A model for predicting clinical outcome in patients with human papillomavirus-positive tonsillar and base of tongue cancer. Issue 12 (August 2015)

• Record Type: Journal Article
• Authors: Tertipis, Nikolaos; Hammar, Ulf; Näsman, Anders; Vlastos, Andrea; Nordfors, Cecilia; Grün, Nathalie; Ährlund-Richter, Andreas; Sivars, Lars; Haeggblom, Linnea; Marklund, Linda; Hammarstedt-Nordenvall, Lalle; Chaturvedi, Anil K.; Munck-Wikland, Eva; Ramqvist, Torbjörn; Bottai, Matteo; Dalianis, Tina
• Is Part Of: European journal of cancer. Volume 51:Issue 12(2015:Aug.)
• Page Start: 1580
• Page End: 1587
• Publication Date: 2015-08
• Subjects: Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Cancer; Tumors; Electronic journals; Periodicals; Electronic journals; 616.994
• DOI: 10.1016/j.ejca.2015.04.024
• Languages: English
• ISSNs: 0959-8049

Abstract

<abstract xml:lang="en" abstract-type="author" id="ab005"> <title id="st005">Abstract</title> <sec> <title id="st010">Aim</title> <p id="sp0005">To combine clinical and molecular markers into an algorithm for predicting outcome for individual patients with human papillomavirus (HPV) DNA/p16<sup>INK4a</sup> positive tonsillar and base of tongue squamous cell carcinoma (TSCC and BOTSCC).</p> </sec> <sec> <title id="st015">Background</title> <p id="sp0010">Head-neck cancer treatment has become more intensified, comprising not only surgery and radiotherapy, but also induction/concomitant chemotherapy and targeted therapy. With less treatment, 3-year disease free survival (DFS) is 80% for HPV-positive TSCC and BOTSCC. An 85–100% 3-year DFS is observed for HPV<sup>+</sup> TSCC and BOTSCC with absence of HLA class I, or CD44 expression, or high CD8<sup>+</sup> tumour-infiltrating lymphocyte (TIL) counts suggesting that therapy could be tapered for many if patients could be identified individually.</p> </sec> <sec> <title id="st020">Patients and methods</title> <p id="sp0015">Patients treated curatively, with HPV DNA/p16<sup>INK4a</sup> positive tumours examined for HLA class I and II, CD44 and CD8<sup>+</sup>TILs, were included. An L1-regularised logistic regression was used to evaluate the effect of the biomarker data, age, stage, diagnosis, smoking and treatment on 3-year risk of death or relapse on a training cohort of 197 patients diagnosed 2000–2007 and validated on a cohort of 118 patients diagnosed 2008–2011.</p> </sec> <sec> <title id="st025">Results</title> <p id="sp0020">The variables finally included in the model were HLA class I, CD8<sup>+</sup> TILs, age, stage and diagnosis (TSCC or BOTSCC). The model showed acceptable discrimination and calibration. The discriminative ability of the model did not diminish after validation (AUC = 0.77).</p> </sec> <sec> <title id="st030">Conclusion</title> <p id="sp0025">To our knowledge, this is the first model to utilise information from several markers to predict an individual probability of clinical outcome for patients with HPV DNA/p16<sup>INK4a</sup> positive tumours.</p> </sec> </abstract>