Serum cell division control 42 reflects treatment response and survival profiles in recurrent or metastatic oral squamous cell carcinoma patients who receive programmed death-1 inhibitors.

OBJECTIVES

Cell division control 42 (CDC42) facilitates tumor growth, migration, and immune escape to accelerate the pathogenesis and progression of oral squamous cell carcinoma (OSCC). This study intended to explore the optimal cut-value of serum CDC42 for predicting treatment response to programmed death-1 (PD-1) inhibitors and survival in recurrent or metastatic (R/M) OSCC patients.

METHODS

CDC42 was detected from serum by enzyme-linked immunosorbent assay in 45 R/M OSCC patients before initiating PD-1 inhibitors with or without chemotherapy. Different cutoff values (500, 600, 700, and 800 pg/mL) of CDC42 were selected for further analyses.

RESULTS

The median (interquartile range) value of CDC42 was 604.0 (477.5-867.5) pg/mL in R/M OSCC patients. Generally, objective response rate (ORR) and disease control rate (DCR) were 37.8 % and 62.2 %. Additionally, ORR (P = 0.030) and DCR (P = 0.004) were decreased in patients with CDC42 ≥ 700 pg/mL versus those with CDC42 < 700 pg/mL; meanwhile, DCR was also reduced in patients with CDC42 ≥ 800 pg/mL versus those with CDC42 < 800 pg/mL (P = 0.014). Interestingly, CDC42 ≥ 600 (P = 0.023), 700 (P = 0.007), and 800 (P = 0.039) pg/mL were related to shorter progression-free survival (PFS). While only CDC42 ≥ 700 (P = 0.004) and 800 (P = 0.046) pg/mL were correlated with worse overall survival (OS). After adjustment, only CDC42 ≥ 700 pg/mL (yes vs. no) independently estimated poor PFS (hazard ratio (HR) = 2.637, P = 0.005) and OS (HR = 5.824, P < 0.001).

CONCLUSION

CDC42 ≥ 700 pg/mL exerts the optimal prognostic ability to reflect poor treatment response and survival profiles in R/M OSCC patients who receive PD-1 inhibitors.