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Prognostic stratification of HPV-associated oropharyngeal cancer based on CD103+ immune cell abundance in patients treated on TROG 12.01 and De-ESCALaTE randomized trials.
Rischin, D; Mehanna, H; Young, R J; Bressel, M; Dunn, J; Corry, J; Soni, P; Fulton-Lieuw, T; Iqbal, G; Kenny, L; Porceddu, S; Wratten, C; Robinson, M; Solomon, B J.
Affiliation
  • Rischin D; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia. Electronic address: danny.rischin@petermac.org.
  • Mehanna H; Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, UK.
  • Young RJ; Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia.
  • Bressel M; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Australia.
  • Dunn J; Warwick Clinical Trials Unit, University of Warwick, Coventry, UK.
  • Corry J; Genesiscare St Vincent's Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia.
  • Soni P; Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia.
  • Fulton-Lieuw T; Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, UK.
  • Iqbal G; Warwick Clinical Trials Unit, University of Warwick, Coventry, UK.
  • Kenny L; Department of Radiation Oncology, Royal Brisbane & Women's Hospital, Brisbane, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia.
  • Porceddu S; Faculty of Medicine, University of Queensland, Brisbane, Australia; Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Australia.
  • Wratten C; Department of Radiation Oncology, Calvary Mater Hospital and University of Newcastle, Newcastle, Australia.
  • Robinson M; Cellular Pathology, Newcastle upon Tyne Hospitals, Newcastle, UK.
  • Solomon BJ; Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia.
Ann Oncol ; 33(8): 804-813, 2022 08.
Article in En | MEDLINE | ID: mdl-35525376
ABSTRACT

BACKGROUND:

High CD103+ intratumoral immune cell (ITIC) abundance is associated with better prognosis in unselected patients with human papilloma virus-associated oropharyngeal squamous cell carcinoma (HPV-associated OPSCC) treated with cisplatin and radiotherapy (CIS/RT). Substituting cetuximab (CETUX) for CIS with RT in HPV-associated OPSCC resulted in inferior efficacy. Our aim was to determine whether quantification of CD103 ITIC could be used to identify a population of HPV-associated OPSCC with superior prognosis. PATIENTS AND

METHODS:

We pooled data from the TROG 12.01 and De-ESCALaTE randomized trials that compared CETUX/70GyRT with CIS/70GyRT in low-risk HPV-associated OPSCC American Joint Committee on Cancer 7 stage III (excluding T1-2N1) or stage IV (excluding N2b-c if smoking history >10 pack-years and/or distant metastases), including all patients with available tumor samples. The primary endpoint was failure-free survival (FFS) in patients receiving CETUX/RT comparing CD103+ ITIC high (≥30%) versus low (<30%). High and low CD103 were compared using Cox regression adjusting for age, stage and trial.

RESULTS:

Tumor samples were available in 159/182 patients on TROG 12.01 and 145/334 on De-ESCALaTE. CD103+ ITIC abundance was high in 27% of patients. The median follow-up was 3.2 years. The 3-year FFS in patients treated with CETUX/RT was 93% [95% confidence interval (CI) 79% to 98%] in high CD103 and 74% (95% CI 63% to 81%) in low CD103 [adjusted hazard ratio = 0.22 (95% CI 0.12-0.41), P < 0.001]. The 3-year overall survival in patients treated with CETUX/RT was 100% in high CD103 and 86% (95% CI 76% to 92%) in low CD103, P < 0.001. In patients treated with CIS/RT, there was no significant difference in FFS.

CONCLUSIONS:

CD103+ ITIC expression separates CETUX/RT-treated low-risk HPV-associated OPSCC into excellent and poor prognosis subgroups. The high CD103 population is a rational target for de-intensification trials.
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Full text: 1 Collection: 01-internacional Health context: 2_ODS3 Database: MEDLINE Main subject: Oropharyngeal Neoplasms / Papillomavirus Infections / Head and Neck Neoplasms Type of study: Clinical_trials / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Ann Oncol Year: 2022 Document type: Article

Full text: 1 Collection: 01-internacional Health context: 2_ODS3 Database: MEDLINE Main subject: Oropharyngeal Neoplasms / Papillomavirus Infections / Head and Neck Neoplasms Type of study: Clinical_trials / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Ann Oncol Year: 2022 Document type: Article