Ex vivo functional assay for predicting radiation treatment response in squamous cell carcinoma of the head and neck

A 53-year-old man was admitted for tooth mobility. A mass was identified at the tooth base by CT. Histopathology of the excisional biopsy revealed a moderately differentiated squamous cell carcinoma. Many intact neutrophils were observed within the malignant cell cytoplasm. The patient underwent partial maxillectomy and bilateral neck dissection. Significant neutrophilic emperipolesis was detected in the resected material. Four tumor recurrences developed in the head and neck region during follow-up. Surgery and chemoradiotherapy was performed. The latest tumor recurrence occurred in the peripharyngeal and the posterior parotideal region. The patient was started on pembrolizumab therapy and nearly complete treatment response occurred. Pembrolizumab was discontinued due to the adrenal insufficiency and pulmonary tuberculosis that developed as a treatment side effect. Pembrolizumab was commenced again when tumor recurrence occurred. The patient is currently alive with ongoing pembrolizumab and antituberculous treatment. We present this case to remark the presence of a significant neutrophilic emperipolesis in the squamous cell carcinoma of the hard palate and maxilla which is rarely encountered. Emperipolesis may predict tumor behavior and the consequences of immune-modulating treatment response in squamous cell carcinomas of the head and neck in regard to the findings of our case.

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Intravoxel incoherent motion diffusion-weighted MRI during chemoradiation therapy to characterize and monitor treatment response in human papillomavirus head and neck squamous cell carcinoma

Journal of Magnetic Resonance Imaging ◽

10.1002/jmri.25523 ◽

2016 ◽

Vol 45 (4) ◽

pp. 1013-1023 ◽

Cited By ~ 21

Author(s):

Ramesh Paudyal ◽

Jung Hun Oh ◽

Nadeem Riaz ◽

Praveen Venigalla ◽

Jingao Li ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Human Papillomavirus ◽

Cell Carcinoma ◽

Head And Neck ◽

Treatment Response ◽

Squamous Cell ◽

Chemoradiation Therapy ◽

Neck Squamous Cell Carcinoma ◽

Diffusion Weighted Mri ◽

Monitor Treatment Response

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Abstract 3205: Superiority of response to carboplatin vs cisplatin in combination with pembrolizumab for head and neck squamous cell carcinoma predicted using ex vivo platform, CANscript

10.1158/1538-7445.am2019-3205 ◽

2019 ◽

Author(s):

Vidushi Kapoor ◽

Munisha Smalley ◽

Amit Verma ◽

Saravanan Thyiagarajan ◽

Biswanath Majumder ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Ex Vivo ◽

Neck Squamous Cell Carcinoma

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Abstract 6278: Glutaminase inhibition in combination with ionizing radiation improves treatment response in head and neck squamous cell carcinoma models

10.1158/1538-7445.am2020-6278 ◽

2020 ◽

Author(s):

Christina A. Wicker ◽

Brian G. Hunt ◽

Sarah Palackdharry ◽

William R. Elaban ◽

Gordon B. Mills ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Ionizing Radiation ◽

Cell Carcinoma ◽

Head And Neck ◽

Treatment Response ◽

Squamous Cell ◽

Neck Squamous Cell Carcinoma

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Correlation between PI3K/PTEN/AKT/mTOR pathway genetic variations and clinical outcome in patients with squamous cell carcinoma of the head and neck receiving cetuximab-docetaxel treatment.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.5572 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 5572-5572

Author(s):

Alberto Fusi ◽

Katharina Pfisterer ◽

Konrad Friedrich Klinghammer ◽

Maren Knoedler ◽

Anika Nonnenmacher ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Clinical Outcome ◽

Cell Carcinoma ◽

Head And Neck ◽

Treatment Response ◽

Squamous Cell ◽

Genetic Variations ◽

Mtor Pathway ◽

Homozygous Variant ◽

Increased Risk

5572 Background: The PI3K/PTEN/AKT/mTOR pathway is one of the most targeted in human cancers and alterations in the axis are frequent events in squamous cell carcinoma of the head and neck (HNSCC). Specific genetic variations in this pathway have been associated with variation in recurrence, survival and response in lung cancer and esophageal cancer. The aim of this study was to determine whether single nucleotide nucleotide polymorphisms (SNPs) in AKT1, AKT2, FRAP1, PI3KCA and PTEN identified in other cancers were associated with treatment response and clinical outcome in patients with HNSCC. Methods: Genomic DNA was extracted from FFPE tissue specimens of 45 patients with recurrent or initially metastatic HNSCC who received a combined treatment with docetaxel and cetuximab in a phase II study. Eleven single SNPs in the genes AKT1, AKT2, FRAP1 (mTOR), PIK3CA and PTEN were genotyped by means of Real Time PCR system or by direct sequencing and analysed for association with response to therapy and survival. Results: None of the SNPs was related to treatment response. Two SNPs (AKT2:rs8100018 and PTEN:rs12569998) were associated with variation in progression risk. The AKT2:rs8100018 homozygous variant resulted in increased risk, with a HR of 4.83 (95% CI, 1.11-21.03) and the PTEN:rs12569998 homozygous variant in an increased risk, with a HR of 2.36 (95% CI, 1.24-4.50). AKT2:rs8100018 and PTEN:rs12569998 genetic variation had an additive effect on risk of tumor progression. The AKT2:rs8100018 homozygous variant was significantly associated with overall survival (OS) with HR of 3.57 (95% CI, 1.06-12.00) while presence of one of the two variant alleles of AKT1:rs3803304 with a lower risk of death (HR: 0.51; 95% CI, 0.27-0.97). Conclusions: We found significant associations between common genetic variants in the PI3K/PTEN/AKT/mTOR pathway and outcome in patients with HNSCC. Despite the small sample size, patient cohort and treatment were homogeneous. As a consequence, evaluation of SNPs as a host factor may be considered in addition to tumor-specific mutations for personalized treatment development.

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