A Head and Neck Cancer Tumor Response-Specific Gene Signature for Cisplatin, 5-Fluorouracil Induction Chemotherapy Fails with Added TaxanesReportar como inadecuado

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It is a major clinical challenge to predict which patients, with advanced stage head and neck squamous cell carcinoma, will not exhibit a reduction in tumor size following induction chemotherapy in order to avoid toxic effects of ineffective chemotherapy and delays for instituting other therapeutic options. Further, it is of interest to know to what extent a gene signature, which identifies patients with tumors that will not respond to a particular induction chemotherapy, is applicable when additional chemotherapeutic agents are added to the regimen.

Methodology-Principal Findings

To identify genes that predict tumor resistance to induction with cisplatin-5-fluorouracil PF or PF and a taxane, we analyzed patient tumor biopsies with whole genome microarrays and quantitative reverse transcriptase-PCR TLDA cards. A leave one out cross-validation procedure allowed evaluation of the prediction tool. A ten-gene microarray signature correctly classified 12-13 responders and 7-10 non-responders to PF 92% specificity, 82.6% accuracy. TLDA analysis using the same classifier of the patients correctly classified 12-12 responders and 8-10 non-responders 100% specificity, 90.9% accuracy. Further, TLDA analysis correctly predicted the response of 5 new patients and, overall, 12-12 responders and 13-15 non-responders 100% specificity, 92.6% accuracy. The protein products of the genes constituting the signature physically associate with 27 other proteins, involved in regulating gene expression, constituting an interaction network. In contrast, TLDA-based prediction with the same gene signature of responses to induction with PF and either of two taxanes was poor 0% specificity, 25% accuracy and 33.3% specificity, 25% accuracy.


Successful transfer of the microarray-based gene signature to an independent, PCR-based technology suggests that TLDA-based signatures could be a useful hospital-based technology for determining therapeutic options. Although highly specific for tumor responses to PF induction, the gene signature is unsuccessful when taxanes are added. The results illustrate the subtlety in developing -personalized medicine-.

Autor: Céline Tomkiewicz , Stéphane Hans , Marie Hélène Mucchielli , Nicolas Agier, Hervé Delacroix, Laetitia Marisa, Daniel Brasnu

Fuente: http://plos.srce.hr/


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