BackgroundHPV is important in a subset of HNSCC. Our meta-analysis determined the clinical characteristics of HPV-related HNSCC.MethodPubmed search terms "HPV" and "HNSCC" were used to identify 34 studies since 1980. We obtained pooled adjusted odds ratio (OR) or hazard ratio (HR) using random or fixed-effects model and compared OS depicted in forest plot.ResultsA total of 5681 patients were included. The prevalence of HPV+ tumors was 22%, with 86.7% of HPV16+ genotype. The OR for HNSCC in HPV16+ patients was 4.44 (95% CI = 2.87-6.02). HPV status was associated with p16 expression (adj OR = 3.00; 0.90-9.70), and HPV+ tumors were less likely to harbor p53 mutations (adj OR = 0.21; 0.04-0.38). The HR for death in HPV+ patients was 0.42 (0.27-0.57). HPV+ HNSCC also had a better response to therapy.ConclusionHPV+ HNSCC are established as a separate biologic entity. Prospective trials are needed to establish the optimal therapy for HPV+ HNSCC.

Purpose Vemurafenib, a selective inhibitor of BRAFV600 has shown significant activity in BRAFV600 melanoma, but not in the <10% of metastatic BRAFV600 colorectal cancers (CRC), suggesting that studies of the unique hypermethylated phenotype and concurrent oncogenic activation of BRAFmut CRC may provide combinatorial strategies Experimental Design We performed comparative proteomic analysis of BRAFV600E melanoma and CRC cell lines, followed by correlation of PI3K pathway activation and sensitivity to the vemurafenib-analog PLX-4720. Pharmacologic inhibitors and siRNA were used in combination with PLX4720 to inhibit PI3K and methyltrasnferase in cell lines and murine models. Results Compared to melanoma, CRC lines demonstrate higher levels of PI3K/AKT pathway activation. CRC cell lines with mutations in PTEN or PIK3CA were less sensitive to growth inhibition by PLX4720 (P=0.03), and knockdown of PTEN expression in sensitive CRC cells reduced growth inhibition by the drug. Combined treatment of PLX4720 with PI3K inhibitors caused synergistic growth inhibition in BRAF-mutant CRC cells with both primary and secondary resistance. In addition, methyltransferase inhibition was synergistic with PLX4720 and decreased AKT activation. In vivo, PLX4720 combined with either inhibitors of AKT or methyltransferase demonstrated greater tumor growth inhibition than PLX4720 alone. Clones with acquired resistance to PLX4720 in vitro demonstrated PI3K/AKT activation with EGFR or KRAS amplification. Conclusions We demonstrate that activation of the PI3K/AKT pathway is a mechanism of both innate and acquired resistance to BRAF inhibitors in BRAFV600E CRC, and suggest combinatorial approaches to improve outcomes in this poor prognosis subset of patients.

Prostate cancer is a complex disease in which metastasis to the bone is the main cause of death. Initial stages of metastasis are generally similar to those for most solid tumors; however, the mechanisms that underlie the homing of prostate tumor cells to the bone remain incompletely understood. Prostate cancer bone metastasis is also a microenvironment-driven disease, involving bi-directional interactions between the tumor and the bone microenvironment. In this review, we discuss the current understanding of the biologic processes and regulatory factors involved in the metastasis of prostate cancer cells, and their specific properties that promote growth in bone. Although many of these processes still need to be fully elucidated, a better understanding of the complex tumor/microenvironment interplay is slowly leading to more effective therapies for patients with prostate cancer bone metastases.

Purpose Plasmacytoid urothelial carcinoma (PUC) is a rare variant histology with poorly defined clinical behavior. We report clinical outcomes information on patients with predominant PUC. Materials and Methods Retrospective analysis of treatments and outcomes in patients with predominant PUC seen at MD Anderson Cancer Center from 1990–2010. Kaplan-Meier method was used to calculate Overall (OS) and progression-free survival (PFS). Results 31 patients were identified (median age:63.5yrs; 83.3% male; TNM stage:cT1N0,n=4;cT2N0,n=7;cT3b-4aN0,n=5; cT4b, N+ or M+ n = 15). Median OS for all patients was 17.7months (Stage I-III vs IV: 45.8 vs 13.3mo). Of 16 patients with potentially surgically resectable PUC (<=pT4aN0M0) 5 received neo-adjuvant chemotherapy, 10 had initial surgery, and one was treated with TURBT alone. Despite pathologic downstaging in 80% of patients treated with neo-adjuvant chemotherapy, relapses were common and there was no difference in survival between patients treated with neo-adjuvant chemotherapy compared to initial surgery, even though adjuvant chemotherapy was given in 7 patients. Surgical upstaging with positive margins was also common with surgery alone. The most common site of recurrence was in the peritoneum (19/23), with relapses occurring even in those with pCR at surgery. In patients presenting with metastatic disease who were treated with chemotherapy, the median survival was 12.6 months. Conclusions PUC is a very aggressive subset with overall poor outcomes. Although downstaging is seen with neoadjuvant chemotherapy, there are few long-term survivors. There is a strong predilection for recurrences along the peritoneal lining.

BACKGROUND The authors have recently shown that a majority of patients with myelodysplastic syndrome (MDS) classified by the International Prognostic Scoring System as lower risk die without transformation to acute myelogenous leukemia (AML). The cause of death (COD) of these patients is not well understood. Identifying the COD could help to guide early therapy decisions. METHODS The authors retrospectively analyzed the COD in a cohort of 273 deceased patients with lower-risk MDS according to the International Prognostic Scoring System at presentation to The University of Texas M. D. Anderson Cancer Center from 1980 to 2004. MDS-related death was defined as infection, bleeding, transformation to AML, or disease progression. Remaining CODs were classified as non–MDS-related. RESULTS Median age at presentation was 66 years (range, 19-88 years). Overall median survival was 59 weeks (range, 1-831 weeks). All French-American-British leukemia classification subgroups were represented. The percentage of International Prognostic Scoring System low and intermediate-1 groups were 21% and 79%, respectively. The most common cytogenetic abnormality (9%) was del(5q). Patients received supportive care only. The COD was identified as MDS-related in 230 of 273 (84%) patients. The most common disease-related CODs were infection (38%), transformation to AML (15%), and hemorrhage (13%). The most frequent non–disease-related COD was cardiovascular events (19 of 43 patients). CONCLUSIONS The majority of patients with low- or intermediate-1 risk MDS will die because of causes related to their underlying disease. Although these results need to be validated in different populations, early therapeutic intervention could be considered in the management of these patients to improve survival.

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Primary drug resistance is a major problem in multiple myeloma, an incurable disease of the bone marrow. Cell adhesion-mediated drug resistance (CAM-DR) causes strong primary resistance. By coculturing multiple myeloma cells with bone marrow stromal cells (BMSCs), we observed a CAM-DR of about 50% to melphalan, treosulfan, doxorubicin, dexamethasone, and bortezomib, which was not reversed by secreted soluble factors. Targeting the adhesion molecules lymphocyte function-associated antigen 1 (LFA-1) and very late antigen 4 (VLA-4) by monoclonal antibodies or by the LFA-1 inhibitor LFA703 reduced CAM-DR significantly. Only statins such as simvastatin and lovastatin, however, were able to completely restore chemosensitivity. All these effects were not mediated by deadhesion or reduced secretion of interleukin 6. Targeting

Deletions on chromosome 9q are seen in a subset of acute myeloid leukemia (AML) cases and are specifically associated with t(8;21) AML. We previously defined the commonly deleted region in del(9q) AML and characterized the genes in this interval. To determine the critical lost gene(s) that might cooperate with the AML1-ETO fusion gene produced by t(8;21), we developed a set of shRNAs directed against each gene in this region. Within this library, shRNAs to TLE1 and TLE4 were the only shRNAs capable of rescuing AML1-ETO expressing U937T-A/E cells from AML1-ETO-induced cell-cycle arrest and apoptosis. Knockdown of TLE1 or TLE4 levels increased the rate of cell division of the AML1-ETO-expressing Kasumi-1 cell line, whereas forced expression of either TLE1 or TLE4 caused apoptosis and cell death. Knockdown of Gro3, a TLE homolog in zebrafish, cooperated with AML1-ETO to cause an accumulation of noncirculating hematopoietic blast cells. IntroductionOne of the most common genetic aberrations in acute myeloid leukemia (AML) is the balanced chromosomal translocation t(8;21). This translocation, seen in 8% to 13% of de novo AML cases, 1-3 creates the RUNX1-MTG8/AML1-ETO fusion gene. AML1-ETO is insufficient for leukemogenesis as evidenced by mouse models, 4-7 the detection of fusion gene transcripts in AML patients in long-term remission, 8,9 as well as the finding of transcripts in newborns who did not develop t(8;21) AML for more than 10 years. 10 Although AML1-ETO expression promotes the maintenance of early hematopoietic precursors, 11,12 it markedly inhibits short-term expansion of primary human bone marrow cells and the proliferation of committed progenitors and CD34 ϩ cells. 13 This suggests a model in which secondary mutations are required to further transform preleukemic stem cells and allow their progeny to expand.Deletion of a portion of the long arm of chromosome 9, del(9q), is a recurring abnormality in malignant myeloid diseases reported in approximately 2% of AML cases and is nonrandomly associated with t(8;21). Approximately 36% to 50% of samples with del(9q) have t(8;21); conversely, 7% to 14% of pediatric AML samples with t(8;21) have del(9q). 1,[14][15][16] After numerical abnormalities, del(9q) is the single most common associated structural chromosomal abnormality seen with t(8;21) AML, indicating loss of function of a gene or genes on chromosome 9q may be one of the most important cooperating genes in t(8;21) AML.In a search for this cooperating gene(s), we recently narrowed the commonly deleted region (CDR) in 43 del(9q) AML samples to less than 2.4 Mb at 9q21.32-9q21.33. There are 10 known genes within, or immediately adjacent to, this region -TLE (transducin like enhancer of split)-1, FRMD3, UBQLN1, GKAP42, KIF27, HNRPK, SLC28A3, RMI1 (Q9H9A7), and NTRK2, and 3 novel or potential genes, RASEF, C9orf103 (ENSG00000148057), and C9orf64 (Q8N2B1). 17 Sequence analysis of the coding regions of these genes failed to identify clearly inactivating mutations in the remaining allele in del(9q) AML sampl...