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Chapel Hill – A team of UNC scientists report that in laboratory studies, overexpression of a specific protein could be used as a prognostic marker and as a guide for therapeutic choices for patients with head and neck cancer. Their findings appear in the September 9, 2011 online issue of the journal Clinical Cancer Research.

At present there are few prognostic factors in head and neck squamous cell carcinoma, the most common type of head and neck cancer. The UNC team identified a protein – XRCC1- that when overexpressed in a tumor, is associated with poorer response to chemotherapy and radiation therapy as well as overall survival.

Neil Hayes, MD, MPH, associate professor of medicine and study senior author, explains, “Head and neck cancer is a particularly important cancer when it comes to selection of initial therapy because almost all patients have a hopeful prognosis at the time of initial presentation. The decision for therapy is usually between surgery-based therapy or chemotherapy plus radiation.

“At the present time, the decision to select between these two therapies is based more on anatomy than on the likelihood that the tumor will respond better to one therapy or the other. If we had even a slight clue that a patient would respond more favorably to surgery or chemotherapy, it would be a major improvement in the way we care for patients.” Hayes is a member of UNC Lineberger Comprehensive Cancer Center and of the UNC Head and Neck Oncology Program.

Using tumor samples and outcomes information from a 2002-2006 UNC study called Carolina Head and Neck Cancer (CHANCE), scientists analyzed these data to determine the consequences of XRCC1 overexpression. They found that high expression of XRCC1 may increase the DNA repair capacity of tumor cells, leading to increased tolerance of DNA damage from chemo and radiation therapies. These therapies work by damaging DNA, making repair impossible and therefore eradicating tumor cells.

Other UNC authors are: Mei-Kim Ang, MD; Mihir R. Patel, MD; Xiao-Ying Yin, MD; Sneha Sundaram, PhD; Karen Fritchie, MD; Ni Zhao, MS; Yufeng Liu, PhD; Alex Freemerman, PhD; Matthew Wilkerson, PhD; Vonn Walter, PhD; Mark Weissler, MD; William Shockley, MD; Marion Couch, MD; Adam Zanation, MD; Trevor Hackman, MD; Bhisham Chera, MD; Stephen Harris, MD; Ryan Miller, MD, PhD; Leigh Thorne, MD; Michele Hayward, RD; William Funkhouser, MD; Andrew Olshan, PhD; Carol Shores, MD, PhD; Liza Makowski, PhD.