IL-6; cancer associated fibroblasts; epithelial-to-mesenchymal transition; head and neck squamous cell carcinoma; radioresistance
Résumé :
[en] [en] BACKGROUND: Cancer-associated fibroblasts have been reported to play a central role in driving cancer progression, promoting metastasis, and conferring resistance to therapy in HNSCC.
METHODS: Indirect and direct co-culture models of HPV-positive and HPV-negative HNSCC cells with fibroblasts were developed to study the effect of fibroblasts on cancer cells. ELISA was used to measure IL-6 secretion in these models. To dissect the underlying signalling mechanisms, the effects of IL-6, an IL-6 receptor (IL-6R) inhibitor, a MAPK/ERK inhibitor, and a JAK/STAT inhibitor were evaluated. Epithelial-to-mesenchymal transition (EMT) was assessed by measuring EMT markers and conducting scratch assays and spheroid assays. Radioresistance was evaluated using clonogenic assays. Additionally, radioresistant (RR) cell lines were established from parental cells to examine the correlation between radioresistance and EMT.
RESULTS: Fibroblasts were found to drive EMT-like changes and heightened radioresistance in HNSCC cells through IL-6 secretion. Remarkably, these Fb-driven effects were robustly reversed using IL-6R and MAPK/ERK inhibitors in both HPV-positive and HPV-negative cell lines, whereas JAK/STAT inhibitors proved effective only in HPV-negative cells. RR cell lines exhibit a more aggressive phenotype than their parental counterparts, marked by pronounced EMT features and heightened resistance to radiotherapy. Importantly, these aggressive characteristics were substantially attenuated by targeting IL-6R or MAPK/ERK pathways.
CONCLUSIONS: This study highlights the critical role of fibroblast-secreted IL-6 in driving and maintaining EMT and radioresistance in HNSCC, resulting in a more aggressive tumour phenotype. Targeting the IL-6/IL-6R/ERK pathway emerges as a promising therapeutic approach for combating CAF-driven tumour progression and improving clinical outcomes in patients with aggressive, therapy-resistant HNSCC.
Disciplines :
Sciences du vivant: Multidisciplinaire, généralités & autres
Auteur, co-auteur :
Li, Xinyang; Head and Neck Oncology Group, Centre for Host Microbiome Interaction, King's College London, Hodgkin Building, London SE1 1UL, UK
ESCOFFIER, Hugues ; University of Luxembourg > Faculty of Science, Technology and Medicine (FSTM) > Department of Life Sciences and Medicine (DLSM)
SAUTER, Thomas ; University of Luxembourg > Faculty of Science, Technology and Medicine (FSTM) > Department of Life Sciences and Medicine (DLSM)
Tavassoli, Mahvash ; Head and Neck Oncology Group, Centre for Host Microbiome Interaction, King's College London, Hodgkin Building, London SE1 1UL, UK
Co-auteurs externes :
yes
Langue du document :
Anglais
Titre :
Targeting Fibroblast-Derived Interleukin 6: A Strategy to Overcome Epithelial-Mesenchymal Transition and Radioresistance in Head and Neck Cancer.
Joint PhD program between King’s College London and China Scholarship Council FNR - Luxembourg National Research Fund
N° du Fonds :
PRIDE21/16763386/CANBIO2
Subventionnement (détails) :
This work was supported by a joint PhD program between King’s College London and China Scholarship Council (2021-KCSC) and the Luxembourg National Research Fund (PRIDE21/16763386/CANBIO2).
Aupérin A. Epidemiology of head and neck cancers: An update Curr. Opin. Oncol. 2020 32 178 186 10.1097/CCO.0000000000000629 32209823
Johnson D.E. Burtness B. Leemans C.R. Lui V.W.Y. Bauman J.E. Grandis J.R. Head and neck squamous cell carcinoma Nat. Rev. Dis. Primers 2020 6 92 10.1038/s41572-020-00224-3
Du E. Mazul A.L. Farquhar D. Brennan P. Anantharaman D. Abedi-Ardekani B. Weissler M.C. Hayes D.N. Olshan A.F. Zevallos J.P. Long-term Survival in Head and Neck Cancer: Impact of Site, Stage, Smoking, and Human Papillomavirus Status Laryngoscope 2019 129 2506 2513 10.1002/lary.27807
Goel B. Tiwari A.K. Pandey R.K. Singh A.P. Kumar S. Sinha A. Jain S.K. Khattri A. Therapeutic approaches for the treatment of head and neck squamous cell carcinoma-An update on clinical trials Transl. Oncol. 2022 21 101426 10.1016/j.tranon.2022.101426
Mihara M. Hashizume M. Yoshida H. Suzuki M. Shiina M. IL-6/IL-6 receptor system and its role in physiological and pathological conditions Clin. Sci. 2012 122 143 159 10.1042/CS20110340 22029668
Huang B. Lang X. Li X. The role of IL-6/JAK2/STAT3 signaling pathway in cancers Front. Oncol. 2022 12 1023177 10.3389/fonc.2022.1023177 36591515
Browning L. Patel M.R. Horvath E.B. Tawara K. Jorcyk C.L. IL-6 and ovarian cancer: Inflammatory cytokines in promotion of metastasis Cancer Manag. Res. 2018 10 6685 6693 10.2147/CMAR.S179189
Duffy S.A. Taylor J.M. Terrell J.E. Islam M. Li Y. Fowler K.E. Wolf G.T. Teknos T.N. Interleukin-6 predicts recurrence and survival among head and neck cancer patients Cancer 2008 113 750 757 10.1002/cncr.23615
Uz U. Eskiizmir G. Association between interleukin-6 and head and neck squamous cell carcinoma: A systematic review Clin. Exp. Otorhinolaryngol. 2021 14 50 10.21053/ceo.2019.00906 33587847
Custódio M. Biddle A. Tavassoli M. Portrait of a CAF: The story of cancer-associated fibroblasts in head and neck cancer Oral. Oncol. 2020 110 104972 10.1016/j.oraloncology.2020.104972 33011636
Dourado M.R. Guerra E.N.S. Salo T. Lambert D.W. Coletta R.D. Prognostic value of the immunohistochemical detection of cancer-associated fibroblasts in oral cancer: A systematic review and meta-analysis J. Oral. Pathol. Med. 2018 47 443 453 10.1111/jop.12623
Knops A.M. South A. Rodeck U. Martinez-Outschoorn U. Harshyne L.A. Johnson J. Luginbuhl A.J. Curry J.M. Cancer-Associated Fibroblast Density, Prognostic Characteristics, and Recurrence in Head and Neck Squamous Cell Carcinoma: A Meta-Analysis Front. Oncol. 2020 10 565306 10.3389/fonc.2020.565306 33330034
Bienkowska K.J. Hanley C.J. Thomas G.J. Cancer-Associated Fibroblasts in Oral Cancer: A Current Perspective on Function and Potential for Therapeutic Targeting Front. Oral. Health 2021 2 686337 10.3389/froh.2021.686337 35048030
Brabletz T. Kalluri R. Nieto M.A. Weinberg R.A. EMT in cancer Nat. Rev. Cancer 2018 18 128 134 10.1038/nrc.2017.118 29326430
Peltanova B. Raudenska M. Masarik M. Effect of tumor microenvironment on pathogenesis of the head and neck squamous cell carcinoma: A systematic review Mol. Cancer 2019 18 63 10.1186/s12943-019-0983-5 30927923
Vasan N. Baselga J. Hyman D.M. A view on drug resistance in cancer Nature 2019 575 299 309 10.1038/s41586-019-1730-1
Okuyama K. Suzuki K. Yanamoto S. Relationship between Tumor Budding and Partial Epithelial-Mesenchymal Transition in Head and Neck Cancer Cancers 2023 15 1111 10.3390/cancers15041111 36831453
Puram S.V. Tirosh I. Parikh A.S. Patel A.P. Yizhak K. Gillespie S. Rodman C. Luo C.L. Mroz E.A. Emerick K.S. et al. Single-Cell Transcriptomic Analysis of Primary and Metastatic Tumor Ecosystems in Head and Neck Cancer Cell 2017 171 1611 1624 10.1016/j.cell.2017.10.044 29198524
Fiori M.E. Di Franco S. Villanova L. Bianca P. Stassi G. De Maria R. Cancer-associated fibroblasts as abettors of tumor progression at the crossroads of EMT and therapy resistance Mol. Cancer 2019 18 70 10.1186/s12943-019-0994-2 30927908
Uciechowski P. Dempke W.C.M. Interleukin-6: A Masterplayer in the Cytokine Network Oncology 2020 98 131 137 10.1159/000505099 31958792
Yadav A. Kumar B. Datta J. Teknos T.N. Kumar P. IL-6 promotes head and neck tumor metastasis by inducing epithelial-mesenchymal transition via the JAK-STAT3-SNAIL signaling pathway Mol. Cancer Res. 2011 9 1658 1667 10.1158/1541-7786.MCR-11-0271
Karakasheva T.A. Lin E.W. Tang Q. Qiao E. Waldron T.J. Soni M. Klein-Szanto A.J. Sahu V. Basu D. Ohashi S. et al. IL-6 Mediates Cross-Talk between Tumor Cells and Activated Fibroblasts in the Tumor Microenvironment Cancer Res. 2018 78 4957 4970 10.1158/0008-5472.CAN-17-2268 29976575
Chen C.C. Chen W.C. Lu C.H. Wang W.H. Lin P.Y. Lee K.D. Chen M.F. Significance of interleukin-6 signaling in the resistance of pharyngeal cancer to irradiation and the epidermal growth factor receptor inhibitor Int. J. Radiat. Oncol. Biol. Phys. 2010 76 1214 1224 10.1016/j.ijrobp.2009.09.059 20206020
Guerrera I.C. Quetier I. Fetouchi R. Moreau F. Vauloup-Fellous C. Lekbaby B. Rousselot C. Chhuon C. Edelman A. Lefevre M. et al. Regulation of interleukin-6 in head and neck squamous cell carcinoma is related to papillomavirus infection J. Proteome Res. 2014 13 1002 1011 10.1021/pr401009f
Alsahafi E.N. Thavaraj S. Sarvestani N. Novoplansky O. Elkabets M. Ayaz B. Tavassoli M. Legends M.F. EGFR overexpression increases radiotherapy response in HPV-positive head and neck cancer through inhibition of DNA damage repair and HPV E6 downregulation Cancer Lett. 2021 498 80 97 10.1016/j.canlet.2020.10.035 33137407
Hutchinson M.-K.N.D. Mierzwa M. D’Silva N.J. Radiation resistance in head and neck squamous cell carcinoma: Dire need for an appropriate sensitizer Oncogene 2020 39 3638 3649 10.1038/s41388-020-1250-3 32157215
Dickson M.A. Hahn W.C. Ino Y. Ronfard V. Wu J.Y. Weinberg R.A. Louis D.N. Li F.P. Rheinwald J.G. Human keratinocytes that express hTERT and also bypass a p16(INK4a)-enforced mechanism that limits life span become immortal yet retain normal growth and differentiation characteristics Mol. Cell Biol. 2000 20 1436 1447 10.1128/MCB.20.4.1436-1447.2000
Gray M. Turnbull A.K. Ward C. Meehan J. Martínez-Pérez C. Bonello M. Pang L.Y. Langdon S.P. Kunkler I.H. Murray A. et al. Development and characterisation of acquired radioresistant breast cancer cell lines Radiat. Oncol. 2019 14 64 10.1186/s13014-019-1268-2
Raulf N. Lucarelli P. Thavaraj S. Brown S. Vicencio J.M. Sauter T. Tavassoli M. Annexin A1 regulates EGFR activity and alters EGFR-containing tumour-derived exosomes in head and neck cancers Eur. J. Cancer 2018 102 52 68 10.1016/j.ejca.2018.07.123 30142511
Nantajit D. Presta L. Sauter T. Tavassoli M. EGFR-induced suppression of HPV E6/E7 is mediated by microRNA-9-5p silencing of BRD4 protein in HPV-positive head and neck squamous cell carcinoma Cell Death Dis. 2022 13 921 10.1038/s41419-022-05269-8 36333293
Suh Y.E. Raulf N. Gäken J. Lawler K. Urbano T.G. Bullenkamp J. Gobeil S. Huot J. Odell E. Tavassoli M. MicroRNA-196a promotes an oncogenic effect in head and neck cancer cells by suppressing annexin A1 and enhancing radioresistance Int. J. Cancer 2015 137 1021 1034 10.1002/ijc.29397 25523631
Vinci M. Box C. Eccles S.A. Three-dimensional (3D) tumor spheroid invasion assay J. Vis. Exp. 2015 99 52686 10.3791/52686-v
Colaprico A. Silva T.C. Olsen C. Garofano L. Cava C. Garolini D. Sabedot T.S. Malta T.M. Pagnotta S.M. Castiglioni I. et al. TCGAbiolinks: An R/Bioconductor package for integrative analysis of TCGA data Nucleic Acids Res. 2016 44 e71 10.1093/nar/gkv1507 26704973
Korotkevich G. Sukhov V. Budin N. Shpak B. Artyomov M.N. Sergushichev A. Fast gene set enrichment analysis bioRxiv 2016 060012
Therneau T.M. Grambsch P.M. The Cox Model Modeling Survival Data: Extending the Cox Model Therneau T.M. Grambsch P.M. Springer New York, NY, USA 2000 39 77
Kassambara A. Ggplot2: Guide to Create Beautiful Graphics in R CreateSpace Scotts Valley, CA, USA 2013
Choi J.-H. Lee B.-S. Jang J.Y. Lee Y.S. Kim H.J. Roh J. Shin Y.S. Woo H.G. Kim C.-H. Single-cell transcriptome profiling of the stepwise progression of head and neck cancer Nat. Commun. 2023 14 1055 10.1038/s41467-023-36691-x
Hao Y. Stuart T. Kowalski M.H. Choudhary S. Hoffman P. Hartman A. Srivastava A. Molla G. Madad S. Fernandez-Granda C. Dictionary learning for integrative, multimodal and scalable single-cell analysis Nat. Biotechnol. 2024 42 293 304 10.1038/s41587-023-01767-y
Pastushenko I. Blanpain C. EMT Transition States during Tumor Progression and Metastasis Trends Cell Biol. 2019 29 212 226 10.1016/j.tcb.2018.12.001
Li X. González-Maroto C. Tavassoli M. Crosstalk between CAFs and tumour cells in head and neck cancer Cell Death Discov. 2024 10 303 10.1038/s41420-024-02053-9
Wu F. Yang J. Liu J. Wang Y. Mu J. Zeng Q. Deng S. Zhou H. Signaling pathways in cancer-associated fibroblasts and targeted therapy for cancer Signal Transduct. Target. Ther. 2021 6 218 10.1038/s41392-021-00641-0
Aida Y. Honda K. Tanigawa S. Nakayama G. Matsumura H. Suzuki N. Shimizu O. Takeichi O. Makimura M. Maeno M. IL-6 and soluble IL-6 receptor stimulate the production of MMPs and their inhibitors via JAK-STAT and ERK-MAPK signalling in human chondrocytes Cell Biol. Int. 2012 36 367 376 10.1042/CBI20110150
Rong C. Muller M.F. Xiang F. Jensen A. Weichert W. Major G. Plinkert P.K. Hess J. Affolter A. Adaptive ERK signalling activation in response to therapy and in silico prognostic evaluation of EGFR-MAPK in HNSCC Br. J. Cancer 2020 123 288 297 10.1038/s41416-020-0892-9
Adachi M. Cui C. Dodge C.T. Bhayani M.K. Lai S.Y. Targeting STAT3 inhibits growth and enhances radiosensitivity in head and neck squamous cell carcinoma Oral Oncol. 2012 48 1220 1226 10.1016/j.oraloncology.2012.06.006 22770899
Dudas J. Ladanyi A. Ingruber J. Steinbichler T.B. Riechelmann H. Epithelial to Mesenchymal Transition: A Mechanism that Fuels Cancer Radio/Chemoresistance Cells 2020 9 428 10.3390/cells9020428
Vilalta M. Rafat M. Graves E.E. Effects of radiation on metastasis and tumor cell migration Cell. Mol. Life Sci. 2016 73 2999 3007 10.1007/s00018-016-2210-5 27022944
Pal A. Barrett T.F. Paolini R. Parikh A. Puram S.V. Partial EMT in head and neck cancer biology: A spectrum instead of a switch Oncogene 2021 40 5049 5065 10.1038/s41388-021-01868-5
Özdemir B.C. Pentcheva-Hoang T. Carstens J.L. Zheng X. Wu C.C. Simpson T.R. Laklai H. Sugimoto H. Kahlert C. Novitskiy S.V. et al. Depletion of carcinoma-associated fibroblasts and fibrosis induces immunosuppression and accelerates pancreas cancer with reduced survival Cancer Cell 2014 25 719 734 10.1016/j.ccr.2014.04.005
Tsai M.-S. Chen W.-C. Lu C.-H. Chen M.-F. The prognosis of head and neck squamous cell carcinoma related to immunosuppressive tumor microenvironment regulated by IL-6 signaling Oral Oncol. 2019 91 47 55 10.1016/j.oraloncology.2019.02.027
Johnson D.E. O’Keefe R.A. Grandis J.R. Targeting the IL-6/JAK/STAT3 signalling axis in cancer Nat. Rev. Clin. Oncol. 2018 15 234 248 10.1038/nrclinonc.2018.8 29405201
Dijkgraaf E. Santegoets S. Reyners A. Goedemans R. Wouters M. Kenter G. Van Erkel A. Van Poelgeest M. Nijman H. Van Der Hoeven J. A phase I trial combining carboplatin/doxorubicin with tocilizumab, an anti-IL-6R monoclonal antibody, and interferon-α2b in patients with recurrent epithelial ovarian cancer Ann. Oncol. 2015 26 2141 2149 10.1093/annonc/mdv309 26216383
Peterlin P. Garnier A. Le Bourgeois A. Guillaume T. Le Bris Y. Theisen O. Béné M.C. Eveillard M. Rimbert M. Jullien M. et al. Tocilizumab in combination with a standard induction chemotherapy in acute myeloid leukaemia patients (TOCILAM study): A single-centre, single-arm, phase 1 trial EClinicalMedicine 2023 64 102254 10.1016/j.eclinm.2023.102254 37786451
Abdel-Wahab N. Montazari E. Spillson C. Bentebibel S.-E. Awiwi M. Elsayes K.M. Gao J. Altan M. Wong M.K. Glitza I.C. Tocilizumab in combination with ipilimumab and nivolumab in solid tumors JCO 2022 40 TPS9600 10.1200/JCO.2022.40.16_suppl.TPS9600
Junk D.J. Bryson B.L. Smigiel J.M. Parameswaran N. Bartel C.A. Jackson M.W. Oncostatin M promotes cancer cell plasticity through cooperative STAT3-SMAD3 signaling Oncogene 2017 36 4001 4013 10.1038/onc.2017.33 28288136
Chamorro Petronacci C.M. García García A. Padin Iruegas E. Rivas Mundiña B. Lorenzo Pouso A.I. Perez Sayans M. Identification of prognosis associated microRNAs in HNSCC subtypes based on TCGA dataset Medicina 2020 56 535 10.3390/medicina56100535
Mehanna H. Robinson M. Hartley A. Kong A. Foran B. Fulton-Lieuw T. Dalby M. Mistry P. Sen M. O’Toole L. et al. Radiotherapy plus cisplatin or cetuximab in low-risk human papillomavirus-positive oropharyngeal cancer (De-ESCALaTE HPV): An open-label randomised controlled phase 3 trial Lancet 2019 393 51 60 10.1016/S0140-6736(18)32752-1 30449623
Chen X. Fu E. Lou H. Mao X. Yan B. Tong F. Sun J. Wei L. IL-6 induced M1 type macrophage polarization increases radiosensitivity in HPV positive head and neck cancer Cancer Lett. 2019 456 69 79 10.1016/j.canlet.2019.04.032
Artaza-Irigaray C. Molina-Pineda A. Aguilar-Lemarroy A. Ortiz-Lazareno P. Limón-Toledo L.P. Pereira-Suárez A.L. Rojo-Contreras W. Jave-Suárez L.F. E6/E7 and E6(*) From HPV16 and HPV18 Upregulate IL-6 Expression Independently of p53 in Keratinocytes Front Immunol. 2019 10 1676 10.3389/fimmu.2019.01676 31396215
Xing D.T. Khor R. Gan H. Wada M. Ermongkonchai T. Ng S.P. Recent Research on Combination of Radiotherapy with Targeted Therapy or Immunotherapy in Head and Neck Squamous Cell Carcinoma: A Review for Radiation Oncologists Cancers 2021 13 5716 10.3390/cancers13225716
Chang L. Ni J. Beretov J. Wasinger V.C. Hao J. Bucci J. Malouf D. Gillatt D. Graham P.H. Li Y. Identification of protein biomarkers and signaling pathways associated with prostate cancer radioresistance using label-free LC-MS/MS proteomic approach Sci. Rep. 2017 7 41834 10.1038/srep41834 28225015
Chang L. Graham P.H. Hao J. Ni J. Bucci J. Cozzi P.J. Kearsley J.H. Li Y. Acquisition of epithelial-mesenchymal transition and cancer stem cell phenotypes is associated with activation of the PI3K/Akt/mTOR pathway in prostate cancer radioresistance Cell Death Dis. 2013 4 e875 10.1038/cddis.2013.407
Steinbichler T.B. Alshaimaa A. Maria M.V. Daniel D. Herbert R. Jozsef D. Ira-Ida S. Epithelial-mesenchymal crosstalk induces radioresistance in HNSCC cells Oncotarget 2018 9 3641 3652 10.18632/oncotarget.23248
You G.R. Chang J.T. Li Y.L. Chen Y.J. Huang Y.C. Fan K.H. Chen Y.C. Kang C.J. Cheng A.J. Molecular Interplays Between Cell Invasion and Radioresistance That Lead to Poor Prognosis in Head-Neck Cancer Front Oncol. 2021 11 681717 10.3389/fonc.2021.681717 34307149
You G.-R. Cheng A.-J. Lee L.-Y. Huang Y.-C. Liu H. Chen Y.-J. Chang J.T. Prognostic signature associated with radioresistance in head and neck cancer via transcriptomic and bioinformatic analyses BMC Cancer 2019 19 64 10.1186/s12885-018-5243-3
Zang C. Liu X. Li B. He Y. Jing S. He Y. Wu W. Zhang B. Ma S. Dai W. et al. IL-6/STAT3/TWIST inhibition reverses ionizing radiation-induced EMT and radioresistance in esophageal squamous carcinoma Oncotarget 2017 8 11228 11238 10.18632/oncotarget.14495 28061440
Yuan X. Zhang L. Huang Y. Liu D. Peng P. Liu S. Long G. Hu G. Sun W. Induction of interleukin-6 by irradiation and its role in epithelial mesenchymal transition and radioresistance of nasopharyngeal carcinoma cells Head Neck 2021 43 757 767 10.1002/hed.26531 33150659
Bu L. Yu G. Wu L. Mao L. Deng W. Liu J. Kulkarni A. Zhang W. Zhang L. Sun Z. STAT3 induces immunosuppression by upregulating PD-1/PD-L1 in HNSCC J. Dent. Res. 2017 96 1027 1034 10.1177/0022034517712435 28605599
Campochiaro C. Farina N. Tomelleri A. Ferrara R. Lazzari C. De Luca G. Bulotta A. Signorelli D. Palmisano A. Vignale D. Tocilizumab for the treatment of immune-related adverse events: A systematic literature review and a multicentre case series Eur. J. Intern. Med. 2021 93 87 94 10.1016/j.ejim.2021.07.016
Fizazi K. De Bono J. Flechon A. Heidenreich A. Voog E. Davis N. Qi M. Bandekar R. Vermeulen J. Cornfeld M. Randomised phase II study of siltuximab (CNTO 328), an anti-IL-6 monoclonal antibody, in combination with mitoxantrone/prednisone versus mitoxantrone/prednisone alone in metastatic castration-resistant prostate cancer Eur. J. Cancer 2012 48 85 93 10.1016/j.ejca.2011.10.014 22129890
Rossi J. Négrier S. James N.D. Kocák I. Hawkins R. Davis H. Prabhakar U. Qin X. Mulders P. Berns B. A phase I/II study of siltuximab (CNTO 328), an anti-interleukin-6 monoclonal antibody, in metastatic renal cell cancer Br. J. Cancer 2010 103 1154 1162 10.1038/sj.bjc.6605872 20808314
Angevin E. Tabernero J. Elez E. Cohen S.J. Bahleda R. Van Laethem J.-L. Ottensmeier C. Lopez-Martin J.A. Clive S. Joly F. A phase I/II, multiple-dose, dose-escalation study of siltuximab, an anti-interleukin-6 monoclonal antibody, in patients with advanced solid tumors Clin. Cancer Res. 2014 20 2192 2204 10.1158/1078-0432.CCR-13-2200 24563479
Stanam A. Love-Homan L. Joseph T.S. Espinosa-Cotton M. Simons A.L. Upregulated interleukin-6 expression contributes to erlotinib resistance in head and neck squamous cell carcinoma Mol. Oncol. 2015 9 1371 1383 10.1016/j.molonc.2015.03.008
Kiprian D. Czarkowska-Paczek B. Wyczalkowska-Tomasik A. Fuksiewicz M. Kotowicz B. Paczek L. Radiotherapy and radiochemotherapy increase serum levels of pro-inflammatory interleukin-6 and C-reactive protein in patients with head and neck cancers Transl. Cancer Res. 2018 7 41 47 10.21037/tcr.2017.12.23
Gao J. Zhao S. Halstensen T.S. Increased interleukin-6 expression is associated with poor prognosis and acquired cisplatin resistance in head and neck squamous cell carcinoma Oncol. Rep. 2016 35 3265 3274 10.3892/or.2016.4765
Bagley S. Polley M.-Y. Kotecha R. Brem S. Tolakanahalli R. Iwamoto F. Gilbert M. Won M. Mehta M. CTIM-21. NRG-BN010: A safety run-in and phase ii study evaluating the combination of tocilizumab, atezolizumab, and fractionated stereotactic radiotherapy in recurrent glioblastoma—trial in progress Neuro Oncol. 2022 24 vii64 10.1093/neuonc/noac209.253