Effect of co-occurring TP53 and intracellular proliferation pathway mutations on disease recurrence and survival benefits in head and neck cancers.

• DOI: 10.1200/jco.2025.43.16_suppl.e18046
• Publication Date: 2025-05-28T21:12:31Z
• Authors: Rajnish Vasant Na...; Mohsina Hussain; Sirshendu Roy; Mukesh Chaudhary; Srinivas Raut; Sucheta Gandhe; Yogesh Pawar; Mina Darooei; Madhura Basavalin...; Aarthi Ramesh; Mohan Uttarwar; Gowhar Shafi; Jayant Khandare

e18046 Background: Head and neck cancer (HNC) is often driven by genetic alterations, particularly co-occurring mutations in TP53 gene key proliferation pathways. Offering continuous low-dose treatment (Oral metronomic chemotherapy) has shown potential improving survival outcomes minimizing toxicity while also targeting cellular molecular drivers. However, of HNC remains challenging due to factors such as tumor heterogeneity, late-stage diagnosis, resistance. Recurrence the presence residual or drug-resistant cells that poses significant challenges long-term survival. This study focuses on genomic profiles patients with disease recurrence their association benefits adjuvant therapy. Methods: We investigated 22 adjunct clinical follow-up data. A total twenty-one had previously undergone surgery 14 recurrence. 6 oral chemotherapy (OMCT) which 4 a combination nivolumab. 3 were undergoing maintenance immunotherapy. Next Generation Sequencing (NGS) test was performed using OncoIndx Assay (Aarthi et al., 2024). Results: Molecular analysis 63.6% (n=14) who reported continued further treatment. 21.4% (n=3/14) detected compound 64.3% (n=9/14) showed co-occurrence cell progression intracellular pathway alterations. 92.9% (n=13/14) positive PD-L1 expression. Interestingly, profiling under OMCT (CDKN2A) alterations (MYC, NRAS, KRAS) 83.3% (n=5/6) indicating benefits. Conclusions: Although proliferative found predominant recurrence, it only included downstream genes not surface receptors like EGFR. Thus, pathways indicative but suggestive from cohort since all overall between 8 months more than years.