Novel Diagnostic Tool to Revolutionize Treatment Guidance of Head and Neck Cancer

Head and neck squamous cell carcinoma (HNSCC) is a solid tumor type commonly treated with surgery. However, there has been no clinically available method to determine which patients can be cured with surgery alone and which require additional therapies such as radiation or chemotherapy. These oncological treatments often lead to significant side effects, increased healthcare costs, and diminished quality of life. Currently, only two biomarkers—p16 and PD-L1—are in widespread clinical use for HNSCC, both of which have serious limitations in guiding treatment decisions, especially in early-stage disease. Now, researchers have identified the first clinically translatable biomarker for selecting patients who may benefit from surgery alone, paving the way for a diagnostic test to identify such patients.

Researchers from the University of Turku (Turku, Finland) and Turku University Hospital (Turku, Finland) have developed an easy-to-use immunohistochemical assay for detecting the LIMA1-alpha protein, which reliably predicts whether patients can be cured with surgery alone, thus avoiding the need for harmful oncological treatments. In their study, the researchers analyzed tissue samples from patients with newly diagnosed HNSCC in a prospective clinical study across all five university hospitals in Finland. The assay employs antibodies specific to LIMA1 isoforms and detects the presence of the LIMA1-alpha protein in tumor tissue. It was designed to stratify patients based on their likelihood of needing additional treatment beyond surgery. Mechanistic studies also revealed that LIMA1 promotes epithelial–mesenchymal transition and enhances cancer invasiveness, which explains its link to poor prognosis.

Image: A diagnostic test can distinguish patients with head and neck squamous cell carcinoma who can be cured with surgery alone (Photo courtesy of University of Turku)

The assay’s prognostic accuracy was confirmed using retrospective, population-validated tissue microarrays and two independent prospective cohorts. The findings, published in ACS Chemical & Biomedical Imaging - Bioimaging of Metals, showed that LIMA1-alpha was the only biomarker that significantly predicted poor surgical outcomes. None of the LIMA1-negative patients in the validation groups died from HNSCC during the two-year follow-up period. These results suggest the assay could serve as a reliable and cost-effective tool for identifying patients who can be spared from multimodal treatment. The researchers plan to commercialize the test later this year with the aim of incorporating LIMA1 testing into routine diagnostics to enable more personalized and less toxic treatment strategies for patients with head and neck cancer.

“Our findings suggest that immunohistochemical detection of LIMA1-alpha can serve as a reliable and cost-effective tool for identifying patients who could be cured with surgery only and thus spared from the burden of multimodal treatments,” said Docent Sami Ventelä, University of Turku. “This kind of stratification is long overdue and needed in head and neck cancer care.”

Related Links:
University of Turku
Turku University Hospital