title: Low PTEN expression is associated with worse overall survival in head and neck squamous cell carcinoma patients treated with chemotherapy and cetuximab.
abstract: BACKGROUND
  Platinum-based chemotherapy associated with cetuximab is the first-line treatment for inoperable recurrence or metastatic head and neck squamous cell carcinoma (HNSCC). There is no established biomarker for cetuximab efficacy in HNSCC. The PI3K pathway is one of the most frequently altered pathways in HNSCC. Loss of phosphatase and tensin homolog (PTEN) expression occurs in up to 30 % of cases.
  
  
  METHODS
  This was a retrospective analysis of data from 61 patients with inoperable recurrence or metastatic HNSCC treated with cetuximab. PTEN, epidermal growth factor receptor and p16 expression were analyzed by immunohistochemistry and tested for association with clinical outcomes.
  
  
  RESULTS
  Median overall survival was 11.4 months and progression-free survival was 6.9 months. Low PTEN expression was present in 26.2 % of patients and identified patients with worse prognosis. p16 was positive in only 8.5 % of tumors.
  
  
  CONCLUSIONS
  Low PTEN expression in patients treated with cetuximab plus chemotherapy emerged as a prognostic biomarker and should be evaluated for its predictive role for cetuximab efficacy.
authors.affiliation: Medical Oncology Department, Fundação Antonio Prudente, AC Camargo Cancer Center, 211 Professor Antonio Prudente Street, Liberdade, São Paulo, SP, 01509-900, Brazil, alexandreandredacosta@gmail.com.
authors.forename: Alexandre A B A
authors.initials: AA
authors.lastname: da Costa
authors.forename: Felipe
authors.initials: F
authors.lastname: D'Almeida Costa
authors.forename: Adriana R
authors.initials: AR
authors.lastname: Ribeiro
authors.forename: Andréia P
authors.initials: AP
authors.lastname: Guimarães
authors.forename: Ludmila T
authors.initials: LT
authors.lastname: Chinen
authors.forename: Clóvis A P
authors.initials: CA
authors.lastname: Lopes
authors.forename: Vladmir C C
authors.initials: VC
authors.lastname: de Lima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D016190:Carboplatin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000737:chemistry* / Q000188:drug therapy; D000068818:Cetuximab / Q000008:administration & dosage*; D002945:Cisplatin / Q000008:administration & dosage; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000032:analysis; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000737:chemistry* / Q000188:drug therapy; D010039:Otorhinolaryngologic Neoplasms / Q000737:chemistry* / Q000188:drug therapy; D051059:PTEN Phosphohydrolase / Q000032:analysis*; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D019941:Cyclin-Dependent Kinase Inhibitor p16; D016190:Carboplatin; D066246:ErbB Receptors; D051059:PTEN Phosphohydrolase; C494929:PTEN protein, human; D000068818:Cetuximab; D002945:Cisplatin; D005472:Fluorouracil