Towards personalized medicine in head and neck cancer
| PhD ceremony: | drs. M.F. van der Kamp |
| When: | September 03, 2025 |
| Start: | 14:30 |
| Supervisors: | dr. G.B. (Gyuri) Halmos, prof. dr. E.M.D. (Ed) Schuuring, prof. dr. B.F.A.M. van der Laan |
| Co-supervisor: | B. (Bert) van der Vegt |
| Where: | Academy building RUG |
| Faculty: | Medical Sciences / UMCG |
Towards personalized medicine in head and neck cancer
This thesis of Martine van der Kamp explores how (biological) age, cancer biology, and the tumor microenvironment (TME) influence outcomes in head and neck cancer (HNC), with the aim of contributing to a better understanding and the development of more effective treatment strategies, particularly for older patients
An analysis of treatment patterns and survival rates in HNC revealed a shift toward non-surgical therapies for most tumor sites, generally accompanied by improved survival. The exception was advanced-stage vocal cord cancer, where survival slightly declined.
Another study examined whether age affects the risk of distant metastases (DM). Male sex, tumors in the hypopharynx, advanced tumor stage, poor differentiation, lymph node metastases, and extracapsular extension were identified as major risk factors, but no link was found between age and DM.
Age-specific oncogenic pathways were explored. A distinct subgroup of elderly HNC patients was identified: HPV-negative, non-smokers, and non-drinkers, whose cancers appear driven by mechanisms such as genomic instability, immunosenescence, cell cycle disruption, and telomere shortening.
The TME was assessed in relation to age and prognosis. Biologically older patients showed reduced immune cell infiltration, suggesting that some immunotherapies may be less effective in this group.
A systematic review and meta-analysis on tumor-associated macrophages (TAMs) found that CD163-positive TAMs were strongly linked to better survival, indicating potential as a clinical biomarker.
Finally, a predictive model including TME features showed that high CD4+ T cell levels reduced recurrence risk, while lymph node metastases, extracapsular spread, and perineural invasion increased it. Adding TME components did not outperform conventional models but may help guide more personalized treatment approaches.