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  • Bersani, CinziaKarolinska Institutet (author)

A model using concomitant markers for predicting outcome in human papillomavirus positive oropharyngeal cancer

  • Article/chapterEnglish2017

Publisher, publication year, extent ...

  • Elsevier,2017
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:umu-137406
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-137406URI
  • https://doi.org/10.1016/j.oraloncology.2017.03.007DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:136004892URI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Objective: Head-neck cancer therapy has become intensified. With radiotherapy alone, 3-year disease-free survival (DFS) is 80% for HPV-positive TSCC/BOTSCC and better for patients with favorable characteristics, suggesting therapy could be tapered for some, decreasing side-effects. Therefore, we built a model to predict progression-free survival for patients with HPV-positive TSCC and BOTSCC. Material and methods: TSCC/BOTSCC patients treated curatively between 2000 and 2011, with HPV16 DNA/E7 mRNA positive tumors examined for CD8(+) TILs, HPV16 mRNA and HLA class I expression were included. Patients were split randomly 65/35 into training and validation sets, and LASSO regression was used to select a model in the training set, the performance of which was evaluated in the validation set. Results: 258 patients with HPV DNA/E7 mRNA positive tumors could be included, 168 and 90 patients in the respective sets. No treatment improved prognosis compared to radiotherapy alone. CD8(+) TIL counts and young age were the strongest predictors of survival, followed by T-stage <3 and presence of HPV16 E2 mRNA. The model had an area under curve (AUC) of 76%. A model where the presence of three of four of these markers defined good prognosis captured 56% of non-relapsing patients with a positive predictive value of 98% in the validation set. Furthermore, the model identified 35% of our cohort that was over-treated and could safely have received de-escalated therapy. Conclusion: CD8(+) TIL counts, age, T-stage and E2 expression could predict progression-free survival, identifying patients eligible for randomized trials with milder treatment, potentially reducing side effects without worsening prognosis.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Mints, MichaelKarolinska Institutet,Umeå universitet,Institutionen för kirurgisk och perioperativ vetenskap,Dept. of Medicine, Karolinska Institutet, Stockholm, Sweden(Swepub:umu)mimi0028 (author)
  • Tertipis, Nikolaos (author)
  • Haeggblom, LinneaKarolinska Institutet (author)
  • Sivars, LarsKarolinska Institutet (author)
  • Ährlund-Richter, Andreas (author)
  • Vlastos, Andrea (author)
  • Smedberg, Cecilia (author)
  • Grün, Nathalie (author)
  • Munck-Wikland, EvaKarolinska Institutet (author)
  • Näsman, AndersKarolinska Institutet (author)
  • Ramqvist, TorbjörnKarolinska Institutet (author)
  • Dalianis, TinaKarolinska Institutet (author)
  • Karolinska InstitutetInstitutionen för kirurgisk och perioperativ vetenskap (creator_code:org_t)

Related titles

  • In:Oral Oncology: Elsevier68, s. 53-591368-83751879-0593

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