of cancer stem cell marker expression and hypoxia-induced gene expression for patients with locally advanced HNSCC after postoperative radiotherapy
title_fullStr Independent validation of the prognostic value of cancer stem cell marker expression and hypoxia-induced gene expression for patients with locally advanced HNSCC after postoperative radiotherapy
title_full_unstemmed Independent validation of the prognostic value of cancer stem cell marker expression and hypoxia-induced gene expression for patients with locally advanced HNSCC after postoperative radiotherapy
title_short Independent validation of the prognostic value of cancer stem cell marker expression and hypoxia-induced gene expression for patients with locally advanced HNSCC after postoperative radiotherapy
title_sort independent validation of the prognostic value of cancer stem cell marker expression and hypoxia induced gene expression for patients with locally advanced hnscc after postoperative radiotherapy
topic Biomarker
Cancer stem cells
HNSCC
HPV
Hypoxia
Postoperative radiochemotherapy
Validation
url http://www.sciencedirect.com/science/article/pii/S2405630816300064
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