Study of induction chemotherapy efficacy in oral squamous cell carcinoma using pseudotargeted metabolomics

The effect of induction chemotherapy on oral cancer is controversial owing to inconsistent results. However, the efficacy of induction chemotherapy is closely related to locoregional recurrence, distant metastasis, and overall survival after the treatment. A pseudotargeted metabolomics revealed that metabolites involved in glycolysis and amino acid metabolism were inversely regulated in patients with different chemotherapy responses, and most fatty acids, steroids, and antioxidant substances were up-regulated in all patients after the treatment. Among the metabolites, lactic acid, glucose, glutamic acid, aspartic acid, leucine, and glycerol were remarkably associated with induction chemotherapy efficacy. Subsequently, lactic acid, glutamic acid, and aspartic acid were defined as potential biomarkers of the suitability and efficacy of induction chemotherapy. Our results show that 100.0 and 84.37% of patients with different chemotherapy efficacy were correctly identified in the training and test sets, respectively. Moreover, patient suitability for treatment was correctly predicted for 100.0, 81.25, and 100.0% of patients in the training, test, and external validation sets, respectively. In conclusion, metabolites related to glycolysis, redox homeostasis, and anabolic progress were indicative of induction chemotherapy efficacy both pre- and post-chemotherapy and beneficial for outcome evaluation and prediction. These results illustrate the potentials of metabolomics in personalized induction chemotherapy.