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KMID : 0939920190510010300
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2019 Volume.51 No. 1 p.300 ~ p.312
Investigating the Feasibility of Targeted Next-Generation Sequencing to Guide the Treatment of Head and Neck Squamous Cell Carcinoma
Lim Sun-Min

Cho Sang-Hee
Hwang In-Gyu
Choi Jae-Woo
Chang Hyun
Ahn Myung-Ju
Park Keon-Uk
Kim Ji-Won
Ko Yoon-Ho
Ahn Hee-Kyung
Cho Byoung-Chul
Nam Byung-Ho
Chun Sang-Hoon
Hong Ji-Hyung
Kwon Jung-Hye
Choi Jong-Gwon
Kang Eun-Joo
Yun Tak
Lee Keun-Wook
Kim Joo-Hang
Kim Jin-Soo
Lee Hyun-Woo
Kim Min-Kyoung
Jung Dong-Min
Kim Ji-Eun
Keam Bhum-Suk
Yun Hwan-Jung
Kim Sang-Woo
Kim Hye-Ryun
Abstract
Purpose: Head and neck squamous cell carcinoma (HNSCC) is a deadly disease in which precision medicine needs to be incorporated. We aimed to implement next-generation sequencing (NGS) in determining actionable targets to guide appropriate molecular targeted therapy in HNSCC patients.

Materials and Methods: Ninety-three tumors and matched blood samples underwent targeted sequencing of 244 genes using the Illumina HiSeq 2500 platform with an average depth of coverage of greater than 1,000¡¿. Clinicopathological data from patients were obtained from 17 centers in Korea, and were analyzed in correlation with NGS data.

Results: Ninety-two of the 93 tumors were amenable to data analysis. TP53 was the most common mutation, occurring in 47 (51%) patients, followed by CDKN2A (n=23, 25%), CCND1 (n=22, 24%), and PIK3CA (n=19, 21%). The total mutational burden was similar between human papillomavirus (HPV)?negative vs. positive tumors, although TP53, CDKN2A and CCND1 gene alterations occurred more frequently in HPV-negative tumors. HPV-positive tumors were significantly associated with immune signature-related genes compared to HPV-negative tumors. Mutations of NOTCH1 (p=0.027), CDKN2A (p < 0.001), and TP53 (p=0.038) were significantly associated with poorer overall survival. FAT1 mutations were highly enriched in cisplatin responders, and potentially targetable alterations such as PIK3CA E545K and CDKN2A R58X were noted in 14 patients (15%).

Conclusion: We found several targetable genetic alterations, and our findings suggest that implementation of precision medicine in HNSCC is feasible. The predictive value of each targetable alteration should be assessed in a future umbrella trial using matched molecular targeted agents.
KEYWORD
Squamous cell carcinoma of the head and neck, Next-generation sequencing, Molecular Targeted Therapy, Biomarkers, Clinical trial
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