Effect of actionable somatic mutations on racial/ethnic disparities in head and neck cancer prognosis

Head Neck. 2016 Aug;38(8):1234-41. doi: 10.1002/hed.24420. Epub 2016 Mar 29.

Abstract

Background: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide and minorities have the worst survival. However, the molecular mechanisms underlying survival disparities have not been elucidated.

Methods: In a retrospective study, we assessed association between HNSCC early death (<2 years) and 208 somatic mutations of 10 cancer-related genes in 214 patients: 98 non-Hispanic whites (46%), 72 Hispanic whites (34%), and 44 African Americans (20%).

Results: Hispanic whites and African Americans had significantly higher mutation rates for EGFR, HRAS, KRAS, and TP53. HNSCC early death was significantly associated with 3+ mutations (odds ratio [OR] = 2.78, 95% confidence interval [CI] = 1.16, 6.69), NOTCH1 mutations in non-Hispanic whites (OR = 5.51; 95% CI = 1.22-24.83) and TP53 mutations in Hispanic whites (OR = 3.84; 95% CI = 1.08-13.68) in multivariable analysis adjusted for age, sex, tumor site, and tumor stage.

Conclusion: We have provided the proof-of-principal data to link racial/ethnic-specific somatic mutations and HNSCC prognosis and pave the way for precision medicine to overcome HNSCC survival disparities. © 2016 Wiley Periodicals, Inc. Head Neck 38:1234-1241, 2016.

Keywords: cancer disparities; head and neck squamous cell carcinoma (HNSCC); precision medicine; prognosis; somatic mutations.

Publication types

  • Comparative Study

MeSH terms

  • Carcinoma, Squamous Cell / genetics*
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy
  • Cohort Studies
  • Databases, Factual
  • Disease-Free Survival
  • Ethnicity / genetics*
  • Ethnicity / statistics & numerical data
  • Female
  • Genes, erbB-1 / genetics
  • Head and Neck Neoplasms / genetics*
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / therapy
  • Health Status Disparities
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Mutation
  • Proto-Oncogene Proteins p21(ras) / genetics
  • Racial Groups / ethnology
  • Racial Groups / genetics*
  • Receptor, Notch1 / genetics
  • Retrospective Studies
  • Risk Assessment
  • Squamous Cell Carcinoma of Head and Neck
  • Survival Analysis
  • Tumor Suppressor Protein p53 / genetics
  • United States

Substances

  • KRAS protein, human
  • NOTCH1 protein, human
  • Receptor, Notch1
  • TP53 protein, human
  • Tumor Suppressor Protein p53
  • HRAS protein, human
  • Proto-Oncogene Proteins p21(ras)