The following is a summary of “Tumor volume and cancer stem cell expression as prognostic markers for high-dose loco-regional failure in head and neck squamous cell carcinoma – a DAHANCA 19 study,” published in the February 2024 issue of Oncology by Kristensen et al.

In pursuit of reliable prognostic indicators for patients with Head and Neck Squamous Cell Carcinoma (HNSCC) undergoing biologically driven radiotherapy (RT), this study explored the predictive value of putative cancer stem cell (CSC) markers, hypoxia, and tumor volume, with loco-regional high-dose failure (HDF) as the primary endpoint. Tumor tissue samples were collected from patients treated with primary chemo-radiotherapy (C-RT) and nimorazole as part of the Danish Head and Neck Cancer Study Group (DAHANCA) 19 study. Analyses encompassed tumor volume, hypoxic characterization, and CSC markers CD44, SLC3A2 expression levels, and MET. 

Among patients with complete data on all parameters (n=340), the risk of HDF post-primary C-RT was assessed based on these biomarkers, both collectively and stratified according to p16 status (p16-positive oropharynx [p16+ OPSCC] vs. p16-negative [p16-] tumors, including those of the oral cavity, p16- oropharynx, hypopharynx, and larynx). Findings revealed an elevated HDF risk in patients with larger primary and nodal volumes (>25cm³), high expression levels of SLC3A2 and CD44, and p16- tumor status. Notably, p16- tumors exhibited higher CSC marker expression than p16+ OPSCC. Factors associated with the greatest HDF risk included larger tumor volume for p16- tumors and high SLC3A2 expression for p16+ OPSCC. 

These results underscore the potential utility of tumor volume, p16 status, and CSC markers as prognostic biomarkers for HDF in HNSCC patients undergoing (C-)RT, with lower CSC expression contributing to improved tumor control in p16+ OPSCC.

Source: sciencedirect.com/science/article/abs/pii/S0167814024000707