University of Cincinnati scientists have recently discovered that DEK, a human gene known to cause cancer, can be detected in the plasma of patients with head and neck cancer. DEK may help clinicians understand how a person’s immune system can be used to treat cancer or predict outcomes for patients.
The information, titled “The DEK oncogene can be detected in the plasma of head and neck cancer patients and may predict immune response and prognosis,” was presented via poster at the Multidisciplinary Head and Neck Cancer Symposium Feb. 18-20 in Scottsdale, Arizona.
“Head and neck cancer remains the sixth most common cancer worldwide,” said Trisha Wise-Draper, M.D., Ph.D., assistant professor in the Division of Hematology Oncology at the UC College of Medicine, in a news release. Wise-Draper is a member of both the Cincinnati Cancer Center and UC Cancer Institute and she was the principal investigator on this study.
“Although infection with the human papilloma virus, or HPV, has emerged as a factor for determining outcomes for head and neck squamous cell carcinoma [head and neck cancer], leading to less intense treatment strategies for patients, no plasma biomarkers exist to predict tumor response to treatment or possible relapse,” she said.
“One potential plasma biomarker is programmed by the human DEK gene, which has been found to promote cancer. DEK RNA and protein are highly increased in tissue specimens from several tumor types, including head and neck cancer, breast cancer, and melanoma, and antibodies to DEK also are detected in patients with autoimmune diseases like juvenile rheumatoid arthritis and lupus,” Wise-Draper said. “Our previous work has shown that DEK is highly and universally present in head and neck cancer tissue specimens regardless of stage or HPV infection, and has suggested tumor-association. In addition, white blood cells (macrophages) secrete DEK protein, leading to the hypothesis that DEK may be present in the plasma of cancer patients and could be correlated with aggressiveness of disease and patient outcomes.”
DEK mRNA and protein expression are up-regulated in the tissue of patients with head and neck cancer, with previous studies demonstrating that DEK is highly expressed in tissue samples of patients with head and neck cancer, regardless of the cancer stage or status of HPV infection.
Wise-Draper and colleagues used whole blood from either patients with newly diagnosed and untreated head and neck cancer or age-matched normal healthy participants. Plasma was separated from the samples, and an enzyme-linked immunosorbent assay (ELISA), a test that uses antibodies and color change to identify a substance, was administered.
The results revealed that DEK could be detected in the plasma of patients with head and neck cancer and in healthy controls. However, compared to people without cancer, those with cancer had decreased levels of DEK, which inversely correlated with plasma levels of interleukin-6.
“We found that DEK was present in the plasma of both healthy control subjects and those with head and neck cancer,” Wise-Draper said. “Overall, DEK was decreased in head and neck cancer patients compared to healthy patients, but it was inversely correlated with IL-6, which is secreted by T-cells (white blood cells that play a role in immunity) and triggers an immune response in the plasma.
“The immune system’s reaction to the tumor also appeared to be linked with high DEK plasma levels. So, although DEK presence is increased in head and neck cancer tissue, plasma DEK levels are decreased in patients when compared with healthy individuals and are further decreased in patients with advanced cancers,” she said.
The results from this study, along with DEK’s link to IL-6 levels, indicate that high levels of DEK may mean better outcomes for patients.
“Furthermore, high DEK levels in the plasma may predict better immunotherapy in terms of cancer treatment,” Wise-Draper said. “Further analyses are ongoing to determine whether DEK levels predict response to various treatments, correlate with the body’s immune response, and whether DEK presence in the serum (in blood, serum includes all proteins not used in blood clotting and all the electrolytes, antibodies, antigens, hormones or any external substances, like drugs) will predict remaining disease or early relapse.”
“This information will be important to verify DEK plasma measurements as a clinically useful test and may give insight to future personalized and targeted treatment strategies for head and neck cancer,” Wise-Draper said.