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Original Article
- Clinical Impact of TP53 Mutations in Patients with Head and Neck Cancer Who Were Treated with Targeted Therapies or Immunotherapy
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Eun Joo Kang1
, Shinwon Hwang2, Yun-Gyoo Lee3, Jong-Kwon Choi4, Seong Hoon Shin5, Yoon Hee Choi6, Keun-Wook Lee7, Hyun Woo Lee8, Min Kyoung Kim9, Seung Taek Lim10, Hwan Jung Yun11, Sang-Gon Park12, Sangwoo Kim13, Sung-Bae Kim14
, Hye Ryun Kim15
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DOI: https://doi.org/10.4143/crt.2024.836 [Accepted]
Published online: December 23, 2024
1Division of Hemato-oncology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
2Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea
3Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
4Division of Hematology and Medical Oncology, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
5Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
6Division of Hematology-Oncology, Department of Internal Medicine, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea
7Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
8Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
9Division of Hematology-Oncology, Department of Internal Medicine, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea
10Department of Hematology and Medical Oncology, Wonju Severance Christianity Hospital, Wonju, Korea
11Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
12Department of Hemato-oncology, Chosun University Hospital, Gwangju, Korea
13Department of Biomedical Systems Informatics and Graduate School of Medical Science, Yonsei University College of Medicine, Seoul, Korea
14Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
15Divison of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
2Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea
3Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
4Division of Hematology and Medical Oncology, Department of Internal Medicine, Konyang University Hospital, Daejeon, Korea
5Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
6Division of Hematology-Oncology, Department of Internal Medicine, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea
7Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
8Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
9Division of Hematology-Oncology, Department of Internal Medicine, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea
10Department of Hematology and Medical Oncology, Wonju Severance Christianity Hospital, Wonju, Korea
11Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
12Department of Hemato-oncology, Chosun University Hospital, Gwangju, Korea
13Department of Biomedical Systems Informatics and Graduate School of Medical Science, Yonsei University College of Medicine, Seoul, Korea
14Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
15Divison of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
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Corresponding author:
Sung-Bae KimEmail: sbkim3@amc.seoul.kr
Hye Ryun Kim
Tel: 82-2-2228-8130 Email: NOBELG@yuhs.ac
- Eun Joo Kang and Shinwon Hwang contributed equally to this work.
Received: 28 August 2024 • Accepted: 21 December 2024
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Abstract
Purpose
TP53 mutations are common in head and neck squamous cell carcinoma (HNSCC). We evaluated their clinical impact in patients treated with targeted agents or immunotherapy in the KCSG HN15-16 TRIUMPH trial.
Materials and Methods
We analyzed clinical characteristics and outcomes of patients with TP53 mutations in the TRIUMPH trial, a multicenter, biomarker-driven umbrella trial in Korea. Patients were assigned to treatment groups based on genomic profiles: Group 1, alpelisib; Group 2, poziotinib; Group 3, nintedanib; and Group 4, abemaciclib. If there was no identifiable target, the patients were allocated to Group 5 (durvalumab ± tremelimumab).
Results
TP53 mutations were detected in 116/179 patients (64.8%), more frequently in HPV-negative and non-oropharyngeal cancers. Patients with TP53 mutations exhibited shorter progression-free survival (PFS) than TP53 wild-type in all the patients (1.7 vs. 3.8 months, p=0.002) and in those who received targeted treatments (2.5 vs. 7.3 months, p=0.009). Furthermore, TP53 mutations were strongly associated with poor overall survival than TP53 wild-type in all the patients (11.1 vs. 28.8 months, p=0.005) and in Group 5 (8.1 vs. 33.0 months, p=0.001).
Conclusion
TP53 mutations were associated with aggressive clinical characteristics and poor survival, particularly in HNSCC patients treated with immunotherapy.
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