Mcl-1 vascular endothelial growth factor-R2, and 14-3-3σ expression might predict primary response against radiotherapy and chemotherapy in patients with locally advanced squamous cell carcinomas of the head and neck

Purpose: This study was done to explore whether the expression of a selected set of proteins could predict primary response to radiotherapy or concomitant radiotherapy and chemotherapy in patients with advanced head and neck cancer. Experimental Design: Forty-three pretreatment tumor biopsies were taken during diagnostic panendoscopy and examined for Mcl-1, vascular endothelial growth factor (VEGF) R2, CD9, and 14-3-3 sigma expression by immunohistochemistry. Forty-three patients underwent primary radiotherapy, of which, 29 patients received concomitant chemotherapy (low dose daily cisplatin, mitomycin C bolus). The primary end-point was locoregional tumor control 6 months after completion of radiotherapy. Mcl-1,VEGF-R2, CD9, and 14-3-3 sigma expression were correlated with patients' primary response to radiotherapy and chemotherapy and with established clinicopathologic variables. Results: Thirty complete and 13 partial responses were observed in our patient group. High expression levels of Mcl-1 (P = 0.021),VEGF-R2 (P = 0.032), and 14-3-3(7 (P = 0,013), but not of CD9, in tumor biopsies was correlated with complete response. Overexpression of at least two of the three aforementioned proteins in pretreatment biopsies predicted-with a likelihood of 80%-whether a patient would achieve complete response to radiotherapy and chemotherapy. However, if only one of these proteins is overexpressed, there is a likelihood of 84.6% that this patient would not completely respond to therapy. Conclusion: Determining the expression levels of Mcl-1,VEGF-R2, and 14-3-3(1 may be helpful in predicting the early clinical response in head and neck tumor patients receiving primary radiotherapy and chemotherapy and may further allow a pretherapeutic selection of patients.