LAUSR

Current frontline chemotherapy and radiotherapy for head and neck cancer (HNC) is insufficient as ~60% of patients relapse within two years, indicating a need to identify novel targeted therapies to improve survival outcomes for HNC patients. Human papilloma virus (HPV) incidence is a major cause of head and neck squamous cell carcinoma (HNSCC) in addition to tobacco use. HPV- HNSCC patients are less responsive to frontline treatment than HPV+ HNSCC patients. However, HPV- and HPV+ HNSCC patients are treated similarly. The cell cycle serine-threonine kinase polo-like kinase 1 (Plk1) is known to be overexpressed in HNC. The Cancer Genome Atlas (TCGA) revealed that high expression of Plk1 correlates with worse survival in HNSCC patients (p<0.05). Yet, Plk1 is expressed at similar levels when comparing HPV- and HPV+ HNSCC patients. Therefore, in this study we sought to establish if Plk1 inhibition with onvansertib (currently in Phase I/II clinical trials) alone and in combination with radiation would inhibit HPV- and HPV+ HNSCC growth. We used two HPV+ (UMSCC47, UDSCC2), and two HPV- (HN5, Cal27) human HNSCC cell lines. First, we confirmed that Plk1 inhibition with onvansertib stalls HNSCC cells at the G2/M phase of the cell cycle (n=3). Then, we determined that HNSCC cell viability is reduced in a dose-dependent manner after Plk1 inhibition with onvansertib. Surprisingly, HPV- HNSCC cells exhibited a 2-fold decrease in cell viability as compared to HPV+ HNSCC cells (n=3). These findings were confirmed when assessing 3D spheroid growth of HNSCC cells. Plk1 inhibition with onvansertib (25nM) reduced HPV- HNSCC spheroid growth more than HPV+ (n=2). Combining Plk1 inhibition with radiation also reduced colony formation (n=3, p<0.0001) and increased G2/M stalling (n=3) compared to either single agent in HPV- HNSCC cells. Functionally, onvansertib induces cleaved PARP and pPlk1 expression in HNSCC cells. However, pPlk1 is induced to a higher degree in HPV+ HNSCC cells potentially indicating a positive feedforward loop leading to decreased sensitivity to Plk1 inhibition. In HPV- but not HPV+ HNSCC cells, Plk1 expression is also increased after radiation emphasizing Plk1 as an attractive target to mitigate radioresistance in HPV- HNSCCs (n=3). Our findings that HPV+ HNSCC cells are more resistant to Plk1 inhibition than HPV- HNSCC cells provides novel mechanistic insight into these disease subtypes. As HPV- HNSCC is typically more resistant to standard therapies, these results support a novel combinatorial approach using an already approved Plk1 inhibitor with radiation to improve HPV- HNSCC patient outcomes. Citation Format: Julianna Korns, Samuel Thompson, Trisha Wise-Draper, Vinita Takiar. Plk1 signaling as a therapeutic target for HPV- head and neck cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2832.