The Correlation among Circulating Tumor Cells in Human Papillomavirus-Positive Oropharyngeal Cancer Patients and Clinical Outcomes

Head and neck squamous cell carcinoma (HNSCC) is the 4th highest incidence of cancer and 6th of cancer death of the males in Taiwan. Because the patients were mainly middle-aged male, the disease eventually resulted in a huge loss of labor force, productivity and a huge burden of family supports and medicinal costs. Unfortunately, the incidence and death of HNSCC seemed to be increasing in Taiwan. Currently, the primary treatments of HNSCC are mainly surgery, radiotherapy, chemotherapy or targeted therapy or concurrent chemoradiotherapy. Compared to oral cavity cancer, patients with oropharyngeal cancer would possibly harbor human papillomavirus (HPV) infections and have better treatment outcomes, prognosis and survival with clinically significance. In recent years, we have developed a new method for isolation and detection of circulating tumor cells (CTCs) in HNSCC patients. Our data found that high level of CTCs in patients with oropharyngeal cancer (Wang/Hsieh et al. 2014) and might be associated with disease prognosis, response to treatment and distant metastasis. This novel tool enhances the studies addressing on metastases or recurrence process in HNSCC patients. However, we did not focus whether if the dynamic change of CTCs and specific surface markers on CTCs, such as P16INK4A –positive CTCs are clinically meaningful. Therefore, in the first year of this 3-year project, we will utilize our developing device and protocol (Lin et al. 2013 & Huang et al. 2013) to isolate high-purity CTCs to further identify P16INK4A positivity on CTCs. In the following 2 years of the project, we will enroll 150 cases including 120 freshly diagnosed patients with oropharyngeal cancer at all stages (60 P16 INK4A -positive and 60 P16 INK4A -nergative patients) and 30 healthy donors, and then analyze CTCs, background white blood cells signals, and their initial biopsied tissue for P16INK4A positivity test. Further statistical tests with clinical conditions (disease status, treatment effects, progression or distant metastasis and death) will be performed to elucidate their clinical significance. In addition, we will also analyze the habitual status of alcohol; cigarette and betel nut use to P16INK4A-positive CTCs and attempt to understand their influence to P16 INK4A status dynamically. Hopefully, we will clarify the clinical significance of circulating P16INK4A expression status on CTCs by this study and provide a new biomarker for clinical cancer care.

Project ID:PC10501-2286
External Project ID:MOST104-2314-B182-031-MY3