ONCOLOGY OF STEM CELL MARKERS' PROGNOSTIC FUNCTIONS IN ORAL SQUAMOUS CELL CARCINOMA PATIENTS RECEIVING CHEMOTHERAPY
Main Article Content
Keywords
oncology, stem cell markers, prognostic functions, oral squamous cell carcinoma, chemotherapy
Abstract
Oral squamous cell carcinoma (OSCC) is a top-ranked cancer in the global population, and patient survival has remained unchanged at ∼50% for several decades. Recent advances have claimed that a subset of tumour cells, called cancer stem cells (CSCs), are responsible for tumour progression, treatment resistance, and metastasis, which leads to a poor prognosis. Anti-EGFR-based therapies have limited success in OSCC patients. Predictive biomarkers are needed to identify the patients most likely to benefit from these therapies. Here, we studied prognostic associations of different cancer stem cell markers in HPV-negative locally advanced (LA) OSCC patients. Pretreatment tumour tissues of 404 HPV-negative LA-OSCCs patients and a subset of study were comparing cisplatin-radiation (CRT) and nimotuzumab plus cisplatin-radiation(NCRT). The expression levels of CD44, CD44v6, CD98hc, ALDH1A1, SOX2 and OCT4A were evaluated using immunohistochemistry. Progression-free survival (PFS), loco-regional control(LRC),- and overall survival(OS) were estimated by Kaplan–Meier method. Hazard ratios were estimated by Cox proportional hazard models. NCRT showed significantly improved OS with low membrane expression of CD44 compared to CRT [HR (95% CI) = 0.69 (0.44–0.98)]. Patients with low CD44v6 also showed better outcomes with NCRT [LRC: HR (95% CI) = 0.25 (0.09–0.64); OS: HR (95% CI) = 0.39 (0.17–0.68)]. No similar benefit with NCRT observed in patients with high CD44 or CD44v6 expression. It was concluded that CD44 and CD44v6 are potential predictive biomarkers for NCRT response. CD98hc emerged as an independent negative prognostic biomarker.
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Zahid Manzoor Khanday
Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar Jammu and Kashmir 190011
Sejuti Sarker Tinny
Viqarunnisa Noon School and College, Baily Road, Dhaka Bangladesh
Usman Manzoor Warraich
Bakhtawar Amin Medical and Dental College, Multan, Punjab, Pakistan
Amna Rehman
Liaquat College of Medicine and Dentistry, Karachi, Pakistan
Hijab Farid Khan
Liaquat College of Medicine and Dentistry, Karachi, Pakistan
Samreen Malik
Liaquat College of Medicine and Dentistry, Karachi, Pakistan
Rabia Zulfiqar
Oral & Maxillofacial Surgery Department, King Edward Medical University/Mayo Hospital Lahore, Pakistan
Muhammad Omair Khitab
Khyber Medical University, Peshawar, Pakistan
Fozan Ahmad
King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia