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6th ICHNO
page 47
6
th
ICHNO Conference
International Conference on innovative approaches in Head and Neck Oncology
16 – 18 March 2017
Barcelona, Spain
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PO-098 Searching for therapeutic targets from whole
transcriptome of oral cancer
B. Roy
1
, N. De Sarkar
2
, R. Singh
1
1
Indian Statistical Institute, Human genetics, Kolkata,
India
2
Fred Hutchinson Cancer Research Centre, HB Division,
Seattle, USA
Purpose or Objective
Gingivo-buccal squamous cell carcinoma (GBSCC) is one of
the most common oral cavity cancers in India. Even after
decades of intense research, 5-year survival is less than
50%. So, it is necessary to discover therapeutic targets for
better treatment of oral cancer patient. To search for
therapeutic targets; expression and somatic mutations in
whole transcriptomes of GBSCC from tobacco smokers and
smokeless tobacco users/chewers were examined.
Material and Methods
Whole transcriptome data from 12 pairs of GBSCC and
adjacent normal tissues were generated by next
generation sequencing method in Illumina platform. Data
were analyzed to find out expression deregulation and
somatic mutations of the transcripts.
Results
Expression of 1582 genes was significantly deregulated in
cancer tissues. Data analysis indicated that cell-cell
adhesion and ECM-receptor processes were most aberrant
pathways. Other altered pathways include AMPK, PPAR
and arachidonic acid metabolism which may highlight
their importance in primary GBSCC. Interestingly,
smokeless tobacco users/chewers were clustered together
when expression deregulation of genes involved in cell
adhesion, proteoglycans, AMPK and PPAR pathways were
considered for cluster analysis. We also generated
proliferation score using expression of cell cycle
progression marker genes and found that smokeless
tobacco users tend to show higher proliferation score.
Tumors from smokers and smokeless tobacco users have
distinct CD47 & SIRPA and PD-1 & PDL-1 expression,
respectively, and a range of variation in infiltrating
immune cell signature to infer differential immune
evasion strategy. Integrative analysis of miRNA and mRNA
expression helped us to identify several important miRNAs
which are playing important roles in shaping expression
profiles of several cell adhesion, tissue architecture
maintenance and energy metabolism pathways.
Conclusion
Transcriptome analysis highlighted few potential
targetable nodes and neo-antigens which could be
effective precision therapeutic or immunotherapeutic
targets. Further, this study also suggests that therapeutic
targets might be different for oral cancer patients who
used smoking or smokeless tobacco. Data of deleterious
somatic and germline variants along with expression
profile could be useful in treatment plan.
PO-099 Human papillomavirus in head and neck cancer
in the UK: a clinician survey of current practice
B. Foran
1
, J. Fenwick
2
, B. Byrne
2
, J. Christian
3
1
Weston Park Hospital, Oncology, Sheffield, United
Kingdom
2
Merck Serono Ltd- UK- an affiliate of Merck KGaA-
Darmstadt- Germany, Medical Affairs, Feltham, United
Kingdom
3
Nottingham City Hospital, Oncology, Nottingham, United
Kingdom
Purpose or Objective
An increasing number of head and neck (H&N) cancers are
associated with human papillomavirus (HPV) infection.
Compared with HPV negative H&N cancers, HPV positive
tumours tend to affect younger patients and non-smokers.
The prognosis on the whole is very high, with cure rates
published in excess of 90%; this presents unique challenges
for patient management in view of the late consequences
of H&N cancer treatment. Additionally, because HPV is a
sexually transmitted infection, the diagnosis may have an
impact on patients’ emotional and psychological
wellbeing. We conducted a survey of H&N cancer
clinicians from oncology departments in the UK and
Ireland, to increase understanding about the current
management of patients with HPV positive H&N cancers.
Material and Methods
During March 2016, 55 H&N clinicians from centres across
the UK and Ireland were invited to complete an e-mail
survey about their current practices in relation to HPV
screening, counselling on the implications of HPV
positivity and approaches to treatment.
Results
The majority of respondents (85%, 47/55) were consultant
clinical or medical oncologists (n=44 and n=3,
respectively), with the remaining 8 comprising H&N
cancer specialist nurses (n=3), specialist oncology
registrars/clinical fellows (n=3) and surgeons (n=2). 36% of
respondents (20/55) said that they routinely test all H&N
cancer patients for HPV, 60% (33/55) test only specific
subgroups (oropharyngeal [n=28], unknown primary [n=6],
oral cavity [n=3], basaloid [n=1]) and 4% (2/55) don’t test
routinely. The estimated percentage of patients with
oropharyngeal cancer who are HPV positive ranged
between respondents from 5-80%, with a median of 60%
(
figure 1
). The number of respondents from each UK
region was low, but median HPV prevalence estimates
ranged from 25% in Ireland (n=5) to 75% in the South of
England (n=8) and Wales (n=3). 33% of respondents (18/55)
routinely counsel patients about the implications of HPV
positivity, 47% (26/55) provide counselling only when
asked and 20% (11/55) don’t provide routine counselling.
33% (18/55) have literature available in clinic about HPV
positive tumours. Outside of clinical trials, 91% (50/55)
don’t treat HPV positive patients differently to HPV
negative
patients.
Conclusion
The wide range in the estimated percentage of patients
with oropharyngeal cancer who are HPV positive suggests
that there may be geographical variations in the
prevalence of HPV in different areas of the UK. This would
correlate with known national variation in cigarette
smoking. Differences in HPV screening practice were also
identified, with some clinicians routinely testing all
patients and others testing only specific subgroups. There
is a need for more literature about HPV positive tumours,
to facilitate healthcare professional discussions with