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NOTCH1 acts as a tumor suppressor that induces early differentiation in head and neck cancer
Chenfei Huang, Shhyam Moorthy, Qiuli Li, Kazi M. Ahmed, Kalil Saab, Defeng Deng, Jiping Wang, Xiayu Rao, Jiexin Zhang, Yuanxin Xi, Jing Wang, Zhiyi Liu, Noriaki Tanaka, David A. Wheeler, Eve Shinbrot, Rami Saade, Curtis R. Pickering, Tong-Xin Xie, Adel K. El-Naggar, Abdullah A. Osman, Kunal Rai, Patrick A. Zweidler-McKay, John V. Heymach, Lauren A. Byers, Faye M. Johnson, Vlad C. Sandulache, Jeffrey N. Myers, Pedram Yadollahi, Mitchell J. Frederick
Chenfei Huang, Shhyam Moorthy, Qiuli Li, Kazi M. Ahmed, Kalil Saab, Defeng Deng, Jiping Wang, Xiayu Rao, Jiexin Zhang, Yuanxin Xi, Jing Wang, Zhiyi Liu, Noriaki Tanaka, David A. Wheeler, Eve Shinbrot, Rami Saade, Curtis R. Pickering, Tong-Xin Xie, Adel K. El-Naggar, Abdullah A. Osman, Kunal Rai, Patrick A. Zweidler-McKay, John V. Heymach, Lauren A. Byers, Faye M. Johnson, Vlad C. Sandulache, Jeffrey N. Myers, Pedram Yadollahi, Mitchell J. Frederick
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Research Article Cell biology Oncology

NOTCH1 acts as a tumor suppressor that induces early differentiation in head and neck cancer

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Abstract

Inactivating NOTCH1 mutations in head and neck squamous cell carcinoma (HNSCC) were described over a decade ago, suggesting a tumor suppressor function — unlike its oncogenic role in other tumors. Today, much debate persists regarding a putative oncogenic role in HNSCC as well, with reports that NOTCH1 signaling drives tumor growth and a cancer stem cell (CSC) phenotype. In this work, comprehensive experiments unequivocally demonstrate that NOTCH1 is a tumor suppressor in HNSCC regardless of mutation or activation status and that it reduces CSC frequency. We developed a signature of NOTCH1 activation showing the pathway is associated with very early differentiation, an altered tumor microenvironment, and better prognosis. Clarifying whether NOTCH1 occasionally functions as an oncogenic driver in HNSCC is crucial to prognosis and personalized therapy. The results presented unify the field, reconcile conflicting data, and provide critical insights into the biological and clinical significance of NOTCH1, with broader implications in other squamous carcinomas with NOTCH1 mutations.

Authors

Chenfei Huang, Shhyam Moorthy, Qiuli Li, Kazi M. Ahmed, Kalil Saab, Defeng Deng, Jiping Wang, Xiayu Rao, Jiexin Zhang, Yuanxin Xi, Jing Wang, Zhiyi Liu, Noriaki Tanaka, David A. Wheeler, Eve Shinbrot, Rami Saade, Curtis R. Pickering, Tong-Xin Xie, Adel K. El-Naggar, Abdullah A. Osman, Kunal Rai, Patrick A. Zweidler-McKay, John V. Heymach, Lauren A. Byers, Faye M. Johnson, Vlad C. Sandulache, Jeffrey N. Myers, Pedram Yadollahi, Mitchell J. Frederick

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Figure 5

Comparison of genes regulated by NOTCH1 in vitro and genes differentially expressed in primary HNSCC tumors with a NOTCH1 activation signature.

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Comparison of genes regulated by NOTCH1 in vitro and genes differentiall...
(A) Consensus hierarchical clustering of TCGA OCSCC primary tumors based on a 95-gene NOTCH1 activation signature identified a cluster of patient tumors (Cluster 2, N = 57) with an expression pattern indicative of active NOTCH1 signaling and another cluster (Cluster 1, N = 255) predicted to have loss of NOTCH1 signaling. Genes are annotated with vertical boxes according to whether they were upregulated (red) or downregulated (blue) by JAG1 in vitro. Samples with a NOTCH1 mutation are annotated horizontally with a black box and association between NOTCH1 mutation status and cluster for patients with sequencing information was analyzed by χ2 analysis. (B) Parallel clustering and analysis of TCGA LHSCC primary tumors using the same 95-gene NOTCH1 signature. (C) Venn diagram illustrating overlap of genes upregulated (FDR < 0.1, |fold change| ≥ 1.25) by NOTCH1 in vitro (JAG_up), the subset of upregulated genes part of the NOTCH1 signature (Sig_up), and genes upregulated (FDR < 0.1, |fold change| ≥ 1.25) in Cluster 2 from OCSCC or LHSCC. (D) Venn diagram illustrating overlap of genes downregulated (FDR < 0.1, |fold change| ≥ 1.25) by NOTCH1 in vitro (JAG_down), the subset of downregulated genes part of the NOTCH1 signature (Sig_down), and genes downregulated (FDR < 0.1, |fold change| ≥ 1.25) in Cluster 2 from OCSCC or LHSCC.

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