p53 and P-glycoprotein expression are significant prognostic markers in advanced head and neck cancer treated with chemo/radiotherapy

✍ Scribed by Warnakulasuriya, Saman; Jia, Chaoying; Johnson, Newell; Houghton, Joan

• Publisher: John Wiley and Sons
• Year: 2000
• Tongue: English
• Weight: 117 KB
• Volume: 191
• Category: Article
• ISSN: 0022-3417
• DOI: 10.1002/(sici)1096-9896(200005)191:1<33::aid-path585>3.0.co;2-b

✦ Synopsis

The development of biological markers of response to chemo-and radiotherapy to judge bene®t to risk ratios for toxic treatments is still at an experimental stage. Tumour cell death is largely by apoptosis and the p53 gene has a major in¯uence on this. P-glycoprotein (P-gp) accumulation has been correlated with treatment failure in several types of cancer. p53 and P-gp expression were studied in 111 advanced head and neck cancers treated with radiotherapy and up to four courses of synchronous or sequential chemotherapy. The probability of survival at 5 years for patients in the trial as a whole was 27.7%, while the cohort used for this marker project was 29.4%. Among the subjects used for the marker study at the time of analysis, 13 remained disease-free and 18 were alive. Immunohistochemistry was used to assess p53 and P-gp expression; 27/111 (24%) head and neck cancers demonstrated p53/P-gp expression and 33/111 (30%) were both p53-and P-gpnegative. In univariate analysis, both p53 and P-gp expression were associated with reduced disease-free and overall survival. Multivariate analysis revealed tumour size, p53, and P-gp expression as the most powerful pretreatment prognosticators in the study cohort. Long-term follow-up results suggest that p53 and P-gp co-expression predicts the biological behaviour or the outcome following chemo/radiotherapy in advanced head and neck cancer.