Head and Neck Squamous Cell Carcinoma (HNSCC) is a leading cause of cancer deaths worldwide and recent unbiased comprehensive genomic characterizations of HNSCC revealed that TP53 is the most common somatically mutated gene in this tumor type. The main objective of this project is to explore novel ways to improve the outcome of HNSCC patients who harbor deleterious TP53 mutations. While it has been established that HNSCC patients harboring TP53 mutations tend to have poor therapeutic response, efforts to utilize p53 mutational status as a clinical biomarker to guide therapy have been unsuccessful thus far due to the complex heterogeneity of TP53 mutations. We have developed a novel TP53 scoring algorithm based upon evolutionary action (EAp53) that can accurately stratify patients as high or low risk subtypes, which we hypothesize will predict survival, therapeutic response and treatment failure in HNSCC patients. In this application, we first propose to validate this EAp53 scoring system in several HNSCC patient cohorts and in preclinical models. Moreover, we propose to demonstrate that the promising Wee-1 kinase inhibitor currently being used in clinical trials, MK-1775, in combination with cisplatin and/or radiation can overcome the high risk mutant p53-mediated resistance to chemotherapy or radiation in HNSCC using in vitro and in vivo models. We shall also examine the cellular and molecular mechanisms by which Wee-1 kinase inhibition sensitizes HNSCC to cisplatin and/or radiation treatment. Our work may have far reaching clinical significance by enabling identification of patients least likely to benefit from contemporary treatment strategies. In addition, we will overcome resistance to chemotherapy and radiation through synthetic lethal strategies targeting DNA repair and discover mechanisms driving the response of tumor cells to DNA damaging agents in the presence of Wee 1 kinase inhibition which could improve future cancer treatment.

Public Health Relevance

Head and Neck Cancer is the sixth most common cancer worldwide and is a devastating disease because of poor survival rates. We are studying the effect of p53 mutations on survival and response to chemoradiotherapy of patients with form of cancer. Our hope is that knowledge gained will lead to better and more personalized treatment for HNSCC patients.

National Institute of Health (NIH)
National Institute of Dental & Craniofacial Research (NIDCR)
Research Project (R01)
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Developmental Therapeutics Study Section (DT)
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Venkatachalam, Sundaresan
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University of Texas MD Anderson Cancer Center
United States
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Gadhikar, Mayur A; Zhang, Jiexin; Shen, Li et al. (2018) CDKN2A/p16 Deletion in Head and Neck Cancer Cells Is Associated with CDK2 Activation, Replication Stress, and Vulnerability to CHK1 Inhibition. Cancer Res 78:781-797
Tanaka, Noriaki; Osman, Abdullah A; Takahashi, Yoko et al. (2018) Head and neck cancer organoids established by modification of the CTOS method can be used to predict in vivo drug sensitivity. Oral Oncol 87:49-57
Lindemann, A; Takahashi, H; Patel, A A et al. (2018) Targeting the DNA Damage Response in OSCC with TP53 Mutations. J Dent Res 97:635-644
Tanaka, Noriaki; Patel, Ameeta A; Tang, Lin et al. (2017) Replication Stress Leading to Apoptosis within the S-phase Contributes to Synergism between Vorinostat and AZD1775 in HNSCC Harboring High-Risk TP53 Mutation. Clin Cancer Res 23:6541-6554
Zhou, Ge; Liu, Zhiyi; Myers, Jeffrey N (2016) TP53 Mutations in Head and Neck Squamous Cell Carcinoma and Their Impact on Disease Progression and Treatment Response. J Cell Biochem 117:2682-2692
Osman, Abdullah A; Monroe, Marcus M; Ortega Alves, Marcus V et al. (2015) Wee-1 kinase inhibition overcomes cisplatin resistance associated with high-risk TP53 mutations in head and neck cancer through mitotic arrest followed by senescence. Mol Cancer Ther 14:608-19
Neskey, David M; Osman, Abdullah A; Ow, Thomas J et al. (2015) Evolutionary Action Score of TP53 Identifies High-Risk Mutations Associated with Decreased Survival and Increased Distant Metastases in Head and Neck Cancer. Cancer Res 75:1527-36
Tanaka, Noriaki; Patel, Ameeta A; Wang, Jiping et al. (2015) Wee-1 Kinase Inhibition Sensitizes High-Risk HPV+ HNSCC to Apoptosis Accompanied by Downregulation of MCl-1 and XIAP Antiapoptotic Proteins. Clin Cancer Res 21:4831-44
Osman, Abdullah A; Neskey, David M; Katsonis, Panagiotis et al. (2015) Evolutionary Action Score of TP53 Coding Variants Is Predictive of Platinum Response in Head and Neck Cancer Patients. Cancer Res 75:1205-15