LAUSR

OBJECTIVE Head and neck squamous cell carcinoma (HNSCC) is an aggressive cancer associated with poor survival. Phosphatase and tensin homolog (PTEN) is a tumor suppressor gene involved in the maintenance of stem cells. DNA methylation is a known epigenetic modification involved in tumor progression. In this study, we investigated the effect of the DNA demethylation agent 5-AZA-2'-deoxycytidine (5-AZA) over HNSCC and its population of cancer stem cells (CSCs) presenting dysfunctional PTEN. STUDY DESIGN The effects of 5-AZA on HNSCC were evaluated by using WSU-HN13 cells. CSC was assessed by sphere-forming assays, along with the endogenous levels of aldehyde dehydrogenase. The clonogenic potential of tumors was evaluated, along with the protein expression of mTOR signaling and the identification of nuclear factor-κB (NF-κB) and epithelial-mesenchymal transition (EMT)-associated genes, using real-time polymerase chain reaction (PCR). RESULTS We observed that loss of PTEN enhances tumor biologic behavior, including colony- and tumor sphere-forming abilities. We also found that 5-AZA has an inhibitory effect over the CSCs and molecular markers associated with the NF-κB and EMT pathways. CONCLUSIONS Our findings suggest that the stratification of treatment of HNSCC based on PTEN status may identify a subset of patients who can benefit from the coadministration of 5-AZA.