Protein test may predict head/neck cancer survival

A simple protein test could be more useful in predicting survival chances for patients with head and neck cancer compared with existing methods, according British researchers in a recent study in Clinical Oncology (November 2013, Vol. 25:11, pp. 630-638).

The study by researchers at the University of Manchester, which was funded by Cancer Research UK, found the test could allow doctors to choose more appropriate and tailored treatments, according to a press release.

Oral cancers, including the tongue and tonsils, are usually associated with tobacco and alcohol use. However, a growing number of cases instead are linked to human papillomaviruses (HPV), which occur in younger people and have a different biology and a better prognosis.

One approach for detecting HPV-associated oral cancer relies on finding HPV DNA in the tumor sample, but these DNA-based tests may not accurately classify the tumor. Another approach uses an HPV marker rather than testing for HPV DNA directly. The p16 protein usually disappears in tumors that are not caused by HPV infection, and it has been proposed as a surrogate marker of HPV, the researchers noted.

The study examined differences in clinical characteristics, treatment, and survival between p16-positive and p16-negative oral cancers in a group of 217 patients.

"We know that in most cases, p16 is linked to differences in survival. We wanted to see how it compared to other measures such as the stage of disease -- which tells us the size and spread of the cancer, said lead researcher Catharine West, PhD, from the University of Manchester and Manchester Cancer Research Centre. "Anything that allows us to predict outcome could help doctors plan more personalized treatments for individual patients."

The researchers found the presence of p16 in a tumor was strongly linked to increased survival. They also found that tumor stage was linked to survival in p16-negative tumors, but not in p16-positive tumors.

"Despite presenting with a more advanced stage of cancer, patients whose tumors tested positive for p16 had greater survival when compared with p16-negative patients," West said. "Many studies have now shown p16 status is strongly linked to survival. Now we have shown the test works better than routine staging for some cancers, we would recommend this test be offered as standard."

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