1020P - The expression of p53, β-tubulin, bcl-2 according to p16 status in advanced oropharyngeal cancer after induction chemotherapy followed by concurren...

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Head and Neck Cancers
Pathology/Molecular Biology
Surgery and/or Radiotherapy of Cancer
Presenter Sang-Hee Cho
Citation Annals of Oncology (2014) 25 (suppl_4): iv340-iv356. 10.1093/annonc/mdu340
Authors S. Cho1, H. Shim2, J.E. Hwang3, W.K. Bae3, D. Lee4, T. Yoon4, J.K. Lee4, S.C. Lim4, W.K. Chung5, J.S. Ahn3, S.I. Jung2, Y.D. Choi6, I.J. Chung7
  • 1Internal Medicine Hemato-oncology, Chonnam National University Hwasun Hospital, 519-809 - Jeollanamdo/KR
  • 2Department Of Internal Medicine, Chonnam National University Hwasun Hospital, 519-809 - Jeollanamdo/KR
  • 3Hematooncology, Chonnam National University Hwasun Hospital, 519-809 - Jeollanamdo/KR
  • 4Department Of Otolaryngology-head And Neck Surgery, Chonnam National University Hwasun Hospital, 519-809 - Jeollanamdo/KR
  • 5Department Of Radiation Oncology, Chonnam National University Hwasun Hospital, 519-809 - Jeollanamdo/KR
  • 6Department Of Pathology, Chonnam National University Hwasun Hospital, 519-809 - Jeollanamdo/KR
  • 7Medical Oncology, Chonnam National University Hwasun Hospital, KR-519-763 - Jeollanamdo/KR

Abstract

Aim

Oropharyngeal cancer (OPC) associated with human papilloma virus (HPV) shows better treatment outcomes than non-HPV OPC. We investigated the expression of p53, ß-tubulin, bcl-2 and ERCC 1 according to p16 status in OPC patients receiving induction chemotherapy followed by concurrent chemoradiotherapy.

Methods

Patients who were treated with at least 2 cycles of induction chemotherapy for locally advanced oropharyngeal cancer from 2004 to 2011 were reviewed. Immunohistochemical staining of p53, ß-tubulin, bcl-2, ERCC, which are well known to be associated with chemotherapy response, and p16, as a surrogate marker for HPV, was done in paraffin-embedded tumor tissue. We analyzed the response for chemotherapy and survival outcomes according to p16 expression.

Results

Seventy-four patients were enrolled for this study. All patients received induction chemotherapy with docetaxel, 5-FU, cisplatin (n = 72) or 5-FU and cisplatin (n = 2). One patient received a salvage operation and eight patients were not given radiotherapy due to poor general condition after induction chemotherapy. Therefore, 65 patients received chemoradiotherapy subsequently (total radiation dose; ≥60Gy n = 54, <60 Gy: n = 11). After induction chemotherapy, complete response (CR) was shown in 22 patients (30%) and partial response (PR) in 46 patients (62%). Thirty-five patients (47%) expressed p16 positive. p16 positive patients showed better overall response (p = 0.018), PFS (p = 0.076), OS (p = 0.014) than p16 negative patients. The expressions of p53 (p <0.001) and beta-tubulin (p = 0.003) were significantly weaker and bcl-2 (p = 0.019) was stronger in p16-positive than p16-negative patients. ERCC1 showed no significant difference according to p16 status. In multivariate analysis, PS (0 or others), p53, beta tubulin, T stage, postinduction response were significantly associated with OS.

Conclusions

OPC associated with HPV (HPV OPC) showed lower expression of p53, beta tubulin and higher expression of bcl-2 than non-HPV OPC. In addition, the expressions of p53 and beta tubulin were prognostic factors for OPC. This result suggested the underlying mechanism of better response to chemotherapy in case of HPV OPC than non-HPV OPC and de-escalation of treatment in patients with HPV OPC could be considered based on clinical trial results.

Disclosure

All authors have declared no conflicts of interest.