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Wisconsin scientists grow functional vocal cord tissue in the lab

Sat, Nov 21, 2015


Author: press release

Madison, Wisconsin – University of Wisconsin scientists have succeeded in growing functional vocal-cord tissue in the laboratory, a major step toward restoring a voice to people who have lost their vocal cords to cancer surgery or other injuries.

Dr. Nathan Welham, a speech-language pathologist, and colleagues from several disciplines, were able to bioengineer vocal-cord tissue able to transmit sound, they reported in a study published today in the journal Science Translational Medicine.

About 20 million Americans suffer from voice impairments, and many have damage to the vocal-cord mucosae, the specialized tissues that vibrate as air moves over them, giving rise to voice.

While injections of collagen and other materials can help some in the short term, Welham says not much can be done for people who have had larger areas of their vocal cords damaged or removed.

“Voice is a pretty amazing thing, yet we don’t give it much thought until something goes wrong,” says Welham, an associate professor of surgery in the UW School of Medicine and Public Health. “Our vocal cords are made up of special tissue that has to be flexible enough to vibrate, yet strong enough to bang together hundreds of times per second. It’s an exquisite system and a hard thing to replicate.”

Welham and colleagues began with vocal-cord tissue from a cadaver and four patients who had their larynxes removed but did not have cancer. They isolated, purified and grew the cells from the mucosa, then applied them to a 3-D collagen scaffold, similar to a system used to grow artificial skin in the laboratory.

In about two weeks, the cells grew together to form a tissue with a pliable but strong connective tissue beneath, and layered epithelial cells on top. Proteomic analysis showed the cells produced many of the same proteins as normal vocal cord cells. Physical testing showed that the epithelial cells had also begun to form an immature basement membrane which helps create a barrier against pathogens and irritants in the airway.

Welham says the lab-grown tissue “felt like vocal-cord tissue,” and materials testing showed that it had qualities of viscosity and elasticity similar to normal tissue.

To see if it could transmit sound, the researchers transplanted the bioengineered tissue onto one side of larynges that had been removed from cadaver dogs. The larynges were attached to artificial wind pipes and warm, humidified air was blown through them. Not only did the tissue produce sound, but high-speed digital imaging showed the engineered mucosa vibrating like the native tissue on the opposing side. Acoustic analysis also showed the two types of tissue had similar sound characteristics.

Finally, the researchers wanted to see if the tissue would be rejected or accepted by mice that had been engineered to have human immune systems. The tissue grew and was not rejected, performing equally well in mice that had the larynx-cell donor’s immune system (created via a blood donation from the larynx-cell donors) and mice with different human immune systems.

“It seems like the engineered vocal cord tissue may be like cornea tissue in that it is immunoprivileged, meaning that it doesn’t set off a host immune reaction,” Welham says, adding that earlier studies had also suggested this.

In one way, the tissue was not as good as the real thing: its fiber structure was less complex than adult vocal cords, but the authors said this was not surprising because human vocal cords continue to develop for at least 13 years after birth.

Welham says that vocal-cord tissue that is free of cancer is a rare commodity, so clinical applications will either require banking and expansion of human cells, or the use of stem cells derived from bone marrow or other tissues. Stem cells could be primed to differentiate into vocal-cord cells by exposing them to vibration and tensile forces in a “laryngeal bioreactor.” Such work is being pursued by other laboratories, including here at Wisconsin.

Clinical applications are still years away, but Welham says this proof-of-principle study is a “robust benchmark” along the route to replacement vocal-cord tissue. Moving this promising work forward requires more testing of safety and long-term function.

The lead researcher on the paper was associate scientist Changying Ling, a member of Welham’s lab in the division of otolaryngology in the UW School of Medicine and Public Health Department of Surgery. Other team members include:
Immunology expert Dr. Will Burlingham and graduate student Matthew Brown of the transplant division
Materials expert Dr. Sundaram Gunasekaran of the Department of Biological Systems Engineering
Proteomics expert Dr. Lloyd Smith and associate scientist Dr. Brian Frey of the Department of Chemistry
This work was supported by grants R01 DC004428 and R01 DC010777 from the National Institute on Deafness and Other Communication Disorders (NIDCD) and grant R01 AI066219 from the National Institute of Allergy and Infectious Diseases. M.E.B. was supported by training grant T32 GM081061 from the National Institute of General Medical Sciences; E.E.D. was supported by training grant T32 AQ10 DC009401 from the NIDCD. Flow cytometry was performed in the Flow Cytometry Laboratory of the University of Wisconsin Carbone Cancer Center, which is supported by grant P30 CA014520 from the National Cancer Institute.

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Head and neck cancer patients have higher suicide risk

Sat, Nov 21, 2015


Author: Shannon Aymes, MD

Suicide is the 10th leading cause of death in the United States.1 Those with cancer have almost twice the incidence of suicide, but patients with head and neck cancer were three times as likely to end their lives, according to a recent study.

Because large studies of suicide rates among patients with head and neck cancers had not been performed, Richard Chan Woo Park, MD, of the Department of Otolaryngology at Rutgers New Jersey Medical School in Newark, NJ, and colleagues looked at the suicide rate in this patient population with the goal to identify risk factors.

“By highlighting the increased risk of suicide in this population, especially site-specific risks, we hoped to alert clinicians to the need to look for signs of depression and suicidal ideation, and hopefully help patients get the psychiatric help that may save their lives,” Soly Baredes, MD, FACS, professor and chair of the Department of Otolaryngology at Rutgers New Jersey Medical School and coauthor of the paper wrote in an email to Cancer Therapy Advisor.

Investigators conducted a retrospective cohort study using data from 350 413 patients with head and neck cancer recorded in the Surveillance, Epidemiology, and End Results (SEER) program from 1973 to 2011.

They identified 857 suicides and calculated a 37.9 per 100 000 person-years suicide rate after adjusting for age, sex, and race. Using a suicide rate in the general United States population of 11.8 per 100 000 person-years, the standardized mortality ratio (SMR) was calculated to be 3.21 (95% CI: 2.18 – 4.23).

Although the rate of suicide trended down during the study period, the rate of suicide was higher in males and those with late stage disease. Higher suicide rates, though not statistically significant, were also found for white and unmarried patients.

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All ages don the blue lips for mouth cancer action month

Sat, Nov 21, 2015


Author: staff


Pupils from Iochdar Primary School in South Uist were more than happy to put on some blue lips to help raise awareness of Mouth Cancer Action Month.

So were Dr Bird and his staff from South Uist Medical Practice. Lochboisdale Dental Practice staff have been doing some outreach as part of a programme of events for Mouth Cancer Action Month, being run alongside the British Dental Health Foundation.

Dental practices throughout the Western Isles are raising awareness of the signs and symptoms of mouth cancer, as well as the risk factors, throughout the month of November. It is hoped that the national event will make a difference by saving lives through early detection and diagnosis. One of its main aims is to alert patients to what to look out for.

Don’t leave that ulcer unattended for more than three weeks. Don’t ignore that unusual lump or swelling or red and white patches in the mouth.

Dental staff took the opportunity to do some awareness raising when they were at Iochdar Primary School to carry out fluoride varnishing for children under the Childsmile programme.

Morag MacKinnon, Dental Therapist and Oral Health Improvement Co-ordinator at Lochboisdale, said of the visit: “We took the opportunity to make teachers and staff aware of the signs and symptoms of mouth cancer. We also explained to the children that when they come to the dentist we check their teeth but also their lips, tongues and cheeks

“They were delighted to pose for us with their blue lips.”

Information packs have been put together, with information on recognising symptoms of mouth cancer, and staff at South Uist Medical Practice received some of these, as well as being made aware of the ‘cancer research oral cancer toolkit’ – an online resource.

And, of course, the blue lips keep appearing. Where staff are wearing them they will be encouraging their patients to do so as well. To raise awareness further, they are being encouraged to take a picture and hit social media, with the hashtag #bluelipselfie.

NHS Western Isles encourage anyone with any concerns about mouth cancer to contact their local dental practice.

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Head, Neck Cancer Patients May Be at Higher Risk for Suicide: Study

Fri, Nov 13, 2015


Author: Robert Preidt

THURSDAY, Nov. 12, 2015 (HealthDay News) — Head and neck cancer patients may be at raised risk for suicide, new research suggests.

However, the overall risk is still small, the findings showed.

The study included over 350,000 patients in the United States diagnosed with head and neck cancer between 1973 and 2011. Of those patients, 857 died by suicide.

The investigators found that the suicide rate among head and neck cancer patients was three times higher than in the general population. And suicide rates were higher among patients treated with radiation alone compared to surgery alone.

Suicide rates were highest among those with cancers of the lower part of the throat, including the larynx (“voice box”) and hypopharynx, at five times and 12 times higher, respectively, than in the general population.

“This may be linked to these anatomic sites’ intimate relationship with the ability to speak and/or swallow. Loss of these functions can dramatically lower patients’ quality of life,” Dr. Richard Chan Woo Park, of Rutgers New Jersey Medical School, and colleagues wrote.

“It is possible that the increased rates of tracheostomy [breathing tube] dependence and dysphagia [difficulty swallowing] and/or gastrostomy [feeding] tube dependence in these patients are . . . factors in the increased rate of suicide observed,” the authors added.

The study was published online Nov. 12 in the journal JAMA Otolaryngology–Head & Neck Surgery.

“While there is a considerable body of research that examines survival outcomes for patients with head and neck cancer, additional research and effort should also be devoted to the psychological toll that the cancer, treatments and resulting morbidity have on patients,” the researchers concluded.

Suicide is the 10th leading cause of death in the United States and cancer patients are at increased risk for suicide, the study authors pointed out in a journal news release.

More information

The American Cancer Society offers resources on coping with cancer.

Copyright © 2015 HealthDay. All rights reserved.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

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FDA Clears First Tobacco Product for Marketing

Thu, Nov 12, 2015


For the first time since it was given the power to regulate tobacco, the US Food and Drug Administration (FDA) has authorized marketing of a new product.

The agency said that eight new smokeless snus products, to be sold in the United States under the “General” brand name by Stockholm-based Swedish Match AB, are now authorized under the premarket tobacco application pathway, which was established by the 2009 Family Smoking Prevention and Tobacco Control Act. Snus cannot be marketed as “FDA-approved,” however.

“Today’s action demonstrates that the premarket tobacco application process is a viable pathway under which products can be marketed, as long as the public health can be protected,” said Mitch Zeller, director of the FDA’s Center for Tobacco Products, in a statement.

This is the first time any tobacco maker has completed the rigorous premarket tobacco application review process at the agency; others have had products approved by proving they are substantially equivalent to what is already on the market.

The agency said that Swedish Match provided evidence that “these products would likely provide less toxic options if current adult smokeless tobacco users used them exclusively.” The agency also agreed with the company that snus’ availability would not result in substantial new use, delay quit attempts, or attract ex-smokers.

Swedish Match had been seeking separately to remove warnings that snus is harmful, but the agency has not yet ruled on that request.

In that separate application, Swedish Match was seeking to have the 10 types of snus it already sells in the United States designated as modified-risk tobacco products. The agency accepted the company’s application in August 2014 and held a meeting of its advisory panel to review the evidence in April 2015.

The company wanted to remove warnings that snus could cause gum disease and tooth loss or mouth cancer. It also sought to label its products with the statement that reads, “No tobacco product is safe, but this product presents substantially lower risks to health than cigarettes.” The advisory committee could not reach consensus on whether snus was a safer alternative to smoking, and also was not convinced that the product would not attract new users. At that meeting, Dennis Henigan, director of legal and policy analysis for the Campaign for Tobacco-Free Kids, said Swedish Match had failed to show that users would not use both cigarettes and snus, or that young people would not initiate use.

Snus, which is ground tobacco, salt, and water, comes in a pouch that users place under their upper lip. It can be used for up to 30 minutes, according to the company. It is popular in Sweden, but less so in the United States. Swedish Match says its General brand accounts for 11% of American convenience store snus sales. The 60 million cans it sells annually in the United States are dwarfed by the billion cans of smokeless tobacco sold.

The Centers for Disease Control and Prevention estimates that less than 4% of adults use smokeless tobacco, with rates highest among men aged 18 to 25 years (10%). A 2014 Centers for Disease Control and Prevention survey of high school students found that 5.5% of overall used smokeless tobacco, and an additional 1.9% reported current use of snus.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

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A cancer on the rise, and the vaccine too late for Gen X

Thu, Nov 5, 2015


Author: Martha Shade

(CNN)The vaccine given to prevent cervical cancer in women could end up saving men’s lives, too.

Evidence is mounting that the HPV vaccine is also effective in preventing other HPV-related cancers, including those of the head and neck. Although most people who get HPV do not develop cancer, rates of HPV-related head and neck cancers are dramatically rising for men aged 40 to 50, according to Dr. Maura L. Gillison, the Jeg Coughlin Chair of Cancer Research at the Ohio State University Comprehensive Cancer Center.

When Gillison recently gave a presentation showing the increasing rate of HPV-related head and neck cancer among men, her audience was shocked. “I’ve never shown a slide where the audience gasps,” she said.

Related: Yes, oral sex can lead to cancer

“The risk of getting this cancer is strongly related to when you were born. If you are currently a 40- to 45-year-old man, your risk of getting this cancer is dramatically higher than a 40- to 45-year-old man three or four decades ago,” Gillison said.

Today’s 40- to 50-year-old men have had more sexual partners and have engaged in more oral sex than previous generations, according to experts, significantly raising their risk of an HPV-related head and neck cancer.

Actor Michael Douglas made headlines in 2013 when he announced he was battling an HPV-related cancer and that he got it from performing oral sex. Douglas was 68 when he was diagnosed, but many of the men being diagnosed with these HPV-related cancers are much younger.

What’s a Gen X’er to do?

HPV is usually acquired when young. It can lay dormant, and most oropharyngeal cancer (a type of head and neck cancer) is diagnosed decades later, beginning around age 40 to 50. And the more partners you have, the greater your risk.

HPV vaccines weren’t recommended and approved in the United States until 2006. And the vaccine was not even recommended for boys until 2011.

So what’s an aging Gen X’er to do?

“You’re starting to get colonoscopies; you’re starting to get checked for prostate cancer. This is one more thing to add to that list that you really have to watch for,” said Brian Hill, founder of the Oral Cancer Foundation.

Warning signs of HPV-related head and neck cancer

• Persistent lump on neck

• Persistent earache on one side

• Swelling or lump in the mouth

• Chronic sore throat

• Difficult or painful swallowing

• Change in voice

Source: Oral Cancer Foundation, Dr. Carole Fakhry

Symptoms of HPV-related head and neck cancer include a change in voice, a sore throat that doesn’t go away, an earache on one side and difficult or painful swallowing.

Hill’s story is typical: His doctors initially assumed he had an enlarged lymph node due to an infection. Two doctors gave him antibiotics before he was diagnosed with late-stage oropharyngeal cancer. His experience led him to form the Oral Cancer Foundation.

Finding the disease at an early stage is lifesaving. When it’s diagnosed early, these HPV-related cancers are survivable, according to Dr. Carole Fakhry of the Johns Hopkins Head & Neck Cancer Center. “If you have a lump in your neck, make sure to get checked.

“A very common story is: ‘I was shaving and I noticed this lump in my neck,” she said. “And he goes through two or three rounds of antibiotics and then someone finally thinks about cancer.”

‘Dental hygienists are becoming the best screeners’

Traditionally, cancers of the head and neck were often linked to alcohol or smoking, and these non-HPV cancers tend to be located at the front of the mouth and the voice box. Incidence of these cancers are dropping.

“The truth of the matter is that smoking-related cancers are declining,” Fakhry said. “On the other hand, cancers related to HPV are increasing.”

HPV-related cancers usually originate in the back of the mouth. “Most of these cancers are tonsils and back-of-tongue cancers,” she said. “Tonsils are basically these crypts, and tumors grow deep within these crypts, so these tumors can be hard to find.”

Since tumors are often hidden, dentists and dental hygienists are becoming the first line of attack. Men may also be more likely to visit a dentist regularly than a doctor, according to Hill.

“Dental hygienists are becoming the best screeners for this. They’re becoming the point at the end of the spear when it comes to screening and finding abnormalities,” he said.

Dentists and hygienists are encouraged to look for telltale signs of HPV-related cancer: asymmetrical or swollen tonsils, or a lesion in the back of the throat. But these cancers are notoriously tough to spot and tend to be diagnosed after patients develop a lump in the neck.

So what can you do?

“Make sure you get your kids vaccinated (for HPV),” Fakhry said.

Dr. Dan Beachler, lead author of a new study that found further evidence the HPV vaccine protects against multiple types of HPV-related cancers, agrees: “We still don’t know that much about oral HPV. Primary prevention through vaccination might have the most potential.”

Besides the cervix and the head and neck, some strains of HPV can also lead to cancer of the anus, penis and vulva.

A preventive HPV vaccine is most effective when given to children before they become exposed to HPV. The three dose series is recommended at age 11 or 12.

Initially recommended just for girls, the Centers for Disease Control and Prevention now recommends that boys be vaccinated, too. In addition, vaccination is recommended through the age of 26 in women and through age 21 in men who were not vaccinated previously.

“Young people do not avoid oral sex. That being a given, the best thing we can do is increase the vaccination rate. The second thing we can do is be highly aware of signs and symptoms,” Hill said.

And don’t panic. Although HPV-related cancers are on the rise, they’re still uncommon.

“Even though the rates are dramatically increasing, it’s still a relatively rare cancer. We don’t want to create a panic. We just want to raise awareness,” Gillison said.

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Smoking with a hookah or linked to serious oral problems

Thu, Nov 5, 2015


Author: staff

Many people who use a hookah to smoke tobacco think it is a safer way to smoke and that they are reducing their risk. Not so. A new study suggests that using a hookah is associated with serious conditions of the mouth, head, and neck.


Researchers from Rutgers University in New Jersey analyzed 20 published studies that focused on the use of a hookah or water pipe. Ten of the articles pertained to the problems in the mouth, seven to head and neck cancer, and three to problems with the larynx and middle ear.

They found that using a hookah is associated with greater amounts of inflammation, gum diseases, a dental condition called dry socket, premalignant lesions, oral cancer, and cancer of the head, neck, and esophagus. It was also associated with a greater incidence of oral infections by the organism Candida, with swelling of the vocal cords, and a lower vocal pitch.

The number of people who use a hookah or water pipe-also called an argilah or hubbly-bubbly-has risen worldwide in the past few years. To use these devices, people place tobacco into a bowl on the top of the pipe and light it. The tobacco smoke is passed through a container of water before it is inhaled. Often, the tobacco used in a hookah is heavily flavored with sweeteners such as molasses or honey and other favors.

According to the World Health Organization, a typical session of smoking using a hookah lasts up to an hour, during which a smoker inhales 100 to 200 times the amount of smoke inhaled from one cigarette. Despite this, many people believe that filtering the smoke through water somehow makes it less harmful than cigarettes.

The study appeared in the Journal of the American Dental Association. “This study sheds light on the common misconception that smoking from a water pipe is somehow safer than smoking a cigarette,” said journal editor Michael Glick, DMD in a statement. “Whether you are smoking a cigarette, an e-cigarette, a cigar, or tobacco from a water pipe, smoking is dangerous not only to your oral health but to your overall health.”

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Follow-up by advance practice nurses improves care for patients with head, neck cancer

Tue, Nov 3, 2015


Author: Anthony SanFilippo

The launch of an advance practice nurse outpatient follow-up clinic improved symptom management for high-risk patients with head and neck cancer following radiation therapy, according to findings from a study conducted at Cleveland Clinic. This initiative led to fewer ED visits and hospital admissions, results showed.

“These results are significant as they suggest more intensive follow up in high-risk head and neck patients can improve patient outcomes,” Bridgett Harr, CNP, of the department of radiation oncology at Cleveland Clinic, told HemOnc Today. “This intensive symptom management is an important role [advance practice nurses (APNs)] can fill in this and other patient groups by providing consistent, proactive management of symptoms during recovery from treatment. Our study suggests this will lead to improved patient experience, in addition to a reduction in cost to both the patient and health care system as a whole.”

Patients with head and neck cancer often undergo radiotherapy or chemoradiotherapy, and many experience debilitating side effects that require ED management or admission to the hospital. In 2014, an APN-led clinic was launched to focus on the acute rehabilitation of patients with head and neck cancer undergoing these therapies.

Harr and colleagues sought to evaluate the outcomes and incidence of adverse events among patients treated at an APN clinic compared with historical outcomes.

The analysis included data from 25 high-risk patients with head and neck cancer who received care post-treatment at an APN clinic and 24 patients who received standard follow-up care identified using a database. Clinic patients were seen 2 to 4 weeks after treatment and then every 2 to 4 weeks thereafter until their symptoms stabilized. Standard follow-up patients were seen on average between 4 to 6 weeks after treatment and then not again until 3 months post-treatment.

Patients were considered high risk if they had limited social support (35%), resided in a nursing home (16%), required multiple hydrations during treatment (18%), underwent stereotactic body re-irradiation (15%) and/or required a feeding tube (16%).

Ninety percent of patients had stage IV or recurrent cancer. Primary tumor sites included oropharynx (47%), oral cavity (16%), larynx/hypopharynx (12%) and other (25%).

All patients underwent stereotactic body radiation therapy or intensity-modulated radiation therapy. Fifty-five percent of the patients received chemoradiotherapy with either a cisplatin-based regimen (81%) or cetuximab (19%), and 45% of the patients received radiation therapy alone.

Patients in the APN clinic were seen almost twice as often as those in the standard follow-up group (median, 2 vs. 1.2 visits).

Eighteen patients experienced 26 adverse events that required either a visit to the ED or hospital admission. Six of those patients (33%) were seen in the APN clinic, whereas 12 patients (67%) were from the standard follow-up cohort.

“Not only is there greater patient satisfaction when being managed in an outpatient setting, it is more cost-effective to avoid emergency room or hospital admissions,” Harr said in a press release.

The benefits of the APN clinic appeared more substantial among patients who received radiation alone. Significantly fewer patients treated only with radiation who received their follow-up care at the APN clinic experienced an adverse event in the 90 days immediately after radiation compared with patients who received standard follow-up (60% vs. 16.7%; P = .01).

Researchers observed no difference between the arms for patients who underwent chemoradiotherapy because standard follow-up is also intensive, according to the researchers.

“This study illustrates an important role for APNs in radiation oncology,” Harr said. “APNs are in a unique position to provide more intensive follow-up care, allowing them to better manage the post-treatment symptoms of high-risk head and neck cancer patients.”

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New research opens door to understanding human tonsil cancer

Tue, Nov 3, 2015


Author: staff

Researchers at Simon Fraser University and the BC Cancer Agency have developed a groundbreaking method to identify and separate stem cells that reside in the tonsils. Their research, which sheds new light on the fight against oral cancer, is published today in the journal Stem Cell Reports.

While stem cells in many other body tissues have been well studied, little is known about these stem cells, says researcher Catherine Kang, a PhD student in the Department of Biomedical Physiology and Kinesiology and lead author of the paper. Ninety per cent of human tonsil cancers show evidence of HPV (human papillomavirus) infection. But little is known about its role in causing these cancers. Researchers suspect it is a key player, as HPV is the major risk factor for cervical cancer.

Kang, who is working with BPK professor Miriam Rosin, director of the BC Oral Cancer Prevention Program, and UBC professor Connie Eaves of the Terry Fox Laboratory, was interested in finding out why the tonsil is particularly susceptible to HPV and wondered if it might have something to do with the stem cells of the tissue that coats the tonsils.

When she purified these cells and made them incorporate a cancer-causing gene normally transmitted by HPV, the cells grew abnormally in a special tissue culture system, and created what one might imagine what the beginning stages of human tonsil cancer would look like.

“This is a very exciting finding, as it is the first stage of human cancer development that researchers need to learn how to detect and eliminate,” says Kang. The study shows how it can now be done and then studied at will in a petri dish using cells isolated directly from human tonsils.

Cancer of oropharynx, or the tonsils in particular, is an important health concern with rising incidence worldwide, especially in men. The researchers, including Dr. Raj Kannan of the BC Cancer Agency’s Terry Fox Laboratory, say this new method will now allow these next steps to go forward not just here, but around the world, to stop this global trend in its tracks.

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Why groundbreaking new cancer drugs still don’t work for most patients

Fri, Oct 30, 2015


Author: Brady Dennis


Immunotherapy, which aims to harness the body’s immune system to fight off certain cancers, has received plenty of attention, praise and investment in recent years. Breakthrough treatments for melanoma and other cancers have shown startling results, giving some patients months and often years of life they almost certainly would not otherwise have had.

Yet, for all their promise, immune therapies have not produced such dramatic results for the majority of patients. The same drug that causes metastatic melanoma to vanish in one patient might have no effect on another. At best, only one or two patients out of five will respond to immunotherapy treatments — remarkable numbers compared to past standards, but still far lower than anyone would like.

New research published Monday in the journal Nature explores the molecular mechanisms that prevent immunotherapy drugs from working in some patients, and researchers hope the findings will help make the treatments more effective over time.

In short, the researchers studied why certain tumors were able to evade immune therapies designed to unleash the body’s defenses to fight cancer. They noted that tumors with a high concentration of “T cells,” a type of white blood cell essential to the human immune system, were more responsive to the treatments. Tumors with a low number of T cells inside what researchers call the “cancer microenvironment” were far less responsive to the new drugs.

“The tumors are acting to protect themselves,” said Weiping Zou, a senior author of the study and a professor of surgery, immunology and biology at the University of Michigan’s medical school. “If the T cells cannot get in, they have no way to kill the tumors.”

Using human and mouse models of ovarian cancer cells, he and other scientists experimented with specific drugs aimed at helping generate more T cells within a tumor, so that it would then be more responsive to immunotherapy. Although it’s early, the approach seems to have promise.

Immune therapies have rapidly become a pillar of cancer treatment in recent years, and numerous trials are underway in hopes of expanding the successes to bladder cancer, breast cancer, Hodgkin’s lymphoma, head and neck tumors, and other types of the disease. Researchers also are testing the new drugs in combination with one another and with other therapies.

The main obstacle has been the realization that some cancers have proved less susceptible to immune therapies, and some patients have fared far better than others. If researchers such as Zou and his colleagues can engineer ways to make game-changing immune therapies effective in more patients, that would be a game-changing feat.

“How can we make the responders more responsive, and make the non-responders become responders?” Zou said. “That’s the whole goal.”

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