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Loco-regional recurrences and distant metastases represent the main cause of head and neck squamous cell carcinoma (HNSCC) mortality. The overexpression of chemokine receptor 4 (CXCR4) in HNSCC primary tumors associates with higher risk of developing loco-regional recurrences and distant metastases, thus making CXCR4 an ideal entry pathway for targeted drug delivery. In this context, our group has generated the self-assembling protein nanocarrier T22-GFP-H6, displaying multiple T22 peptidic ligands that specifically target CXCR4. This study aimed to validate T22-GFP-H6 as a suitable nanocarrier to selectively deliver cytotoxic agents to CXCR4+ tumors in a HNSCC model. Here we demonstrate that T22-GFP-H6 selectively internalizes in CXCR4+ HNSCC cells, achieving a high accumulation in CXCR4+ tumors in vivo, while showing negligible nanocarrier distribution in non-tumor bearing organs. Moreover, this T22-empowered nanocarrier can incorporate bacterial toxin domains to generate therapeutic nanotoxins that induce cell death in CXCR4-overexpressing tumors in the absence of histological alterations in normal organs. Altogether, these results show the potential use of this T22-empowered nanocarrier platform to incorporate polypeptidic domains of choice to selectively eliminate CXCR4+ cells in HNSCC. Remarkably, to our knowledge, this is the first study testing targeted protein-only nanoparticles in this cancer type, which may represent a novel treatment approach for HNSCC patients. © 2022 Chinese Pharmaceutical Association and Institute of Materia Medica, Chinese Academy of Medical Sciences

ICHNO International Congress on innovative approaches in Head and Neck Oncology (7th, 2019, Barcelona, Spain)

Background. The main purpose of this study was to validate the prognostic significance of tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) in head and neck squamous cell carcinoma (HNSCC) using an independent cohort. Methods. Data were evaluated from 153 patients with HNSCC in stages III to IV, who received radiotherapy (RT) or chemoradiotherapy. We quantified soluble TWEAK (sTWEAK) in pretreatment samples using enzyme-linked immunosorbent assay. Results. The classification tree revealed a cutoff value of 322 pg/mL for sTWEAK to be ideal for discriminating between patients' disease control. Kaplan-Meier curves indicate that the disease-free survival rate in patients with high sTWEAK was significantly higher than in patients with low levels (p=.006, log-rank test). An independent link was identified between low sTWEAK and poor clinical outcome in Cox regression multivariate analysis (hazard ratio = 1.866; 95% confidence interval [CI] = 1.114-3.125; p = .001). Conclusion. Our study highlights the significance of this noninvasive biomarker in the discrimination according to the disease control achieved by patients who received a nonsurgical organ-preservation treatment. (C) 2015 Wiley Periodicals, Inc.

The presence of IL-1 in human cancers is associated with aggressive tumor biology but its prognostic value is unknown. We studied whether IL-1a expression is a prognostic marker of distant metastasis in patients with head and neck squamous cell carcinoma (HNSCC). IL-1a mRNA and protein levels were determined in tumor samples and cancer cell lines using RT-PCR and ELISA. The effects of constitutive IL-1a expression by tumor lines were characterized. IL-1a mRNA and protein secretion were higher in tumor samples from patients who later developed distant metastasis than in patients who did not. By using distant metastasis as a dependent variable, patients were classified into two categories of IL-1a transcript-levels. The high-IL-1a group had a significantly lower five-year distant metastasis-free survival than the low-IL-1a group [70.0% (CI 95%: 55.9-84.1%) vs 94.7% (CI 95%:90.2-99.2%)]. When IL-1a transcript-levels were combined with clinical factors related to tumor metastasis, the predictive power of the model increased significantly. Additionally, transcript levels of IL-1a correlated significantly with those of the IL-1 family genes and genes related to the metastatic process. IL-1 treatment of microvascular endothelial cells increased adhesion of HNSCC cells but no differences were found based on constitutive IL-1a expression by tumor cells. Nevertheless, IL-1a produced by tumor cells effectively increased their transmigration across the endothelium. We found a significant relationship between IL-1a expression and development of distant metastasis in HNSCC patients. IL-1a expression could help to define a subset of patients at high risk of distant metastasis who could benefit from adjuvant treatment.

High SERPINE1 expression is a common event in head and neck squamous cell carcinoma (HNSCC); however, whether it plays a role in determining clinical outcome remains still unknown. We studied SERPINE1 as a prognostic marker in two HNSCC patient cohorts. In a retrospective study (n = 80), high expression of SERPINE1 was associated with poor progression-free (p = 0.022) and cancer-specific (p = 0.040) survival. In a prospective study (n = 190), high SERPINE1 expression was associated with poor local recurrence-free (p = 0.022), progression-free (p = 0.002) and cancer-specific (p = 0.006) survival. SERPINE1 expression was identified as an independent risk factor for progression-free survival in patients treated with chemo-radiotherapy or radiotherapy (p = 0.043). In both patient cohorts, high SERPINE1 expression increased the risk of metastasis spread (p = 0.045; p = 0.029). The association between SERPINE1 expression and survival was confirmed using the HNSCC cohort included in The Cancer Genome Atlas project (n = 507). Once again, patients showing high expression had a poorer survival (p < 0.001). SERPINE1 over-expression in HNSCC cells reduced cell proliferation and enhanced migration. It also protected cells from cisplatin-induced apoptosis, which was accompanied by PI3K/AKT pathway activation. Downregulation of SERPINE1 expression had the opposite effect. We propose SERPINE1 expression as a prognostic marker that could be used to stratify HNSCC patients according to their risk of recurrence.