The Prognostic Value of EGFR Amplifications in Head and Neck Squamous Cell Carcinoma

Objective: The epidermal growth factor receptor (EGFR) pathway plays a crucial role in head and neck squamous cell carcinoma (HNSCC) carcinogenesis, and alterations in this pathway have been explored as potential prognostic biomarkers. This study aimed to evaluate the prognostic role of nextgeneration sequencing (NGS)-defined EGFR amplification in HNSCC by analyzing data from large public datasets. Material and Methods: Individual patient-level data from two publicly available datasets (HNSC_TCGA and HNSC_MDAnderson_2013) were extracted from the cBioPortal database. A total of 567 HNSCC patients were included, with data on age, sex, primary tumor location, EGFR amplification status, TNM stage, surgical margins, extracapsular spread, and survival outcomes. Descriptive statistics and Kaplan-Meier survival analyses were conducted to evaluate the association between EGFR amplification and overall survival (OS). Results: EGFR amplification was present in 9.7% of the patients. Univariate analysis showed that patients with EGFR amplification had a significantly shorter OS (median OS 28.3 vs. 57.4 months, p=0.014). However, in multivariate analysis, EGFR amplification was not a significant predictor of OS after adjusting for other clinical factors (hazard ratio: 1.35, p=0.20). Other significant prognostic factors included extracapsular spread, age, stage, and surgical margin status. Conclusion: While our findings suggest a trend toward shorter OS in patients with EGFR amplification, this association did not reach statistical significance after adjusting for other clinical factors in multivariate analysis. Further research with larger cohorts is needed to clarify the role of NGS-defined EGFR amplification as a prognostic biomarker and improve treatment strategies in HNSCC.