Comprehensive Genome profile testing in head and neck cancer

Auris Nasus Larynx. 2023 Dec;50(6):952-959. doi: 10.1016/j.anl.2023.04.006. Epub 2023 May 8.

Abstract

Objective: Head and neck cancer (HNC) is a tumor occurring in various primary sites with limited chemotherapy options for its treatment. Recently, comprehensive genomic profiling (CGP) testing has become clinically widespread. In this study, we examined the utility of CGP in diagnosing and treating HNC.

Methods: This study included 29 patients with HNC who underwent CGP testing at the Gifu University Hospital between December 2019 and April 2022. We analyzed the types of gene mutations and tumor mutational burden (TMB) based on the CGP results. Squamous cell carcinoma accounted for 55.2%, and other cancers accounted for 44.8%. And we investigated the correlation of prognosis with gene mutations and TMB.

Results: Gene mutations were detected in TP53(48.3%), CDKN2A (27.6%), CDKN2B (17.2%), NOTCH1 (17.2%), PIK3CA (17.2%), ARID1A (13.8%), and NF1 (13.8%). TP53, CDKN2A and CDKN2B mutations significantly decreased survival rate in HNC. Five cases (17.2%) were TMB-high and 82.8% were TMB-low. In SCC cases treated with immune checkpoint inhibitors, TMB-high had better Overall survival than TMB-low. And all patients with TMB-high were oropharyngeal cancer.

Conclusion: Although there were no cases in which effective treatment was actually performed based on the results of CGP, many gene mutations have been detected and several gene mutations correlated with prognosis. Furthermore, TMB can be used as a biomarker to predict the therapeutic effects of immune checkpoint inhibitors in cases of SCC.

Keywords: Cancer genome; Gene mutation; Head and neck cancer; Immune checkpoint inhibitor; Tumor mutational burden.

MeSH terms

  • Biomarkers, Tumor / genetics
  • Carcinoma, Squamous Cell* / drug therapy
  • Carcinoma, Squamous Cell* / genetics
  • Head and Neck Neoplasms* / drug therapy
  • Head and Neck Neoplasms* / therapy
  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use
  • Mutation
  • Prognosis

Substances

  • Immune Checkpoint Inhibitors
  • Biomarkers, Tumor