Prognostic value of p16 expression in Epstein‐Barr virus–positive nasopharyngeal carcinomas

Abstract

Background Overexpression of p16 is associated with improved outcomes among patients with oropharyngeal carcinoma. However, its role in nasopharyngeal cancer patient outcomes remains unclear. Methods Eighty-six patients with nasopharyngeal carcinoma treated at MD Anderson from 2000 to 2014 were identified. Epstein bar virus (EBV) and Human papillomavirus (HPV) status were determined by in situ hybridization and p16 by immunohistochemical staining. Results EBV positivity was associated with extended overall survival (median 95.0 vs. 44.9 months, P<0.004), progression-free survival (PFS) (median 80.4 vs. 28.1 months, P<0.013) and locoregional control (LRC) (median 104.4 vs. 65.5 months, P<0.043). In patients with EBV-positive tumors, p16 overexpression correlated with improved PFS (median 106.3 vs. 27.1 months, P<0.02) and LRC (median 93.6 vs. 64.5 months, P<0.02). Conclusion P16 overexpression is associated with improved PFS and LRC in patients with EBV-positive nasopharyngeal carcinoma. p16 expression may complement EBV status in predicting treatment outcomes for nasopharyngeal carcinoma patients.

Human papillomavirus and World Health Organization type III nasopharyngeal carcinoma: Multicenter study from an endemic area in Southern China

“…The HPV+ tumors were found only in white individuals, and there was a strong association with cigarette smoking . Jiang et al investigated 86 patients with NPC who were treated at The University of Texas MD Anderson Cancer Center in Houston between 2000 and 2014 and reported that p16 overexpression was found to be associated with improved progression‐free survival and locoregional control in patients with EBV+ NPC; they concluded that p16 expression may complement EBV status in predicting treatment outcomes for patients with NPC . Data from the nonendemic countries of Asia also demonstrated that HPV/p16 expression is uncommon in patients with NPC .…”

Prognostic stratification of patients with nasopharyngeal carcinoma based on tumor immune microenvironment

“…[9][10][11][12] Because programmed death-ligand 1 (PD-L1) is frequently overexpressed in many types of human cancers, 13 the PD1/ PD-L1 axis is thought to be one of the mechanisms by which cancer cells escape immune surveillance. [16][17][18] However, very little is known about the precise differences in the tumor immune microenvironments of patients with NPC with EBV and without EBV infection. 14,15 In addition, an EBV infection, which increases the PD-L1 expression, has been shown to improve the prognosis in patients with NPC.…”

Epstein‐Barr virus and human papillomaviruses as favorable prognostic factors in nasopharyngeal carcinoma: A nationwide study in Finland

“…12 Studies from both endemic and nonendemic regions have reported the occurrence of HPV in NPC tumors, with or without the coexistence of EBV. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] Unlike in oropharyngeal carcinoma, 32 no statistical significance for outcome has been attributed to HPV in NPC with 1 exception: Dogan et al reported that patients with HPV-positive tumor had, similarly to the patients with EBVpositive tumor, significantly better overall survival (OS) than the patients with EBV/HPV-negative tumor. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] In addition, Jiang et al suggested that although overexpression of p16 is not a significant prognostic marker for OS in NPC, it correlates with better progression-free survival and locoregional control in patients with EBV-positive tumor.…”

“…[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] In addition, Jiang et al suggested that although overexpression of p16 is not a significant prognostic marker for OS in NPC, it correlates with better progression-free survival and locoregional control in patients with EBV-positive tumor. 22 Previous studies on viral infections in NPC have mainly reported on small and heterogeneous series of patients treated at 1 or 2 institutions. Thus, data on the prognostic value of EBV and HPV in NPC are limited.…”