Establishment and characterization of patient-derived head and neck cancer models from surgical specimens and endoscopic biopsies

Daniel Strüder; Theresa Momper; Nina Irmscher; Mareike Krause; Jan Liese; Sebastian Schraven; Annette Zimpfer; Sarah Zonnur; Ann-Sophie Burmeister; Björn Schneider; Bernhard Frerich; Robert Mlynski; Christina Große-Thie; Christian Junghanss; Claudia Maletzki

doi:10.1186/s13046-021-02047-w

Establishment and characterization of patient-derived head and neck cancer models from surgical specimens and endoscopic biopsies

J Exp Clin Cancer Res. 2021 Aug 6;40(1):246. doi: 10.1186/s13046-021-02047-w.

Authors

Affiliations

¹ Department of Otorhinolaryngology, Head and Neck Surgery "Otto Koerner", Rostock University Medical Center, Rostock, Germany.
² Department of Internal Medicine, Medical Clinic III - Hematology, Oncology, Palliative Medicine, Rostock University Medical Center, Schillingallee 70, 18057, Rostock, Germany.
³ Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Rostock University Medical Center, Rostock, Germany.
⁴ Institute of Pathology, Rostock University Medical Center, Rostock, Germany.
⁵ Department of Internal Medicine, Medical Clinic III - Hematology, Oncology, Palliative Medicine, Rostock University Medical Center, Schillingallee 70, 18057, Rostock, Germany. claudia.maletzki@med.uni-rostock.de.

Abstract

Background: Head and neck squamous cell carcinoma (HNSCC) is heterogeneous in etiology, phenotype and biology. Patient-derived xenografts (PDX) maintain morphology and molecular profiling of the original tumors and have become a standard "Avatar" model for human cancer research. However, restricted availability of tumor samples hindered the widespread use of PDX. Most PDX-projects include only surgical specimens because reliable engraftment from biopsies is missing. Therefore, sample collection is limited and excludes recurrent and metastatic, non-resectable cancer from preclinical models as well as future personalized medicine.

Methods: This study compares the PDX-take rate, -growth, histopathology, and molecular characteristics of endoscopic specimens with surgical specimens. HNSCC samples (n = 55) were collected ad hoc, fresh frozen and implanted into NOD.Cg-Prkdc^scidIl2rg^tm1Wjl/SzJ mice.

Results: Engraftment was successful in both sample types. However, engraftment rate was lower (21 vs. 52%) and growth delayed (11.2 vs. 6.7 weeks) for endoscopic biopsies. Following engraftment, growth kinetic was similar. Comparisons of primary tumors and corresponding PDX models confirmed preservation of histomorphology (HE histology) and molecular profile (Illumina Cancer Hotspot Panel) of the patients' tumors. Accompanying flow cytometry on primary tumor specimens revealed a heterogeneous tumor microenvironment among individual cases and identified M2-like macrophages as positive predictors for engraftment. Vice versa, a high PD-L1 expression (combined positive score on tumor/immune cells) predicted PDX rejection.

Conclusion: Including biopsy samples from locally advanced or metastatic lesions from patients with non-surgical treatment strategies, increases the availability of PDX for basic and translational research. This facilitates (pre-) clinical studies for individual response prediction based on immunological biomarkers.

Keywords: Endoscopic biopsy; HPV positive and negative; Head and neck squamous cell carcinoma; Immune cell infiltration; Individual tumor models; Metastasis; Non-resectable; Primary cancer; Recurrence.

MeSH terms

Aged
Aged, 80 and over
Animals
Biopsy / methods*
Disease Models, Animal
Endoscopy / methods*
Female
Head and Neck Neoplasms / diagnostic imaging*
Head and Neck Neoplasms / pathology
Head and Neck Neoplasms / surgery*
Humans
Male
Mice
Middle Aged