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Open Access 01-03-2021 | Human Papillomavirus | Original Article

Role of cancer stem cell markers ALDH1, BCL11B, BMI-1, and CD44 in the prognosis of advanced HNSCC

Authors: Mark Jakob, MD, PhD, Kariem Sharaf, MD, DMD, Markus Schirmer, MD, PhD, Martin Leu, Stefan Küffer, Mattis Bertlich, MD, PhD, Friedrich Ihler, MD, PhD, Frank Haubner, MD, PhD, Martin Canis, MD, PhD, Julia Kitz, MD

Published in: Strahlentherapie und Onkologie | Issue 3/2021

Abstract

Purpose

Cancer stem cells (CSCs) are held accountable for the progress of head and neck squamous cell carcinoma (HNSCC). In the presented study, the authors evaluated the prognostic value of CSC markers in two particular HNSCC cohorts.

Methods

This two cohort study consisted of 85 patients with advanced stage HNSCC, treated with primary radio(chemo)therapy (pRCT), and 95 patients with HNSCC, treated with surgery and partially adjuvant radio(chemo)therapy. Overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) were assessed. Samples were assessed for the expression of different molecular stem cell markers (ALDH1, BCL11B, BMI‑1, and CD44).

Results

In the pRCT cohort, none of the baseline patient and tumor features exhibited a statistically significant relation with survival in either the cohort or the human papillomavirus (HPV)-stratified subcohorts. High expression of BMI‑1 significantly decreased OS and DFS, while high expression of CD44 decreased all modes of survival. Multivariate analysis showed significant prognostic influence for all tested CSC markers, with high BMI‑1 and CD44 decreasing survival (BMI-1: OS, DFS, DSS; CD44: OS, DFS) and high ALDH1 and BCL11B showing a beneficial effect on survival (ALDH1: OS, DFS; BCL11B: OS, DSS). In the surgical cohort, classical prognosticators such as HPV status, R1 resection, and nodal status in HPV-negative HNSCC played a significant role, but the tested CSC markers showed no significant effect on prognosis.

Conclusion

Although validation in independent cohorts is still needed, testing for CSC markers in patients with advanced or late stage HNSCC might be beneficial, especially if many comorbidities exist or disease is irresectable. The findings might guide the development and earlier use of targeted therapies in the future.

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Title: Role of cancer stem cell markers ALDH1, BCL11B, BMI-1, and CD44 in the prognosis of advanced HNSCC
Authors: Mark Jakob, MD, PhD
Kariem Sharaf, MD, DMD
Markus Schirmer, MD, PhD
Martin Leu
Stefan Küffer
Mattis Bertlich, MD, PhD
Friedrich Ihler, MD, PhD
Frank Haubner, MD, PhD
Martin Canis, MD, PhD
Julia Kitz, MD
Publication date: 01-03-2021
Publisher: Springer Berlin Heidelberg
Keyword: Human Papillomavirus
Published in: Strahlentherapie und Onkologie / Issue 3/2021
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-020-01653-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Role of cancer stem cell markers ALDH1, BCL11B, BMI-1, and CD44 in the prognosis of advanced HNSCC

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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