Kang Eun Joo, Hwang Shinwon, Lee Yun-Gyoo, Choi Jong-Kwon, Shin Seong Hoon, Choi Yoon Hee, Lee Keun-Wook, Lee Hyun Woo, Kim Min Kyoung, Lim Seung Taek, Yun Hwan Jung, Park Sang-Gon, Kim Sangwoo, Kim Sung-Bae, Kim Hye Ryun
Division of Hemato-oncology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea.
Cancer Res Treat. 2025 Jul;57(3):709-719. doi: 10.4143/crt.2024.836. Epub 2024 Dec 23.
Tumor suppressor p53 (TP53) mutations are common in head and neck squamous cell carcinoma (HNSCC). We evaluated their clinical impact in patients treated with targeted agents or immunotherapy in the KCSG HN15-16 TRIUMPH trial.
We analyzed clinical characteristics and outcomes of patients with TP53 mutations in the TRIUMPH trial, a multicenter, biomarker-driven umbrella trial in Korea. Patients were assigned to treatment groups based on genomic profiles: group 1, alpelisib; group 2, poziotinib; group 3, nintedanib; and group 4, abemaciclib. If there was no identifiable target, the patients were allocated to group 5 (durvalumab±tremelimumab).
TP53 mutations were detected in 116/179 patients (64.8%), more frequently in human papillomavirus-negative and non-oropharyngeal cancers. Patients with TP53 mutations exhibited shorter progression-free survival than TP53 wild-type in all the patients (1.7 vs. 3.8 months, p=0.002) and in those who received targeted treatments (2.5 vs. 7.3 months, p=0.009). Furthermore, TP53 mutations were strongly associated with poor overall survival than TP53 wild-type in all the patients (11.1 vs. 28.8 months, p=0.005) and in group 5 (8.1 vs. 33.0 months, p=0.001).
TP53 mutations were associated with aggressive clinical characteristics and poor survival, particularly in HNSCC patients treated with immunotherapy.
肿瘤抑制因子p53（TP53）突变在头颈部鳞状细胞癌（HNSCC）中很常见。我们在KCSG HN15 - 16 TRIUMPH试验中评估了其对接受靶向药物或免疫治疗患者的临床影响。
我们分析了TRIUMPH试验中TP53突变患者的临床特征和结局，该试验是韩国一项多中心、生物标志物驱动的综合性试验。根据基因组概况将患者分配至治疗组：第1组，阿培利司；第2组，波齐替尼；第3组，尼达尼布；第4组，阿贝西利。若无可识别靶点，则将患者分配至第5组（度伐利尤单抗±曲美木单抗）。
179例患者中有116例（64.8%）检测到TP53突变，在人乳头瘤病毒阴性和非口咽癌中更常见。在所有患者中（1.7个月对3.8个月，p = 0.002）以及接受靶向治疗的患者中（2.5个月对7.3个月，p = 0.009），TP53突变患者的无进展生存期短于TP53野生型患者。此外，在所有患者中（11.1个月对2
