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Salivary biomarkers: a promising approach for predicting immunotherapy response in head and neck cancers
Armin Nejat Dehkordi1, Moein Maddahi1, Parinaz Vafa1
1Faculty of Density, Yeditepe University, Istanbul, Turkey.
Abstract:
Head and neck cancers, including cancers of the mouth, throat, voice box, salivary glands, and nose, are a significant global health issue. Radiotherapy and surgery are commonly used treatments. However, due to treatment resistance and disease recurrence, new approaches such as immunotherapy are being explored. Immune checkpoint inhibitors (ICIs) have shown promise, but patient responses vary, necessitating predictive markers to guide appropriate treatment selection. This study investigates the potential of non-invasive biomarkers found in saliva, oral rinses, and tumor-derived exosomes to predict ICI response in head and neck cancer patients. The tumor microenvironment significantly impacts immunotherapy efficacy. Oral biomarkers can provide valuable information on composition, such as immune cell presence and checkpoint expression. Elevated tumor mutation load is also associated with heightened immunogenicity and ICI responsiveness. Furthermore, the oral microbiota may influence treatment outcomes. Current research aims to identify predictive salivary biomarkers. Initial studies indicate that tumor-derived exosomes and miRNAs present in saliva could identify immunosuppressive pathways and predict ICI response. While tissue-based markers like PD-L1 have limitations, combining multiple oral fluid biomarkers could create a robust panel to guide treatment decisions and advance personalized immunotherapy for head and neck cancer patients.
Insights
Saliva biomarkers may predict head and neck cancer immunotherapy response. This research explores oral fluids and exosomes to identify markers for immune checkpoint inhibitor (ICI) treatment selection.
Area of Science:
- Oncology
- Immunotherapy
- Biomarker Discovery
Background:
- Head and neck cancers are a major global health concern, with radiotherapy and surgery as primary treatments.
- Treatment resistance and recurrence necessitate novel approaches like immunotherapy, specifically immune checkpoint inhibitors (ICIs).
- Predictive markers are crucial for selecting appropriate patients for ICI therapy due to variable responses.
Purpose of the Study:
- To investigate non-invasive salivary biomarkers for predicting ICI response in head and neck cancer.
- To explore the potential of oral rinses and tumor-derived exosomes as sources for predictive markers.
- To correlate oral biomarker profiles with tumor microenvironment characteristics and treatment outcomes.
Main Methods:
- Analysis of saliva, oral rinses, and tumor-derived exosomes for potential biomarkers.
- Assessment of immune cell presence, checkpoint expression, and tumor mutation load in oral fluids.
- Investigation of the role of oral microbiota in influencing treatment efficacy.
- Evaluation of microRNAs (miRNAs) within tumor-derived exosomes as predictive indicators.
Main Results:
- Oral biomarkers can reflect the tumor microenvironment, including immune cell infiltration and checkpoint expression.
- Elevated tumor mutation load is linked to increased immunogenicity and better ICI response.
- Preliminary findings suggest tumor-derived exosomes and salivary miRNAs can identify immunosuppressive pathways and predict ICI response.
- Oral microbiota composition may impact immunotherapy outcomes.
Conclusions:
- Non-invasive oral fluid biomarkers, including exosomes and miRNAs, show promise for predicting ICI response in head and neck cancers.
- Combining multiple oral biomarkers could overcome limitations of tissue-based markers like PD-L1.
- This approach could lead to personalized immunotherapy strategies for head and neck cancer patients.
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