Mouth Cancers: Gene May Predict Survival Outcomes | Loyola Medicine
Friday, May 6, 2016

Discovery of Cancer Gene May Predict Survival and Guide Treatment in Patients with Mouth Cancers

MAYWOOD, IL – Loyola researchers have identified a tumor gene that may help to predict survival outcomes in patients with cancer of the mouth and tongue.
 
If the gene is expressed (turned on), patients are 4.6 times more likely to die at any given time, according to a study by researchers at Loyola Medicine and Loyola University Chicago Stritch School of Medicine.
 
The finding, published in the journal Otolaryngology – Head and Neck Surgery, could help guide treatment, researchers say. If the cancer gene is expressed, a patient may require more aggressive treatment, such as radiation and possibly chemotherapy in addition to surgery. Conversely, if the gene is unexpressed (turned off), the patient might be able to safely forgo aggressive treatment and undergo surgery alone.
 
The Gene Expression Barcode, a research tool co-invented by Michael J. Zilliox, PhD, was used to examine genetic data from 54 patients with mouth cancer. Zilliox is corresponding author of the study, director of the Loyola Genomics Facility and an assistant professor in Loyola Stritch School of Medicine and Graduate School’s department of public health sciences.
 
The study involved a type of mouth cancer called squamous cell carcinoma. Physicians estimate survival based on the stage of the disease. Staging is based on factors including the size of the tumor and whether it has spread to nearby lymph nodes or  other organs.
 
But staging provides an imprecise estimate of prognosis. In some cases, patients with early-stage disease can have worse outcomes than patients with later-stage disease. Previous studies have found that patients with oropharynx cancers associated with the human papillomavirus (HPV) tend to have better outcomes. But there is no reliable biomarker to predict outcomes among patients who are HPV negative, said Carol Bier-Laning, MD, a Loyola head-and-neck cancer surgeon and co-author of the study. Dr. Bier-Laning is an associate professor in Stritch School of Medicine’s department of otolaryngology.
 
Using the Gene Expression Barcode, researchers examined publically available genetic data from 54 tumor samples. The samples were taken from patients who had HPV-negative squamous cell carcinoma in the mouth.

The study found that subjects whose tumors expressed a gene called spectrin were 4.6 times more likely to die at any given time when compared with patients without spectrin. (Spectrin is a gene involved in the formation of cell membranes.)
 
Even when researchers controlled for cancer stage and other factors, patients with the expressed spectrin gene still were significantly more likely to die than those in which the gene was turned off. This finding suggests that the spectrin gene may provide more information about survival than cancer stage alone.
 
The researchers caution the results are preliminary and need to be validated in an independent patient group. Such research is ongoing.
 
Research institutions have made public genetic data from nearly 100,000 patients, most of whom had cancer. In raw form, however, these data are too unwieldy to be of much practical use for most researchers. The Gene Expression Barcode applies advanced statistical techniques to make the mass of data much more user-friendly to researchers.
 
The barcode algorithm is designed to estimate which genes are expressed and which are unexpressed. Like a supermarket barcode, the Gene Expression Barcode is binary, meaning it consists of ones and zeroes – the expressed genes are ones and the unexpressed genes are zeros.
 
The Gene Expression Barcode has received funding from the National Institutes of Health and Loyola institutional funds, and is available to academic researchers at no charge.
 
The new study is titled “Candidate biomarkers for HPV-negative head and neck cancer identified via Gene Expression Barcode analysis.” Other co-authors are Shiayin Yang, MD (first author) and William Adams. 

About Loyola Medicine and Trinity Health

Loyola Medicine, a member of Trinity Health, is a quaternary care system based in the western suburbs of Chicago that includes Loyola University Medical Center (LUMC), Gottlieb Memorial Hospital, MacNeal Hospital and convenient locations offering primary and specialty care services from 1,877 physicians throughout Cook, Will and DuPage counties. LUMC is a 547-licensed-bed hospital in Maywood that includes the William G. and Mary A. Ryan Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, Illinois's largest burn center, a certified comprehensive stroke center and a children’s hospital. Having delivered compassionate care for over 50 years, Loyola also trains the next generation of caregivers through its teaching affiliation with Loyola University Chicago’s Stritch School of Medicine and Marcella Niehoff School of Nursing. Gottlieb is a 247-licensed-bed community hospital in Melrose Park with 150 physician offices, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park. MacNeal Hospital is a 374-bed teaching hospital in Berwyn with advanced inpatient and outpatient medical, surgical and psychiatric services, advanced diagnostics and treatments. MacNeal has a 12-bed acute rehabilitation unit, a 25-bed inpatient skilled nursing facility, and a 68-bed behavioral health program and community clinics. MacNeal has provided quality, patient-centered care to the near west suburbs since 1919.

Trinity Health is one of the largest multi-institutional Catholic healthcare systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 94 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually. Based in Livonia, Mich., and with annual operating revenues of $18.3 billion and assets of $26.2 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity employs about 133,000 colleagues, including 7,800 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services—ranked by number of visits—in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.