Head and neck squamous cell carcinoma (HNSCC) occurs in the oral cavity, oropharynx, and larynx and is the 6th leading cancer in terms of incidence, affecting ~600,000 patients throughout the world. Esophageal squamous cell carcinoma (ESCC) is also quite common, with 17,000 new cases estimated in 2015 in the USA. Despite intensive treatment that generally combines surgery, radiation, and chemotherapy, HNSCCs and ESCCs relapse frequently and have poor long?term survival rates. Here we propose to use an approach using lineage?tracing to test the hypothesis that carcinogens cause early molecular changes in some progenitor/stem cells that reduce the diversity of the stem/progenitor cell population and subsequently result in both field cancerization and tumor formation in our murine HNSCC and ESCC carcinogenesis models. Thus, in this application we address one of the Provocative Questions of RFA-CA-15-008: For tumors that arise from a pre-malignant field, what properties of cells in this field can be used to design strategies to inhibit the development of future tumors? We will answer this question by performing two specific aims. Briefly, we will use doubly transgenic Keratin14/cre?ERTAM; Rosa26?lacZ mice to permanently mark individual normal stem/ progenitor cells and their progeny in the oral cavity and esophagus. Cre?dependent recombination will be activated only in cells that express K14 at the time of addition of tamoxifen (Tam), which is required for the cre?ERTAM protein to be active, giving us both temporal control and cell type?specific control over the cre recombinase activity and allowing us to follow the fates of these stem/ progenitor cells and their progeny over time.
In Specific Aim (1), we will perform lineage?tracing, whole genome RNA?seq analyses, and whole exome DNA sequencing of these permanently marked lacZ+ clones of cells derived from individual, epithelial progenitor/stem cells during treatment with the carcinogen 4?nitroquinoline oxide (4?NQO), a tobacco surrogate, in the drinking water.
This aim will delineate early molecular changes that occur in (a) the oral epithelium, and (b) the esophageal epithelium in a mouse model that very closely reflects human HNSCC and esophageal SCC development. We will also measure some key epigenetic changes.
In Specific Aim (2) we will discern the key molecular changes that occur much later in the carcinogenesis process, when visible SCCs are present, by performing lineage tracing, whole genome RNA?seq analyses, and whole exome DNA sequencing of permanently marked clones of cells, derived from individual epithelial progenitor/ stem cells (both HNSCCs & ESCCs).
In Aim (2) we will also compare tumors to clones of cells with normal morphology that are present near SCCs in normal appearing epithelial mucosa. Completion of these aims will define genetic and epigenetic changes that underlie 'field cancerization,' providing much new information about critical, early molecular changes in HNSCC and esophageal carcinogenesis that could be exploited to develop cancer chemopreventive drugs.
Despite intensive treatment that often combines surgery, radiation, and chemotherapy, patients with head and neck squamous cell carcinomas (HNSCCs) and esophageal squamous cell carcinomas (ESCCs) relapse frequently and have poor long?term survival rates. By performing the experiments we propose in this grant application we will gain a better understanding of the steps that occur before a patient or physician can actually detect a 'visible' tumor, steps that involve the ways in which the epithelia cells in the oral cavity and esophagus proliferate and differentiate. An understanding of these steps will allow us to provide earlier therapies targeting prevention of these cancers.
