Prognostic Significance of Oxidation Pathway Mutations in Recurrent Laryngeal Squamous Cell Carcinoma
Organ preservation protocols are commonly used as first line therapy for advanced laryngeal cancer. Recurrence thereafter is associated with poor survival. The aim of this study is to identify genetic alterations associated with survival among patients with recurrent laryngeal cancer undergoing salv...
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| Format: | Article |
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MDPI AG
2020-10-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/12/11/3081 |
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| author | Molly E. Heft Neal Apurva D. Bhangale Andrew C. Birkeland Jonathan B. McHugh Andrew G. Shuman Andrew J. Rosko Paul L. Swiecicki Matthew E. Spector J. Chad Brenner |
| author_facet | Molly E. Heft Neal Apurva D. Bhangale Andrew C. Birkeland Jonathan B. McHugh Andrew G. Shuman Andrew J. Rosko Paul L. Swiecicki Matthew E. Spector J. Chad Brenner |
| author_sort | Molly E. Heft Neal |
| collection | DOAJ |
| description | Organ preservation protocols are commonly used as first line therapy for advanced laryngeal cancer. Recurrence thereafter is associated with poor survival. The aim of this study is to identify genetic alterations associated with survival among patients with recurrent laryngeal cancer undergoing salvage laryngectomy. Sixty-two patients were sequenced using a targeted panel, of which twenty-two also underwent transcriptome sequencing. Alterations were grouped based on biologic pathways and survival outcomes were assessed using Kaplan-Meier analysis and multivariate cox regression. Select pathways were evaluated against The Cancer Genome Atlas (TCGA) data. Patients with mutations in the Oxidation pathway had significantly worse five-year disease specific survival (1% vs. 76%, <i>p</i> = 0.02), while mutations in the HN-Immunity pathway were associated with improved five-year disease specific survival (100% vs. 62%, <i>p</i> = 0.02). Multivariate analysis showed mutations in the Oxidation pathway remained an independent predictor of disease specific survival (HR 3.2, 95% CI 1.1–9.2, <i>p</i> = 0.03). Transcriptome analysis of recurrent tumors demonstrated that alterations in the Oxidation pathway were associated a positive Ragnum hypoxia signature score, consistent with enhanced pathway activity. Further, TCGA analyses demonstrated the prognostic value of oxidation pathway alterations in previously untreated disease. Alterations in the Oxidation pathway are associated with survival among patients with recurrent laryngeal cancer. These prognostic genetic biomarkers may inform precision medicine protocols and identify putatively targetable pathways to improve survival in this cohort. |
| first_indexed | 2024-03-10T15:25:02Z |
| format | Article |
| id | doaj.art-db0596eb9b844299b3e61ac6fcec10cb |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T15:25:02Z |
| publishDate | 2020-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-db0596eb9b844299b3e61ac6fcec10cb2023-11-20T18:07:59ZengMDPI AGCancers2072-66942020-10-011211308110.3390/cancers12113081Prognostic Significance of Oxidation Pathway Mutations in Recurrent Laryngeal Squamous Cell CarcinomaMolly E. Heft Neal0Apurva D. Bhangale1Andrew C. Birkeland2Jonathan B. McHugh3Andrew G. Shuman4Andrew J. Rosko5Paul L. Swiecicki6Matthew E. Spector7J. Chad Brenner8Department of Otolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, MI 48109, USADepartment of Otolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, MI 48109, USADepartment of Otolaryngology–Head and Neck Surgery, University of California Davis, Sacramento, CA 95817, USADepartment of Pathology, University of Michigan, Ann Arbor, MI 48109, USADepartment of Otolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, MI 48109, USADepartment of Otolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, MI 48109, USARogel Cancer Center, University of Michigan Medical School, Ann Arbor, MI 48109, USADepartment of Otolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, MI 48109, USADepartment of Otolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, MI 48109, USAOrgan preservation protocols are commonly used as first line therapy for advanced laryngeal cancer. Recurrence thereafter is associated with poor survival. The aim of this study is to identify genetic alterations associated with survival among patients with recurrent laryngeal cancer undergoing salvage laryngectomy. Sixty-two patients were sequenced using a targeted panel, of which twenty-two also underwent transcriptome sequencing. Alterations were grouped based on biologic pathways and survival outcomes were assessed using Kaplan-Meier analysis and multivariate cox regression. Select pathways were evaluated against The Cancer Genome Atlas (TCGA) data. Patients with mutations in the Oxidation pathway had significantly worse five-year disease specific survival (1% vs. 76%, <i>p</i> = 0.02), while mutations in the HN-Immunity pathway were associated with improved five-year disease specific survival (100% vs. 62%, <i>p</i> = 0.02). Multivariate analysis showed mutations in the Oxidation pathway remained an independent predictor of disease specific survival (HR 3.2, 95% CI 1.1–9.2, <i>p</i> = 0.03). Transcriptome analysis of recurrent tumors demonstrated that alterations in the Oxidation pathway were associated a positive Ragnum hypoxia signature score, consistent with enhanced pathway activity. Further, TCGA analyses demonstrated the prognostic value of oxidation pathway alterations in previously untreated disease. Alterations in the Oxidation pathway are associated with survival among patients with recurrent laryngeal cancer. These prognostic genetic biomarkers may inform precision medicine protocols and identify putatively targetable pathways to improve survival in this cohort.https://www.mdpi.com/2072-6694/12/11/3081HNSCClarynxNrf2/Keap1oxidation |
| spellingShingle | Molly E. Heft Neal Apurva D. Bhangale Andrew C. Birkeland Jonathan B. McHugh Andrew G. Shuman Andrew J. Rosko Paul L. Swiecicki Matthew E. Spector J. Chad Brenner Prognostic Significance of Oxidation Pathway Mutations in Recurrent Laryngeal Squamous Cell Carcinoma Cancers HNSCC larynx Nrf2/Keap1 oxidation |
| title | Prognostic Significance of Oxidation Pathway Mutations in Recurrent Laryngeal Squamous Cell Carcinoma |
| title_full | Prognostic Significance of Oxidation Pathway Mutations in Recurrent Laryngeal Squamous Cell Carcinoma |
| title_fullStr | Prognostic Significance of Oxidation Pathway Mutations in Recurrent Laryngeal Squamous Cell Carcinoma |
| title_full_unstemmed | Prognostic Significance of Oxidation Pathway Mutations in Recurrent Laryngeal Squamous Cell Carcinoma |
| title_short | Prognostic Significance of Oxidation Pathway Mutations in Recurrent Laryngeal Squamous Cell Carcinoma |
| title_sort | prognostic significance of oxidation pathway mutations in recurrent laryngeal squamous cell carcinoma |
| topic | HNSCC larynx Nrf2/Keap1 oxidation |
| url | https://www.mdpi.com/2072-6694/12/11/3081 |
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