Abstract

Salivary gland cancers (SGCs) are rare yet aggressive malignancies with significant histological heterogeneity, which has made prediction of prognosis and development of targeted therapies challenging. In majority of patients, local recurrence and/or distant metastasis are common and systemic treatments have minimal impact on survival. Therefore, identification of novel targets for treatment that can also be used as predictors of recurrence for multiple histological subtypes of SGCs is an area of unmet need. In this study, we developed a novel transgenic mouse model of SGC, efficiently recapitulating the major histological subtype (adenocarcinomas of the parotid gland) of human SGC. CDK2 knock out (KO) mice crossed with MMTV-low molecular weight forms of cyclin E (LMW-E) mice generated the transgenic mouse models of SGC, which arise in the parotid region of the salivary gland, similar to the common site of origin seen in human SGCs. To identify the CDK2 independent catalytic partner(s) of LMW-E, we used LMW-E expressing cell lines in mass spectrometric analysis and subsequent biochemical validation in pull down assays. These studies revealed that in the absence of CDK2, LMW-E preferentially binds to CDK5. Molecular targeting of CDK5, using siRNA, resulted in inhibition of cell proliferation of human SGCs overexpressing LMW-E. We also provide clinical evidence of significant association of LMW-E/CDK5 co-expression and decreased recurrence free survival in human SGC. Immunohistochemical analysis of LMW-E and CDK5 in 424 patients representing each of the four major histological subtypes of human salivary cancers (Aci, AdCC, MEC, and SDC) revealed that LMW-E and CDK5 are concordantly (positive/positive or negative/negative) expressed in 70% of these patients. The co-expression of LMW-E/CDK5 (both positive) robustly predicts the likelihood of recurrence, regardless of the histological classification of these tumors. Collectively, our results suggest that CDK5 is a novel and targetable biomarker for the treatment of patients with SGC presenting with LMW-E overexpressing tumors.

Highlights

  • Salivary gland cancers (SGCs) are rare malignancies with an incidence of 1/100,000 individuals in the United States

  • low molecular weight forms of cyclin E (LMW-E) binds more strongly to CDK2 compared to full-length cyclin E and is resistant to inhibition by CDK inhibitors (CKI)[16]

  • SGTs showed comparable number of mitotic figures, regardless of CDK2 status (Supplementary Fig. 1A). These results suggest that the development of salivary gland adenocarcinomas initiated by LMW-E in our transgenic mouse models is independent of CDK2 status

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Summary

Introduction

Salivary gland cancers (SGCs) are rare malignancies with an incidence of 1/100,000 individuals in the United States. Of the 30 subtypes, the most commonly encountered tumors in SGCs are mucoepidermoid (MEC, 45–70%)[3], adenoid cystic (AdCC, 10–22%)[4], acinic cell (Aci, 8–14%)[5], and salivary duct carcinoma (SDC, 5–10%)[3]. Each of these subtypes significantly differ in their histological patterns, clinical behavior, and genetic alterations[3,5,6,7], making SGCs a heterogeneous disease where standard staging parameters (tumor grade, TNM staging, etc.) have proved insufficient to predict prognosis and response to therapy. There is an unmet need for identifying biomarkers that can predict disease progression and be therapeutically targeted, in more than one histologic subtype of salivary gland cancers

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