- Title
- Prognostic stratification of HPV-associated oropharyngeal cancer based on CD103+ immune cell abundance in patients treated on TROG 12.01 and De-ESCALaTE randomized trials
- Creator
- Rischin, D.; Mehanna, H.; Porceddu, S.; Wratten, C.; Robinson, M.; Solomon, B. J.; Young, R. J.; Bressel, M.; Dunn, J.; Corry, J.; Soni, P.; Fulton-Lieuw, T.; Iqbal, G.; Kenny, L.
- Relation
- Annals of Oncology Vol. 33, Issue 8, p. 804-813
- Publisher Link
- http://dx.doi.org/10.1016/j.annonc.2022.04.074
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2022
- Description
- Background: High CD103+ intratumoral immune cell (ITIC) abundance is associated with better prognosis in unselected patients with human papilloma virus-associated oropharyngeal squamous cell carcinoma (HPV-associated OPSCC) treated with cisplatin and radiotherapy (CIS/RT). Substituting cetuximab (CETUX) for CIS with RT in HPV-associated OPSCC resulted in inferior efficacy. Our aim was to determine whether quantification of CD103 ITIC could be used to identify a population of HPV-associated OPSCC with superior prognosis. Patients and methods: We pooled data from the TROG 12.01 and De-ESCALaTE randomized trials that compared CETUX/70GyRT with CIS/70GyRT in low-risk HPV-associated OPSCC: American Joint Committee on Cancer 7 stage III (excluding T1-2N1) or stage IV (excluding N2b-c if smoking history >10 pack-years and/or distant metastases), including all patients with available tumor samples. The primary endpoint was failure-free survival (FFS) in patients receiving CETUX/RT comparing CD103+ ITIC high (≥30%) versus low (<30%). High and low CD103 were compared using Cox regression adjusting for age, stage and trial. Results: Tumor samples were available in 159/182 patients on TROG 12.01 and 145/334 on De-ESCALaTE. CD103+ ITIC abundance was high in 27% of patients. The median follow-up was 3.2 years. The 3-year FFS in patients treated with CETUX/RT was 93% [95% confidence interval (CI) 79% to 98%] in high CD103 and 74% (95% CI 63% to 81%) in low CD103 [adjusted hazard ratio = 0.22 (95% CI 0.12-0.41), P < 0.001]. The 3-year overall survival in patients treated with CETUX/RT was 100% in high CD103 and 86% (95% CI 76% to 92%) in low CD103, P < 0.001. In patients treated with CIS/RT, there was no significant difference in FFS. Conclusions: CD103+ ITIC expression separates CETUX/RT-treated low-risk HPV-associated OPSCC into excellent and poor prognosis subgroups. The high CD103 population is a rational target for de-intensification trials.
- Subject
- head and neck cancer; oropharyngeal cancer; human papillomavirus; CD103; cetuximab; cisplatin; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1486122
- Identifier
- uon:51782
- Identifier
- ISSN:0923-7534
- Language
- eng
- Reviewed
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