Monthly Archives: July 2012

Stem cell therapy could offer new hope for defects and injuries to head, mouth

Source: www.newswise.com

In the first human study of its kind, researchers found that using stem cells to re-grow craniofacial tissues—mainly bone—proved quicker, more effective and less invasive than traditional bone regeneration treatments.

Researchers from the University of Michigan School of Dentistry and the Michigan Center for Oral Health Research partnered with Ann Arbor-based Aastrom Biosciences Inc. in the clinical trial, which involved 24 patients who required jawbone reconstruction after tooth removal.

Patients either received experimental tissue repair cells or traditional guided bone regeneration therapy. The tissue repair cells, called ixmyelocel-T, are under development at Aastrom, which is a U-M spinout company.

“In patients with jawbone deficiencies who also have missing teeth, it is very difficult to replace the missing teeth so that they look and function naturally,” said Darnell Kaigler, principal investigator and assistant professor at the U-M School of Dentistry. “This technology and approach could potentially be used to restore areas of bone loss so that missing teeth can be replaced with dental implants.”

William Giannobile, director of the Michigan Center for Oral Health Research and chair of the U-M Department of Periodontics and Oral Medicine, is co-principal investigator on the project.

The treatment is best suited for large defects such as those resulting from trauma, diseases or birth defects, Kaigler said. These defects are very complex because they involve several different tissue types—bone, skin, gum tissue—and are very challenging to treat.

The main advantage to the stem cell therapy is that it uses the patient’s own cells to regenerate tissues, rather than introducing man-made, foreign materials, Kaigler said.

The results were promising. At six and 12 weeks following the experimental cell therapy treatment, patients in the study received dental implants. Patients who received tissue repair cells had greater bone density and quicker bone repair than those who received traditional guided bone regeneration therapy.

In addition, the experimental group needed less secondary bone grafting when getting their implants.

The cells used for the therapy were originally extracted from bone marrow taken from the patient’s hip. The bone marrow was processed using Aastrom’s proprietary system, which allows many different cells to grow, including stem cells. These stem cells were then placed in different areas of the mouth and jaw.

Stem cell therapies are still probably 5-10 years away from being used regularly to treat oral and facial injuries and defects, Kaigler said. The next step is to perform more clinical trials that involve larger craniofacial defects in a larger number of patients.

The study, “Stem cell therapy for craniofacial bone repair: A randomized, controlled clinical trial,” appears this month in the journal Cell Transplantation.

Source: University of Michigan

Aspirin Protects Against Barrett’s Esophagus, Study Suggests

Source: ScienceDaily.com

Aspirin use appears to reduce the risk of Barrett’s esophagus (BE), the largest known risk factor for esophageal cancer, according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal of the American Gastroenterological Association.

“The protective effect of aspirin use appears robust because the analyses suggests a dose-response relationship in which high-dose aspirin was significantly associated with decreased Barrett’s esophagus risk,” said Chin Hur, MD, MPH, of the Massachusetts General Hospital Institute for Technology Assessment and lead author of this study. “It would not be advisable at this time for patients to start taking aspirin, particularly at higher doses, if preventing Barrett’s esophagus is the only goal. However, if additional data confirms our findings and an individual at high risk for development of Barrett’s esophagus and esophageal cancer also could derive additional benefits, most notably cardiovascular, aspirin could be a consideration.”

Dr. Hur and his team of researchers analyzed characteristics of 434 BE patients for factors that might be used in screening and management. In addition to finding that those taking aspirin were 44 percent less likely to have BE, they also found that men were more than three times more likely to develop BE than women.

The incidence of esophageal cancer has been increasing at an alarming rate during the past few decades; current attempts at targeted screening for this type of cancer focus on identifying BE. Nonsteroidal anti-inflammatory drugs (NSAIDs), particularly aspirin, have been associated with reduced esophageal cancer incidence. Although there have been many studies analyzing NSAID and aspirin chemoprevention for esophageal cancer or BE progression to this cancer, few have explored NSAIDs for BE prevention.

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

July, 2012|Oral Cancer News|

The Impact of Timing of EGFR and IGF-1R Inhibition for Sensitizing Head and Neck Cancer to Radiation

Source: AntiCancer Research

Abstract

Background: Targeting the epidermal growth factor receptor (EGFR) improved radiotherapy outcome by 10-15% in head and neck tumors (HNSCC). We tested the therapeutic benefits of co-targeting EGFR and insulin-like growth factor-1 receptor (IGF-1R) to further enhance tumor response to radiation. Materials and Methods: Mice bearing FaDu tumor xenografts were treated with ganitumab (previously known as AMG479, an anti-IGF-1R antibody), panitumumab (an anti-EGFR antibody), or both in combination with fractionated doses of radiation. Tumor growth delay and tumor cure/recurrence served as end-points. Results: The best tumor growth delay was achieved when ganitumab and panitumumab were given concurrently with radiation. Tumor cure/recurrence studies showed that combining ganitumab, panitumumab and radiation resulted in significantly higher radiocurability rates than use of either of the agents given with radiation. Conclusion: These findings provide the rationale for clinical testing of the combination of ganitumab and panitumumab for the treatment of HNSCC.

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

July, 2012|Oral Cancer News|

Oral Cancer in Swedish Snuff Dippers

Source: Anticancer Research

Abstract

Over recent decades there has been debate over whether or not Swedish snuff is carcinogenic in humans. Animal studies and molecular biological and experimental studies have shown the carcinogenic potential of Swedish snuff, but this has not been proved in prospective randomized studies. We present a case series of patients with oral squamous cell carcinomas diagnosed at the sites where the patients had used Swedish snuff for several years. Sixteen male patients were referred to and treated at Oral and Maxillofacial Surgery Departments and Ear, Nose and Throat clinics at seven different hospitals in Sweden. The mean age of the patients at the time of diagnosis was 72.9 years and the mean time of snuff use prior to cancer diagnosis was 42.9 years. This case series shows that Swedish snuff may not be a harmless alternative to smoking.

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

July, 2012|Oral Cancer News|

Maura L. Gillison, M.D., Ph.D., Receives AACR’s Richard Hinda Rosenthal Memorial Award for her HPV research

CHICAGO — The American Association for Cancer Research  awards Maura L. Gillison, M.D., Ph.D., with the 36th Annual AACR Richard and Hinda Rosenthal Memorial Award during the AACR Annual Meeting 2012. Gillison is receiving this award in recognition of her significant contributions to the understanding of the role of human papillomavirus (HPV) in head and neck cancers.

“It is an honor to be the recipient of this award,” said Gillison. “Our team strives to generate data that will improve the lives of individuals affected by head and neck cancers, and this is a wonderful validation that we are on the right track.”

This award is designed to provide incentive to young investigators early in their careers. It was established in 1977 by the AACR and the Rosenthal Family Foundation to recognize research that has made, or promises to make, a notable contribution to improved clinical care in the field of cancer.

Gillison is a professor of medicine, epidemiology and otolaryngology and the Jeg Coughlin Chair of Cancer Research at Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute in Columbus, Ohio. She is also adjunct faculty at The Johns Hopkins University School of Medicine, in Baltimore, Md. Her seminal research on the role of HPV in head and neck cancers revolutionized the specialty. Her research has demonstrated that HPV infection causes a distinct molecular, clinical and pathological subset of head and neck squamous cell carcinomas.

In a landmark case-control study, Gillison identified oral sexual behavior and HPV infection as risk factors for oropharyngeal cancer, findings that led the International Agency for Research on Cancer to formally recognize HPV-16 as a significant cause of oropharyngeal cancers.

Results of other key studies conducted by Gillison and her colleagues showed that tumor HPV status is one of the single greatest predictors of survival in head and neck cancer. As a result, multiple organizations now advocate routine HPV testing of oropharyngeal cancer patients. Clinical trial designs have also been amended to adopt HPV testing as a means by which to stratify various cancer subsets, allowing for better targeted therapies and treatment regimens. Additionally, Gillison established the gold standard of HPV diagnostic tests, currently in use within clinics nationwide. Currently, she is the principal investigator of the first phase III trial focused on HPV-positive head and neck cancers, which began enrolling patients in 2011.

Gillison has led several studies in collaboration with the National Cancer Institute and the Centers for Disease Control and Prevention that have examined the effects of HPV infection on head and neck cancer at the population level. She has also been the leader in development of methods for oral HPV detection, which will facilitate the development of primary and secondary prevention strategies for the cancer she characterized.

Gillison’s work has had, and will continue to have, significant public health implications. Her group’s recent research established that HPV has been the cause of a dramatic increase in the incidence of oropharyngeal cancer in the United States during the last 20 years.

Currently, the burden of HPV-caused cancers is shifting from women to men, a trend that is anticipated to continue throughout the next decade. In 2011, such data were presented to the Advisory Committee on Immunization Practices, which now recommends that all preteen boys aged 11 to 12 be vaccinated against HPV.

July, 2012|Oral Cancer News|

Oropharyngeal cancer survival better in those with HPV

Source: www.dailyrx.com
Author: Laurie Stoneham

The human papillomavirus (HPV) causes a number of malignancies, including head and neck and cervical cancers. Oddly enough, being infected with the virus may help those living with oral cancer.

Researchers believe that having HPV improves the lifespan of African Americans who have throat cancer, compared to African Americans who do not have the virus. These are the unexpected findings of a group of researchers, led by Maria J. Worsham, PhD, director of research in the Department of Otolaryngology-Head & Neck Surgery at Henry Ford Health System in Detroit.

“This study adds to the mounting evidence of HPV as a racially-linked sexual behavior lifestyle risk factor impacting survival outcomes for both African American and Caucasian patients with oropharyngeal cancer,” Dr. Worsham said.

Oropharyngeal cancer affects part of the throat, including the base of the tongue, tonsils, soft palate (back of the mouth) and the walls of the throat (pharynx). Risk factors for this oral cancer include smoking, drinking alcohol and HPV infection.

To look at how HPV status impacted the outlook of throat cancer patients, researchers worked with 118 patients – 67 of whom did not have the virus and 51 individuals who did. A total of 42 individuals in the study were African American.

Here’s what researchers learned:

  • African Americans were less likely than Caucasians to have the virus (HPV-positive) as are people over the age of 50
  • HPV-negative patients who didn’t have the virus were nearly 3 times (2.9) more likely to die as those with the virus.
  • African Americans who were were not infected with HPV had significantly lower survival rates than HPV-positive African Americans and Caucasians with and without the virus.

These study results were presented July 22 at the 8th International Conference on Head & Neck Cancer in Toronto. The research was funded by a National Institutes of Health grant.

Note: All research is considered preliminary before it’s published in a peer-reviewed journal.

Best. Obit. Ever.

Source: News.Health.com

This funny, surprising obituary was written by Val Patterson before he died of throat cancer earlier this month. 

I was Born in Salt Lake City, March 27th 1953. I died of Throat Cancer on July 10th 2012. I went to six different grade schools, then to Churchill, Skyline and the U of U. I loved school, Salt Lake City, the mountains, Utah.

I was a true Scientist. Electronics, chemistry, physics, auto mechanic, wood worker, artist, inventor, business man, ribald comedian, husband, brother, son, cat lover, cynic. I had a lot of fun. It was an honor for me to be friends with some truly great people. I thank you. I’ve had great joy living and playing with my dog, my cats and my parrot. But, the one special thing that made my spirit whole, is my long love and friendship with my remarkable wife, my beloved Mary Jane. I loved her more than I have words to express. Every moment spent with my Mary Jane was time spent wisely. Over time, I became one with her, inseparable, happy, fulfilled.

I enjoyed one good life. Traveled to every place on earth that I ever wanted to go. Had every job that I wanted to have. Learned all that I wanted to learn. Fixed everything I wanted to fix. Eaten everything I wanted to eat. My life motto was: “Anything for a Laugh”. Other mottos were “If you can break it, I can fix it”, “Don’t apply for a job, create one”. I had three requirements for seeking a great job; 1 – All glory, 2 – Top pay, 3 – No work.

Now that I have gone to my reward, I have confessions and things I should now say. As it turns out, I AM the guy who stole the safe from the Motor View Drive Inn back in June, 1971. I could have left that unsaid, but I wanted to get it off my chest. Also, I really am NOT a PhD. What happened was that the day I went to pay off my college student loan at the U of U, the girl working there put my receipt into the wrong stack, and two weeks later, a PhD diploma came in the mail. I didn’t even graduate, I only had about 3 years of college credit. In fact, I never did even learn what the letters “PhD” even stood for. For all of the Electronic Engineers I have worked with, I’m sorry, but you have to admit my designs always worked very well, and were well engineered, and I always made you laugh at work.

Now to that really mean Park Ranger; after all, it was me that rolled those rocks into your geyser and ruined it. I did notice a few years later that you did get Old Faithful working again. To Disneyland – you can now throw away that “Banned for Life” file you have on me, I’m not a problem anymore – and SeaWorld San Diego, too, if you read this.

To the gang: We grew up in the very best time to grow up in the history of America. The best music, muscle cars, cheap gas, fun kegs, buying a car for “a buck a year” – before Salt Lake got ruined by over population and Lake Powell was brand new. TV was boring back then, so we went outside and actually had lives. We always tried to have as much fun as possible without doing harm to anybody – we did a good job at that.

If you are trying to decide if you knew me, this might help… My father was RD “Dale” Patterson, older brother “Stan” Patterson, and sister “Bunny” who died in a terrible car wreck when she was a Junior at Skyline. My mom “Ona” and brother “Don” are still alive and well. In college I worked at Vaughns Conoco on 45th South and 29th East. Mary and I are the ones who worked in Saudi Arabia for 8 years when we were young. Mary Jane is now a Fitness Instructor at Golds on Van Winkle – you might be one of her students – see what a lucky guy I am? Yeah, no kidding.

My regret is that I felt invincible when young and smoked cigarettes when I knew they were bad for me. Now, to make it worse, I have robbed my beloved Mary Jane of a decade or more of the two of us growing old together and laughing at all the thousands of simple things that we have come to enjoy and fill our lives with such happy words and moments. My pain is enormous, but it pales in comparison to watching my wife feel my pain as she lovingly cares for and comforts me. I feel such the “thief” now – for stealing so much from her – there is no pill I can take to erase that pain.

If you knew me or not, dear reader, I am happy you got this far into my letter. I speak as a person who had a great life to look back on. My family is following my wishes that I not have a funeral or burial. If you knew me, remember me in your own way. If you want to live forever, then don’t stop breathing, like I did.

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

July, 2012|Oral Cancer News|

Western University profs to test robotic treatment of throat cancer

Source: metronews.ca
Author: Josh Elliott

Western University professors David Palma and Anthony Nichols will lead a first-ever study to see if robotic surgery can treat throat cancer while avoiding the long-term side effects that come with chemotherapy and radiation.

Transoral robotic surgery (TORS) allows doctors to use miniature robotic arms to operate in tight spaces where human hands can’t fit. London has the only TORS program in Canada.

Early stage oropharyngeal cancer patients will be randomly assigned standard radiation care, or the new TORS treatment. Doctors will measure long-term side effects and quality of life following both treatments.

Oropharyngeal cancer affects the back of the throat. Radiation therapy is effective at controlling the cancer, but some patients still suffer long-term side effects such as dry throat, difficulty swallowing, and hearing loss.

“In the U.S., TORS is being used readily in the treatment of oropharyngeal cancer, in spite of the lack of high-level evidence supporting the use,” said Nichols, a head and neck cancer surgeon at London Health Sciences Centre.

Palma, a radiation oncologist at LHSC, says the Western study will compare TORS treatment to traditional radiation therapy.

“Before we can implement TORS, we need to prove that it meets that standard: Are the cure rates just as good, and are the side effects less?”

Nichols sees reason for optimism: “Early studies of TORS show it holds promise to provide good disease control, as well as offer good speech and swallowing outcomes for patients.”

Blacks with throat cancer get harsher therapy

Source: in.reuters.com
Author: Frederik Joelving

Blacks in the United States with throat cancer are more likely than whites to have surgery that leaves them unable to speak than to get gentler voice-preserving therapy, according to a study. Previous research has found a similar racial disparity in breast cancer treatment, with blacks more often having the entire breast removed instead of just the cancerous lumps. It’s unclear why the disparity exists. But study leader Allen Chen, a radiation oncologist at University of California, Davis, said that poverty, less education and deep-rooted historical biases could all be at work.

“There could be an underlying distrust among African Americans where they feel anything less than surgery might be considered quote-unquote experimental,” Chen told Reuters Health.

He referenced the Tuskegee experiment, conducted by the U.S. government from the 1930s into the 1970s, in which black patients with syphilis went untreated despite assurances to the contrary.

“That sort of distrust needs to be addressed or alleviated,” Chen said, because voice-preserving treatment for throat cancer, based on radiation and drug therapy, is now the standard.

His study, published in the Archives of Otolaryngology – Head & Neck Surgery, is based on data from a US cancer registry including nearly 5,400 cases of laryngeal cancer between 1991 and 2008.

About 80 percent of whites had voice-preserving treatment, while the rest had their voice box surgically removed – the traditional approach. Among blacks, 75 percent had the gentler therapy. While that’s only a five-percent difference, “I think that’s a gap that needs to be narrowed,” Chen added.

The racial disparity remained after researchers accounted for age, sex and how advanced patients’ tumors were, and it didn’t disappear in the more recent half of the study, either. However, there was no significant gap between whites and Hispanics or Asians. The study didn’t look at income or education, which might explain some of the difference. It’s also possible that more blacks lived in areas without access to the resources involved in voice-preserving therapy, which requires cooperation between doctors with different specialties.

While the gentler therapy might be just as effective as surgery, an operation does have the advantage of being over at once, whereas it takes several weeks of treatment for drugs and radiation to work.

But if it’s a question of people believing treatment other than surgery is experimental, he added, “That perception needs to be changed.”

Source: Reporting from New York by Frederik Joelving at Reuters Health; editing by Elaine Lies and Bob Tourtellotte

Researchers report early success using saliva to detect oral cancer

Source: www.nih.gov
Author: press release

Scientists funded by the National Institute of Dental and Craniofacial Research, part of the National Institutes of Health, reported today taking a major step forward in using saliva to detect oral cancer. As published in the current issue of Clinical Cancer Research, the scientists found they could measure for elevated levels of four distinct cancer-associated molecules in saliva and distinguish with 91 percent accuracy between healthy people and those diagnosed with oral squamous cell carcinoma.

This so-called “proof-of-principle” study marks the first report in the scientific literature that distinct patterns of “messenger RNA” not only are measurable in saliva but can indicate a developing tumor. Messenger RNA (mRNA) is the molecular intermediate between gene and protein, serving as a chemical record that an individual gene has been expressed.

According to David Wong, D.M.D., D.M.Sc., a scientist at the University of California at Los Angeles (UCLA) School of Dentistry and senior author on the paper, it may be possible with further refinement of the test, possibly by including additional cancer-linked mRNAs, to attain the necessary 99 to 100 percent accuracy of commercial diagnostic tests for oral squamous cell carcinoma, the sixth most common cancer in the United States. Wong noted that currently no biochemical or genetic diagnostic tests are commercially available for oral cancer.

He also noted that the RNA patterns in saliva may be informative for other cancers and common diseases. “Saliva is a mirror of our blood,” said Wong. “We’re now conducting our initial studies of saliva as a possible diagnostic fluid for other human cancers and system diseases, and we should have our preliminary data in the Spring.”

Wong said he and his colleagues never intended to study mRNA patterns in saliva. They had been searching exclusively in the mouth’s soft tissues, or mucosa, for proteins that might be associated with oral cancer, when Maie St. John, M.D., Ph.D., a head-and-neck surgery/otolaryngology resident at UCLA, who was then on a training rotation in Wong’s lab, posed a simple question: If proteins associated with cancer are present in the oral mucosa, can they also pass from tissue into the saliva?

While looking for cancer-linked proteins in saliva, St. John happened to notice mRNA from the gene encoding one of her proteins of interest. This chance discovery raised two intriguing possibilities that would alter the course of research in Wong’s lab: Does saliva contain a wide range of different mRNAs that have value in diagnosing disease? If correct, are there different collective patterns of mRNA in the saliva of a healthy person compared with someone who has a developing cancer?

St. John said pursuing this line of research was potentially important because previous studies had established that mRNA can be as informative of health and disease as changes in protein or DNA. In addition, mRNA has the key advantage over these more traditional analytes in that it can be readily extracted in bulk from a tissue or bodily fluid and processed much faster for a comprehensive picture of which mRNAs are present in a given tissue or bodily fluid and at which levels.

“What really interested us was the idea that mRNA analyses could be performed in a bodily fluid as easily obtained as saliva,” said St. John. “If correct, a salivary test in theory would be quick, painless, and most likely less expensive than current diagnostic tests.”

But would it be as informative as testing blood? Before they could answer this question, Wong and colleagues first had to define all of the individual mRNAs naturally present in saliva. As published this year in the Journal of Dental Research, they found people have about 3,000 chemically distinct mRNAs in their saliva at any one time. Of this total, a “core signature” of about 280 mRNAs are generally present in the saliva of healthy people.

With these baseline data as their scientific anchor, the researchers could begin to test whether saliva contains distinct mRNA patterns. “We obtained saliva and blood from 32 people who had been recently diagnosed with oral squamous cell carcinoma but not treated,” said Yang Li, D.D.S., Ph.D., lead author on the study and a researcher in Wong’s laboratory. “Because salivary diagnostics with RNA had yet to be tried, we referenced all of our data through blood. That is, whatever we found in saliva, we looked to see if it matched our data in blood.”

As presented in their current Clinical Cancer Research paper, the scientists extracted the mRNA from the saliva of the cancer patients and soon discovered 1,679 genes were expressed at significantly different levels in the cancer patients compared to healthy individuals. Upon further analysis, they noticed seven mRNAs in particular that were present at a 3.5-fold higher level in the cancer patients. Interestingly, among them was the mRNA for the gene IL-8, whose protein St. John had originally searched for in saliva.

The researchers then whittled down their list of signature mRNAs to four, based on statistical models that indicated the synchronized rise in expression of these four molecules increased the probability that the saliva belonged to a cancer patient. These four mRNAs are from the following genes: Interleukin 1-beta (IL1B), Ornithine decarboxylase antizyme 1 (OAZ1), spermidine/spermine N1-acetyl transferase (SAT), and interleukin 8 (IL-8).

To put this idea to the test, they screened the saliva again to see how often they could correctly identify the samples from the cancer patients. In all instances, they had no foreknowledge of whether a healthy person or a cancer patient provided the saliva sample.

Wong said the group could identify the saliva from cancer patients in nine out of 10 samples. What’s more, he said the sensitivity and specificity of their saliva tests were as good or better than their reference work in blood. “This was primarily an exploratory study to validate our initial finding of a unique molecular signature of mRNAs in people with oral squamous cell carcinoma,” said Wong. “We will follow up with a larger cohort of about 200 patients in the near future, and this study will hopefully allow us to distinguish in saliva between the various stages of the cancer and ultimately push our accuracy up to as close to 100 percent as possible.”

He also noted that these initial results serve to highlight the potential clinical value of saliva as a diagnostic biofluid. “Many have thought of saliva as very difficult to work with in the laboratory, in part because the molecular information contained within it is highly degradable,” said Wong. “The truth is oral health researchers have worked on saliva for decades, and they have established defined ways to work with fluids that are consistent, reproducible, and which keep these molecules in a stable state. We have a marvelous way to completely stop the degradation of mRNA in saliva, and it allowed us to gather these data.”