Abstract 2280: HPV integration identifies emerging oncogenes and carcinogenic mechanisms, potentially indicating tumor recurrences

Abstract HPV integration events in Head and neck squamous cell carcinomas (HNSCC) are strongly associated with carcinogenesis and tumor progression. Previous studies have elucidated the mechanisms and structures of HPV-human fusion events, pinpointing potential integration “hotspots” (i. e. genes with nearby HPV integration in recurrent patients). However, none has comprehensively investigated the effects of HPV integration on both HPV and human gene expression, nor assessed the clinical implications of these bidirectional expression changes. In this study, we conducted bulk RNA sequencing on 67 Formalin-Fixed Paraffin-Embedded Oropharyngeal Squamous Cell Carcinoma (OPSCC) tumor samples from the University of Michigan hospital, and analyzed them in conjunction with bulk and single cell RNA-seq from another 200 HPV (+) HNSCC patients from four previous studies. Among the 117 samples confidently identified as HPV integration positive, we recaptured all previously known integration “hotspot” genes as well as several novel ones that have altered expression in the integrated samples. Exploring the impact of HPV integration on the expression of human and HPV genes, we found that HPV integration in HNSCC is strongly associated with keratinization, immune response, and the development of HPV (+) HNSCC subtypes. Upon HPV integration, expression of non-oncogenic HPV genes is often lost. We hypothesized that the expression ratio of these potentially HPV immunogenic genes (E1-E5, L1, L2) to the HPV oncogenic genes E6 and E7 (termed the ImmunOnco Score) would predict clinical outcomes. Survival analysis of 70 University of Michigan patients showed low ImmunOnco Score is associated with tumor recurrence. Citation Format: Shiting Li, Shaomiao Xia, Maria Lawas, Tingting Qin, Bailey Grab, Nisha D'Silva, Laura Rozek, Maureen Sartor. HPV integration identifies emerging oncogenes and carcinogenic mechanisms, potentially indicating tumor recurrences abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts) ; 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84 (6Suppl): Abstract nr 2280.