This study set out to observe and better understand the differences, if any, in staining patterns for the oxidative stress response transcription factor Nrf2 in HNSCC patients who were HPV+ non- tobacco and alcohol users vs. HPV- tobacco and alcohol users. Increased Nrf2 activity is associated with resistance to therapy and poor outcomes. Tissues samples were obtained from the head and neck cancer repository of Nashville General Hospital at Meharry and Meharry Medical College. Nashville General Hospital at Meharry is a safety net hospital that serves the under- and uninsured citizens of Davidson County TN. FFPE sections were stained with anti- human Nrf2 antibody (Abcam 31163) and scored using a semi-quantitative evaluation gradient scale from 0-3 with 0 indicating no stain and 3 indicating strong positive Nrf2 staining. This study made use of 5 HPV+ and 2 HPV- patients. The results show that all HNSCC in the HPV+ and HPV- samples revealed positive staining for Nrf2 that ranged from weak to intense. We observed that the poorly differentiated HNSCC had a strong positive nuclear stain for Nrf2 when compared to lower tumor grades. Irrespective of whether the patient was in the HPV+ nonsmoker-nondrinker or HPV- smoker-drinker group, histological data indicates there was a positive correlation between increased Nrf2 staining and worsening tumor grade. These preliminary data suggest that potential use of Nrf2 as a prognostic biomarker for HNSCC will need to be evaluated differently for HPV+ and HPV- tumors, as HPV+ tumors are generally more responsive to therapy. Developing therapy that specifically targets Nrf2 could potentially play an immense role in managing HNSCC. Some of the limitations encountered in this study includes limited sample size.

Citation Format: Oladipupo O. Anibire, Oyinloye Jose, Kenyada Williams, Billy R. Ballard, Michael G. Izban, Dana Marshall. HPV+ and HPV- HNSCC show similar nrf2 nuclear and cytoplasmic staining patterns [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-233.