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Caveolin-1 and Sox-2 are predictive biomarkers of cetuximab response in head and neck cancer
Mehdi Bouhaddou, Rex H. Lee, Hua Li, Neil E. Bhola, Rachel A. O’Keefe, Mohammad Naser, Tian Ran Zhu, Kelechi Nwachuku, Umamaheswar Duvvuri, Adam B. Olshen, Ritu Roy, Aaron Hechmer, Jennifer Bolen, Stephen B. Keysar, Antonio Jimeno, Gordon B. Mills, Scott Vandenberg, Danielle L. Swaney, Daniel E. Johnson, Nevan J. Krogan, Jennifer R. Grandis
Mehdi Bouhaddou, Rex H. Lee, Hua Li, Neil E. Bhola, Rachel A. O’Keefe, Mohammad Naser, Tian Ran Zhu, Kelechi Nwachuku, Umamaheswar Duvvuri, Adam B. Olshen, Ritu Roy, Aaron Hechmer, Jennifer Bolen, Stephen B. Keysar, Antonio Jimeno, Gordon B. Mills, Scott Vandenberg, Danielle L. Swaney, Daniel E. Johnson, Nevan J. Krogan, Jennifer R. Grandis
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Research Article Therapeutics

Caveolin-1 and Sox-2 are predictive biomarkers of cetuximab response in head and neck cancer

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Abstract

The epidermal growth factor receptor (EGFR) inhibitor cetuximab is the only FDA-approved oncogene-targeting therapy for head and neck squamous cell carcinoma (HNSCC). Despite variable treatment response, no biomarkers exist to stratify patients for cetuximab therapy in HNSCC. Here, we applied unbiased hierarchical clustering to reverse-phase protein array molecular profiles from patient-derived xenograft (PDX) tumors and revealed 2 PDX clusters defined by protein networks associated with EGFR inhibitor resistance. In vivo validation revealed unbiased clustering to classify PDX tumors according to cetuximab response with 88% accuracy. Next, a support vector machine classifier algorithm identified a minimalist biomarker signature consisting of 8 proteins — caveolin-1, Sox-2, AXL, STING, Brd4, claudin-7, connexin-43, and fibronectin — with expression that strongly predicted cetuximab response in PDXs using either protein or mRNA. A combination of caveolin-1 and Sox-2 protein levels was sufficient to maintain high predictive accuracy, which we validated in tumor samples from patients with HNSCC with known clinical response to cetuximab. These results support further investigation into the combined use of caveolin-1 and Sox-2 as predictive biomarkers for cetuximab response in the clinic.

Authors

Mehdi Bouhaddou, Rex H. Lee, Hua Li, Neil E. Bhola, Rachel A. O’Keefe, Mohammad Naser, Tian Ran Zhu, Kelechi Nwachuku, Umamaheswar Duvvuri, Adam B. Olshen, Ritu Roy, Aaron Hechmer, Jennifer Bolen, Stephen B. Keysar, Antonio Jimeno, Gordon B. Mills, Scott Vandenberg, Danielle L. Swaney, Daniel E. Johnson, Nevan J. Krogan, Jennifer R. Grandis

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Figure 5

Validation of 8-member biomarker signature in mRNA data sets.

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Validation of 8-member biomarker signature in mRNA data sets.
(A) Heatma...
(A) Heatmap of mRNA mean signal intensities for 8-member biomarker set defined at log2FC threshold of 1, and parallel coordinates chart displaying median-normalized mRNA log2FC of the 8-member biomarker set for each individual PDX of the predicted resistant (red) or sensitive (blue) groups. (B) Fold changes (log2FC) of mRNA levels between the predicted resistant and predicted sensitive groups in this study versus analogous fold changes from Keysar et al. (9) (R = 0.67, P < 2.2 × 10–16). The inset shows patients randomized to either cetuximab-sensitive or -resistant groups prior to calculating the fold change in order to control for the possibility that any grouping would result in a correlation between the studies. (C) (Top) Heatmap of mRNA mean signal intensities for 7 genes of the original 8-member biomarker set, defined at log2FC threshold of 1 from Keysar et al. (9) (FN1 was not present in the Keysar et al. study). (Bottom) Parallel coordinates chart displaying median-normalized mRNA log2FC of 7-member biomarker set for each individual PDX of the resistant (red) or sensitive (blue) groups.

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