March 2018 – Oral Cancer News

Accurately identifying aggressive head and neck cancers

Source: www.eurekalert.org Author: press release The Case Western Reserve-led research team will analyze computerized images of tissue samples for patterns which could become "biomarkers," or predictors, for determining relative risk for recurrence in one particularly common type of head and neck cancers. Those tumors, known as oropharyngeal cancers, occur primarily at the base of the tongue and in the tonsils. Currently, however, oncologists tend to treat all of these tumors with the same aggressive level of therapy. This is the case even though many of the oropharyngeal tumors which are caused by the human papilloma virus (HPV) tend to have favorable outcome-regardless of treatment-while another subset of the tumors progress and metastasize, or spread. "Right now, it's a one-size-fits-all therapy for all of these patients with HPV head and neck cancers," said Anant Madabhushi, MD, the F. Alex Nason Professor II of Biomedical Engineering, founding director of the CCIPD at the Case School of Engineering and primary investigator in the new research. "There are currently very few validated biomarkers and approaches that are accurate enough to be able to identify which of these cancers are more aggressive or which ones are less aggressive," he said. "That has limited the ability of clinicians to even hold clinical trials to find out if they can de-escalate therapy for some of these patients-or who needs more aggressive therapy." The National Cancer Institute (NCI) recently awarded a $3.15 million, five-year academic-industry partnership grant to Madabhushi and his team to pursue the research and build [...]

Oral Cancer Foundation News Team - A2018-03-27T13:01:32-07:00March, 2018|Oral Cancer News|

A better understanding of how genetics influences responses to mouth cancer drugs could lead to improved treatment

Source: medicalxpress.com Author: provided by Agency for Science, Technology and Research (A*STAR) A single letter DNA mutation is a big determinant of whether patients with advanced oral cancer respond to treatments. Researchers from the National Cancer Centre Singapore (NCCS) and A*STAR who uncovered the mechanisms behind this effect hope their findings will help doctors target treatment more effectively. Oral squamous cell carcinoma (OSCC) is characterized by the uncontrolled growth of thin, scale-like squamous cells in the outer layer of the mouth. Only around 50 per cent of patients who are treated through surgery or radiotherapy are cured, and the average duration of survival of those with advanced OSCC that recurs following treatment is just 6 to 9 months. Epidermal growth factor receptors (EGFRs) play important roles in driving the progression of some OSCCs. Drugs that target them, however, only work in a small number of patients. A 2012 clinical trial led by Daniel Tan at NCCS and A*STAR's Genome Institute of Singapore had found that the EGFR-blocking drug gefitinib worked well in two patients with two copies of the EGFR coding gene with an adenine (A) nucleobase in place of the more common guanine (G) at a particular location. More recently, tests by Gopal Iyer, also at NCCS, and Tan showed that OSCC patient-derived cells with the above A/A genotype were sensitive to gefitinib and erlotinib, another EGFR blocker. Those with the G/G or G/A variants exhibited resistance to the drugs. Editing the DNA of the G/G genotype cells to [...]

Oral Cancer Foundation News Team - A2018-03-23T11:39:12-07:00March, 2018|Oral Cancer News|

Management strategies for oral potentially malignant disorders

Source: www.medscape.com Author: Joel M. Laudenbach, DMD Oral potentially malignant disorders (OPMDs) include oral leukoplakia (OL), oral erythroplakia, oral submucous fibrosis, oral lichen planus, proliferative verrucous leukoplakia, and actinic keratosis. Once an OPMD has been clinically diagnosed, execution of management strategy is critical. When formulating the strategy, healthcare providers should consider histopathology, lesion characteristics (ie, surface texture, unifocal, multifocal), lesion location in the mouth (ie, tongue, floor of mouth), patient risk factor assessment, and a detailed medical/cancer history. In this newly published article, Nadeau and Kerr[1] detail various parameters surrounding evaluation and management of OPMDs. The authors make it clear that OPMDs are challenging, each with their own nuances regarding risk for malignant transformation. For example, when OL is unifocal, nonhomogeneous, nodular, or verrucous, there is a much higher chance of the OL becoming dysplastic (12.63-fold) or demonstrating a focus of carcinoma (8.9-fold) when compared with homogeneous types of OLs.[1] Provider knowledge of these variables is critical when counseling patients about their diagnosis and management options and when selecting interventions along with follow-up care. Although progression to malignancy is difficult to predict with OPMDs, clinicians can account for multiple risk factors such as smoking/alcohol status, high-risk location in the oral cavity, and size of lesion (>200 mm2) to help formulate a tailored management plan for each patient. Consultation with an oral pathologist to discuss the histologic appearance in the context of specific patient history and lesion characteristics can provide additional perspective and/or recommendations. Modifiable oral cavity cancer risks related to [...]

Oral Cancer Foundation News Team - A2018-03-16T07:46:35-07:00March, 2018|Oral Cancer News|

The Sate of Liquid Biopsy

Author:Pam Harrison Date: March 5, 2018 Source: Medscape.com So called "liquid biopsies" — which can detect circulating tumor DNA (ctDNA) in blood samples — are not yet ready for prime time in the diagnosis or management of early-stage or advanced solid tumors, a new expert review concludes. These assays are also not useful, outside of clinical trials, for monitoring patients for minimal residual disease following definitive treatment of cancer, nor for cancer screening, the expert review concludes. The review was prepared jointly by the American Society of Clinical Oncology (ASCO) and the College of American Pathologists (CAP) and was published online March 5 in the Journal of Clinical Oncology. "This is an area of great interest to both pathologists and oncologists, [and] it's also an area where we see a lot of commercial advertisement and a lot of enthusiasm from the public," Jason Merker, MD, PhD, cochair of the expert panel, who was representing the CAP, said in a statement. "We thought it was a good time to look at the literature and take an evidence-based approach to various uses for ctDNA assays," he added. "Like all new things in medicine, the use of ctDNA assays in routine cancer care requires evidence of clinical utility. At present, there is insufficient evidence of clinical validity and utility for the majority of ctDNA assays in advanced cancer, including those that interrogate a panel of genes," said Daniel F. Hayes, MD, coauthor of the review, who was representing ASCO. "What is promising is that this area [...]

Charlotte Parker2018-04-21T11:52:07-07:00March, 2018|Oral Cancer News|

Australia may become the first country to eliminate one form of cancer

Author: Brad Jones Date: March 8, 2018 Source: flipboard.com The International Papillomavirus Society has announced that Australia could become the first country to eliminate cervical cancer entirely. According to a new study, Australia's efforts to distribute a human papillomavirus (HPV) vaccine for free in schools have been a resounding success. The sexually transmitted infection causes 99.9 percent of cases of cervical cancer. In 2007, the Australian federal government began offering the vaccine to girls aged 12-13, and in 2013 it was made available to boys, too. Girls and boys outside of that age bracket but under nineteen are also entitled to two free doses of the vaccine. Between 2005 and 2015, the percentage of Australian women aged between 18 and 24 who had HPV dropped from 22.7 percent to just 1.1 percent. Immunization rates have increased further since 2015, contributing to what's being described as a "herd protection" effect. Coupled with a more advanced screening test that was introduced by the Australian government in December 2017, there are hopes that no new cases of cervical cancer will be reported within ten or twenty years. THE WORLD ISN'T CATCHING UP In the US, the HPV vaccine is not free. It can cost as much as $450 for the full regimen, according to the Association of Reproductive Health Professionals, although financial assistance is often available. In 2016, 78.6% of 15-year-old Australian girls, and 72.9% of 15-year-old Australian boys were vaccinated - but only 50% of American girls between 13 and 17, and 38% of American boys between 13 and [...]

Charlotte Parker2018-03-08T14:10:27-07:00March, 2018|Oral Cancer News|

Non-smokers with oral precancerous lesions at increased risk of cancer

Source: www.eurekalert.org Author: press release Precancerous lesions in the mouths of non-smokers are more likely to progress to cancer than those in smokers, new research from the University of British Columbia has found. Although tobacco use is still one of the strongest risk factors associated with mouth cancers, UBC dentistry PhD candidate Leigha Rock found that oral precancerous lesions in non-smokers are more than twice as likely to progress to cancer. Furthermore, lesions in non-smokers progressed to cancer faster than smoking-associated lesions. The study was published this week in Oral Oncology. "This is the first published study where the main focus was to examine the difference in risk of progression to oral cancer between non-smokers and smokers with oral precancerous lesions," said Rock, lead author of the study. "While other studies have also reported a higher rate of transformation among non-smokers, we looked at multiple risk factors including genetic markers." Rock and colleagues looked at case history of 445 patients with oral epithelial dysplasia (OED), a type of precancerous oral lesion, enrolled in the B.C. Oral Cancer Prediction Longitudinal study. One-third of the patients were non-smokers. "As smoking rates decline, we are seeing an increase in the proportion of these types of lesions in non-smokers," said Rock. Among the scientists' findings were that lesions on the floor of the mouth in non-smokers were 38 times more likely to progress to cancer than in smokers. The study is also the first to report on quicker progression to cancer in non-smokers: both [...]

Oral Cancer Foundation News Team - A2018-03-07T11:30:22-07:00March, 2018|Oral Cancer News|

HPV is causing an oral cancer epidemic in men by outwitting natural defenses

Source: www.philly.com Author: Marie McCullough, staff writer Five years ago, when actor Michael Douglas candidly revealed that his throat cancer was linked to having oral sex, two things happened. He made headlines that mortified his family. And he helped publicize the fact that a pervasive, sexually transmitted virus called HPV was unleashing an epidemic of oral cancer among men. Since then, scientists have made headway in figuring out why HPV, the human papillomavirus, has this glaring gender bias. Men are four times more likely than women to be diagnosed with oral cancer, a hard-to-detect, hard-to-treat disease that has overtaken cervical cancer as the most common HPV-related malignancy in the United States. To be sure, changes in sexual norms over the last few generations have played a role in this alarming trend. But research increasingly shows the real problem is something men have practically no control over: their immune response. Compared with women, men are more likely to get infected with HPV — including “high-risk” cancer-causing strains. They also are less able to wipe out infection on their own, and more likely to get reinfected. The reasons are unclear. “There is good evidence that men acquire oral infections more readily than women, even if they have similar sex practices,” said Ashish A. Deshmukh, a University of Florida HPV researcher. “And more than the acquisition, it’s the persistence of the virus. The clearance rate is not that fast in men.” Michael Becker of Yardley has stepped up as the face of this [...]

Oral Cancer Foundation News Team - A2018-03-06T16:31:36-07:00March, 2018|Oral Cancer News|

Immunotherapy: beyond melanoma and lung cancer treatment

Author: David Crow Source: www.ft.com Date: March 4, 2018 In the late 1800s, William Coley, a surgeon in New York, developed what scientists now think was the first cancer immunotherapy. Coley noticed one of his patients, Fred Stein, had started recovering from cancer after catching a serious infection. The observation made him wonder whether the bacteria had somehow stimulated the patient’s immune system and recruited the body’s natural “resisting powers” in the fight against Mr. Stein’s tumours. The surgeon began treating inoperable cancer patients with bacterial injections — known as “Coley’s toxins” — and recorded some success, but his poorly documented findings were dismissed by contemporaries who favoured radiation and chemotherapy. Mr. Coley died in 1936 and his theories were all but forgotten: it would take almost 80 years for oncologists to take cancer immunotherapy seriously. Today, immunotherapies are among the world’s best selling drugs and they have dramatically improved the survival prospects for some of the sickest patients, especially those with melanoma and lung cancer. “Immunotherapy is here to stay,” says Jill O’Donnell-Tormey, chief executive of the Cancer Research Institute. “It's not just a blip, it’s not overhyped — I think it is going to become the standard of care for many cancer types.” The most common immunotherapy drugs are known as checkpoint inhibitors, which work by removing brakes in the immune system so the body can attack cancer. Their discovery was made possible by the research of James Allison, now a professor at the MD Anderson Cancer Center [...]

Charlotte Parker2018-03-05T11:28:31-07:00March, 2018|Oral Cancer News|