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ERCC1 expression associated with improved SCCHN survival with adjuvant therapy
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A retrospective analysis of head and neck squamous cell carcinoma tumor tissue showed that patients with low levels of ERCC1, an enzyme that helps repair cisplatin-related DNA damage, were more likely to benefit from platinum-based chemotherapy and have better survival.
“The results open avenues to testing other agents that could be more effective in specific patients, and have a better side-effects profile,” Renaee Mehra, MD, a medical oncologist at Fox Chase Cancer Center, said in a press release. “While the data are retrospective and preliminary, our goal now will be to validate this assay, reproduce the results with tumors from a different source and design a prospective study to test a patient’s tumor and treat accordingly based on ERCC1 level.”
Researchers built tissue microarrays from SSCHN samples collected from 109 patients treated at Fox Chase from 1990 to 2002. Sections were incubated with ERCC1 antibody and wide-spectrum screening rabbit cytokeratin antibody. Samples were measured for tumor mask, nuclear and cytoplasmic ERCC1 expression. Primary sites for tissue collection include tongue, glottic, retromolar trigone, tonsil, pyriform sinus and oral cavity.
Patients in the cohort were treated with surgery (n=33), or adjuvant radiation or platinum-based chemoradiation (n=76).
ERCC1 expression by AQUA score was defined as high vs. low at the 30th percentile, or 262.37 in nuclear compartment, 161.31 in cytoplasmic compartment and 361.09 in tumor mask.
Among the patients who received adjuvant radiation/chemoradiation, low ERCC1 in the nuclear compartment was associated an increased survival, greater T stage and a beneficial effect with adjuvant therapy with radiation or chemoradiation.
“This is definitely a step toward personalized medicine,” Mehra said. “These findings provide support for the concept that personalized medicine could be possible in a practical way in these cancers.”
Researchers found no correlation between ERCC1 status and survival in the patients treated with surgery alone. Low ERCC1 levels in all three compartments were associated with a higher T stage and tumor size in this cohort.
For more information:
- Mehra R. #2804. Presented at: AACR 101st Annual Meeting; April 17-21; Washington, D.C.