IGF-1R expression is associated with HPV-negative status and adverse survival in head and neck squamous cell cancer

Research output: Contribution to journalArticlepeer-review


  • Oliver T Dale
  • Tamara Aleksic
  • Ketan A Shah
  • Cheng Han
  • Jon D H Sheard
  • Paul Goodyear
  • Navdeep S Upile
  • Max Robinson
  • Terence M Jones
  • Stuart Winter
  • Valentine M Macaulay


Head and neck squamous cell carcinomas (HNSCC) are treated with surgery, radiotherapy and cisplatin-based chemotherapy, but survival from locally-advanced disease remains poor, particularly in patients whose tumors are negative for Human papillomavirus (HPV). Type 1 IGF receptor (IGF-1R) is known to promote tumorigenesis and resistance to cancer therapeutics. Here, we assessed IGF-1R immunohistochemistry on tissue microarrays containing 852 cores from 346 HNSCC patients with primary tumors in the oropharynx (n = 231), larynx (85), hypopharynx (28), oral cavity (2). Of these, 236 (68%) were HPV-negative, 110 (32%) positive. IGF-1R was detected in the cell membrane of 36% and cytoplasm of 92% of HNSCCs; in 64 cases with matched normal tonsillar epithelium, IGF-1R was overexpressed in the HNSCCs (P < 0.001). Overall survival (OS) and disease-specific survival (DSS) were reduced in patients whose tumors contained high membrane IGF-1R [OS: hazard ratio (HR) = 1.63, P = 0.006; DSS: HR = 1.63, P = 0.016], cytoplasmic IGF-1R (OS: HR = 1.58, P = 0.009; DSS: HR = 1.58, P = 0.024) and total IGF-1R (OS: HR = 2.02, P < 0.001; DSS: HR = 2.2, P < 0.001). High tumor IGF-1R showed significant association with high-tumor T-stage (P < 0.001) and HPV-negativity (P < 0.001), and was associated with shorter OS when considering patients with HPV-positive (P = 0.01) and negative (P = 0.006) tumors separately. IGF-1R was independently associated with survival in multivariate analysis including HPV, but not when lymphovascular invasion, perineural spread and T-stage were included. Of these factors, only IGF-1R can be manipulated; the association of IGF-1R with aggressive disease supports experimental incorporation of anti-IGF-1R agents into multimodality treatment programs for HPV-negative and high IGF-1R HPV-positive HNSCC.

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© The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.


Original languageEnglish
Pages (from-to)648-55
Number of pages8
Issue number6
Publication statusPublished - Jun 2015


  • Adult, Aged, Aged, 80 and over, Carcinoma, Squamous Cell, Cell Transformation, Neoplastic, Combined Modality Therapy, Disease-Free Survival, Drug Resistance, Neoplasm, Female, Head and Neck Neoplasms, Humans, Male, Middle Aged, Neoplasm Staging, Papillomaviridae, Papillomavirus Infections, Receptor, IGF Type 1, Young Adult

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