Abstract 1130: Race and sex differences in TP53 mutation in head and neck cancer

Abstract Importance: Head and neck cancer (HNC) is one of the most disparate cancers, with the Black vs. White survival difference being the third worst survival gap of all cancers. It is also a male-dominated cancer, with up to 75% of new cases in males. There remains several gaps in our understanding of the genetic basis for race and sex disparity in HNC, including paucity in characterizing differences in common genetic mutations in HNC, such as TP53 mutations. Objective: To characterize the genetic differences in HNC by race and sex through 1) examining prevalence of TP53 mutation by race, and 2) differences in mutation by sex. Design: Retrospective cohort study. Setting: The AACR GENIE consortium level v17.4 dataset for patients with confirmed diagnosis of HNC, independent of HPV status. Main Outcomes and Measures: First, we estimated the rate of TP53 mutation in our HNC cohort (n = 2, 352). We also estimated relative risk (RR) for TP53 mutation by race, and then adjusted age, and sex. We also estimated differences in TP53 mutation by sex, reporting false discovery (q-value) rate as appropriate. Finally, we estimated adjusted hazard ratio for mortality for TP53, adjusting for clinical and nonclinical variables in the model. Results: In the entire cohort, the rate of TP53 mutation was 48.7%. However, there were only 109 patients in our cohort of 2, 352 patients that self-identified as Black patients, and among these, 60 (55.1%) had TP53 mutation. After adjusting for age and sex, compared to White patients, we found aRR for TP53 = 1.17 for Black patients (95% CI: 0.98, 1.39), and for other minority race and ethnic groups together aRR = 1.17 (95% CI: 1.06, 1.29). By sex, we found a significantly higher prevalence of mutant TP53 in female vs. males patients (57.8% vs. 45.3%, q-value <0.0001). TP53 mutation was associated with significantly increased hazard of mortality (aHR = 1.58; 95% CI: 1.30, 1.91). Conclusion and Relevance: TP53 mutation is very common in HNC, and about one out of every two patients with HNC may have a TP53 mutation based on our results. There may be differences in TP53 mutations in HNC by race and sex, an important finding given the mortality implications of TP53 mutations in HNC. Citation Format: Nosayaba Osazuwa-Peters, May Z. Gao, Tammara L. Watts, Rong Jiang. Race and sex differences in TP53 mutation in head and neck cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 1130.