Predictive markers for response to chemotherapy, organ preservation, and survival in patients with advanced laryngeal carcinoma.
OBJECTIVE
A systematic retrospective study of the largest randomized trial of induction chemotherapy and radiation for advanced laryngeal cancer was undertaken to determine whether specific tumor or biologic factors were predictive of chemotherapy response, organ preservation, or survival.


METHODS
The variables analyzed included clinical and histologic factors, immunohistochemical expression of proliferating cell nuclear antigen and p53, and adjusted DNA index measurements. Variables were evaluated for correlation with outcomes of tumor response, organ preservation, and survival.


RESULTS
Multivariate analysis revealed that the best predictor of complete response to induction chemotherapy was low T class. The full multivariate model for predicting larynx preservation in patients treated with induction chemotherapy plus radiation shows that T class, p53 overexpression, and elevated proliferating cell nuclear antigen index were independent predictors of successful organ preservation.


CONCLUSIONS
These predictive markers should be included in future clinical trials of advanced laryngeal cancer to determine their usefulness prospectively.
Bradford
C R
CR
Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor, MI 48109-0312, USA.
Wolf
G T
GT
Carey
T E
TE
Zhu
S
S
Beals
T F
TF
Truelson
J M
JM
McClatchey
K D
KD
Fisher
S G
SG
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D004273:DNA, Neoplasm / Q000032:analysis*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy; D007830:Larynx / Q000473:pathology; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis*; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate; D016896:Treatment Outcome; D016159:Tumor Suppressor Protein p53 / Q000032:analysis*
D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D018809:Proliferating Cell Nuclear Antigen; D016159:Tumor Suppressor Protein p53