cancer

HPV: The gender-neutral killer in need of prevention among men

Source: CNN
Author: Dominic Rech

In July 2014, Phil Rech, then 59, was diagnosed with tonsil cancer.

“I had got a lump in my neck. I had the tonsils out, and within the next few days, I was having radical neck dissection,” he said. “Then I had six weeks of intensive, targeted radiotherapy. The burning effect towards the end of the treatment became very painful.”

The therapy involved a radiotherapy mask, molded to the shape of his face, that went over his head as radiotherapy was beamed in, targeting the cancer.

The discovery of his cancer not only startled him, it startled everyone who knew him.
Phil is my dad, and to our family, he had always been healthy: He doesn’t smoke, he rarely drinks alcohol, and he generally stays fairly fit.

But that’s not how cancer works.

At the time of the diagnosis, Phil didn’t question how or what could have caused his cancer, as he focused on getting better.

Like many men in the UK and around the world, he wasn’t aware of a group of viruses that were a threat, human papillomavirus or HPV, which were eventually connected to his cancer.

“To discover it was linked to HPV was a massive shock,” he said. “There was a lot of speculation over what could have caused it. To discover it was that, was certainly a surprise. I didn’t really know it was a threat to me.”

A cancerous virus

HPV is a group of 150 related viruses that can be transmitted through any form of sexual contact, whether kissing or intercourse. In most cases, the human body will get rid of it naturally, but certain high-risk types can develop into things like genital warts and cancers, including cervical, anal and throat.

But there is a vaccine, and how it works is pretty simple. It’s a mimic of the virus particle; when administered into someone’s muscle, it creates many more antibodies than a natural infection would, according to John Doorbar, professor of viral pathogenesis at Cambridge University.

According to the US Centers for Disease Control and Prevention, “almost every person who is sexually active will get HPV at some time in their life if they don’t get the HPV vaccine.”

The vaccine needs to be given before a person is exposed to HPV. Its effectiveness in terms of preventing infections is well-known — 100% in some studies — but who gets it is a question of debate around the globe, particularly in the UK.

In the UK, girls ages 12 to 13 are routinely offered the first HPV vaccination. They can get the vaccine for free via the National Health Service from ages 12 to 18. This is encouraged to help combat cervical cancer, which a recent report suggests it has done globally.

In England, between 2010 and 2016, infections with HPV 16 and 18 (two types of the virus responsible for most cervical cancer cases) fell 86% among women 16 to 21 who were eligible for the vaccine during this period, Public Health England found.

But what about men?

Until now, some experts in the UK have argued that men would ultimately be protected against the virus through “herd immunity”: As long as girls are well-protected, the male population should be shielded, too.

But according to the Royal Society of Public Health, which supports providing the vaccine to boys, uptake of the vaccine for girls is insufficiently high to ensure herd immunity in several areas of the UK. Men are still at risk of acquiring HPV from sexual contact with women from countries without a vaccination program, the society said.

In April, NHS England and Public Health England, on recommendation from the UK’s Joint Committee on Vaccination and Immunisation, decided to introduce the vaccine to men 45 or younger who have sex with other men, often called MSM, after concluding that this group does not benefit from herd immunity.

Historically, heterosexual men and young boys have not been offered it through the NHS but can pay to receive it privately. Pharmacies including Boots, Lloyds and Superdrug in the UK charge about 150 pounds ($196) per dose, with people typically needing two or three doses.

But on July 18, the vaccination committee recommended extending the HPV immunization program to boys after it reviewed the evidence for vaccinating boys since 2013. A recommendation last year concluded it was still not cost-effective to vaccinate this group, but experts and campaigners appealed for the committee to look again — and their stance changed.

“It is clear that a programme to vaccinate adolescent males would provide those vaccinated with direct protection against HPV infection, and associated disease including anogenital warts, anal, penile and oropharyngeal cancers,” the statement says. The committee confirmed that evidence has strengthened on the association of HPV with non-cervical cancers, which affect men as well as women, and that vaccination is efficacious in preventing these other HPV-related cancers.

In response to the recommendation, the same day, the Scottish government announced that it would implement a vaccination program to boys as soon as it practically could, Public Health Minister Joe FitzPatrick said. Wales also opted to roll out the vaccine to boys.

The question remaining is whether England will follow suit.

There is some disparity over the number of other countries vaccinating boys against HPV. Shirley Cramer, chief executive of the Royal Society of Public Health, said 20 countries vaccinate boys, while the HPV Action partnership says that about 15 roll it out to boys as well as girls.

The vaccine has been approved for males in the United States for almost 10 years. Italy and Australia are also pioneering gender-neutral vaccination plans.

Lagging behind and increasing rates

In 2017, after being in remission for three years, Phil’s cancer surfaced again — this time, in the brain and the lungs.

“I started to feel some funny fluttery feelings in my chest,” he said. “It was only my oncologist, who revealed to me that I had six small lesions on my lungs. An MRI scan also showed three on my brain.

“That’s the nature of cancer. It’s a crafty disease,” he said.

A 2017 study found that one in nine American men is infected with the oral form of HPV. Nationwide, rates for oral HPV infections are 11.5% of men and 3.2% of women: 11 million men, compared with 3.2 million women, the researchers estimated.

Among HPV-related cancers, a type of head and neck cancer called oropharyngeal squamous cell carcinoma was far more likely to strike men in the US, the same study found, with its incidence surpassing cervical cancer among women. Men who have had multiple sex partners, men who reported having sex with men and men with genital HPV infections were found to have the highest rates of oral HPV.

But in the UK, the discussion around vaccinating boys has been ongoing. In less than 10 years, admissions for primary cancerous tumors of the head and neck increased by almost 10,000, according to the NHS, from 29,198 in 2008-09 to 37,417 in 2016-17.

A recent review by the nonprofit medical research group Cochrane acknowledged that HPV was not only linked to cervical cancers, it increases risk of vulval cancers, penile cancers and some head and neck cancers. But the review also said that these cancers were rarer and that ascertaining the effects of vaccination on them may require the evaluation of non-randomized, population-level evidence over many years.

Beyond the price tag

“The problem is cost-effectiveness, and that is why the government hadn’t made a decision to vaccinate boys in this country,” said Jo Morrison, co-ordinating editor for the Cochrane Gynae, Neuro and Orphan Cancer Group.

However, she added, “doctors and other informed people are looking to get their boys vaccinated.”

Giampiero Favato is one of them. “Twenty years from now, we will laugh about this discussion,” said the health economics specialist at Kingston University. “It is obvious we should vaccinate boys. HPV is a gender-neutral killer. When my son is 12, I will pay for the vaccination if necessary.”

He is skeptical of “herd immunity” and giving the vaccine only to girls: “The current models are not capable of replicating the sexual behavior and preference in the normal population. Most of the models are based on the assumption that sex is only happening between fully heterosexual couples and their partnerships.”

This of course would mean more money for the NHS, but Favato says “price is not the issue,” and the private cost of the vaccine is unlikely be anywhere near that for the NHS, which is likely to get it at a competitive rate. “In Italy, the vaccination costs about $30 to $32 per vial.”

But Helen Bedford, professor of children’s health at the UCL Great Ormond Street Institute of Child Health, added that cost-effectiveness still needs to be taken into account and that the method of calculating this is what ultimately needs to change.

“In view of the long interval between infection with HPV and development of disease, [the Joint Committee on Vaccination and Immunisation] are supportive of changing the methods for calculating cost effectiveness to consider HPV vaccine for boys,” she said. “A review of cost-effectiveness modeling is soon to be concluded, and this is one of the issues that is being considered as part of that review.”

Phil said that if he could have had the vaccine readily available when he was younger, he would have taken it.

He continues to fight his cancer today, but cases like his are increasing amid the discourse on HPV vaccination rollouts in the UK.

“I would urge all boys to be vaccinated as a matter of course,” he said. “We have long vaccinated against the likes of polio, measles, mumps and rubella. HPV is just as serious and life-threatening as any of these.”

Note from OCF: We are one of the first supporters and donors to the HPV Action Partnership that originally supported research and early perception of the concept of boys being vaccinated for herd immunization. This has been a long term endeavor and a labor of love.  Men get oral cancers more than woman do and we want to inform that the HPV Vaccine goes beyond protecting from cervical cancers; it also protects from anal, penile and oropharyngeal cancer.

 

July, 2018|OCF In The News|

Cancer: Can testosterone improve patients’ quality of life?

Source: Medical News Today
Author: Maria Cohut

Cachexia is a condition characterized by loss of body mass — including muscular atrophy — that is usually accompanied by severe weakness and fatigue. Many people who go through cancer experience this.

Studies have noted that “[a]pproximately half of all patients with cancer experience cachexia,” severely impairing their quality of life.

It appears to be “responsible for the death of 22 [percent] of cancer patients.”

What exactly causes this condition — which appears in some patients but not in others — remains unclear, and options to manage and address it are scarce.

But recently, researchers from the University of Texas Medical Branch in Galveston — led by Dr. Melinda Sheffield-Moore, from the Department of Health and Kinesiology — have been investigating the potential of administering testosterone in addition to chemotherapy in order to ameliorate the impact of cachexia.

“We hoped to demonstrate these [cancer] patients [who received testosterone treatment] would go from not feeling well enough to even get out of bed to at least being able to have some basic quality of life that allows them to take care of themselves and receive therapy.”

Dr. Melinda Sheffield-Moore

The researchers’ findings — now published in the Journal of Cachexia, Sarcopenia and Muscle — confirm that administering testosterone to individuals experiencing cachexia can, in fact, improve their quality of life to some extent, by restoring some independence of movement.

Adjuvant testosterone shows promise

The most widely used approach to manage cachexia is special nutrition treatments, but these often fail to prevent or redress the loss of body mass.

So, Dr. Sheffield-Moore and team decided to investigate the potential of testosterone based on existing knowledge that this hormone can help build up muscle mass.

“We already know that testosterone builds skeletal muscle in healthy individuals,” she says, “so we tried using it in a population at a high risk of muscle loss, so these patients could maintain their strength and performance status to be able to receive standard cancer therapies.”

In order to test this theory, the scientists worked — for 5 years — with volunteers who had been diagnosed with squamous cell carcinoma, which is a type of skin cancer.

The patients received chemotherapy, radiotherapy, or both, in order to treat the cancer. For 7 weeks during their treatment, some also received a placebo (the control cohort), while others received testosterone.

Dr. Sheffield-Moore and colleagues noticed that the participants who had been given extra testosterone had maintained total body mass and actually increased lean body mass (body mass minus body fat) by 3.2 percent.

“Patients randomized to the group receiving testosterone as an adjuvant to their standard of care chemotherapy and/or radiation treatment also demonstrated enhanced physical activity,” she continues.

“They felt well enough to get up and take care of some of their basic activities of daily living, like cooking, cleaning, and bathing themselves,” says Dr. Sheffield-Moore.

This effect could make a world of difference to people with cancer, as it allows them to maintain more autonomy.

At present, she and her team are looking to describe cancer patients’ muscle proteomes — the totality of proteins found in skeletal muscles — so as to understand how cancer in general, and specifically cachexia, affects their composition.

According to Dr. Sheffield-Moore, “What the proteome tells us is which particular proteins in the skeletal muscles were either positively or negatively affected by testosterone or by cancer, respectively.”

“It allows us to begin to dig into the potential mechanisms behind cancer cachexia,” she claims.

The scientists’ ultimate goal is to be able to support individuals likely to experience cachexia in continuing to support standard cancer treatment, and maintaining, as much as possible, their quality of life.

July, 2018|OCF In The News|

Suicide Among Cancer Survivors — Highest Risk in HNC

Author: Roxanne Nelson, RN, BSN
Source: MedScape.com
Date: Feb. 20, 2018

ORLANDO, Florida — Head and neck cancer (HNC) accounts for only about 4% of new cancer cases in the United States, but the risk for suicide among survivors is significantly higher than for survivors of all other cancer types, with the exception of pancreatic cancer.

“The risk of suicide is significantly elevated across cancer sites, and the risk is especially high among HNC and pancreatic cancer survivors,” said Nosayaba Osazuwa-Peters, BDS, MPH, CHES, instructor, Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, Missouri.

“Cancer survivors are candidates for suicide-related psychosocial surveillance,” he added.

Cancer is the number 2 cause of death in the United States and accounts for 1 of every 4 deaths. Suicide is the tenth cause of death, independent of cancer. “If you add cancer to it, you get the perfect storm,” he said.

“Survivorship does come at a cost, and this is one of the more unfortunate costs of cancer survivorship,” Osazuwa-Peters told delegates here at the Cancer Survivorship Symposium (CSS) Advancing Care and Research.

Currently, there are more than 16 million survivors in the United States. The good news is that more people are surviving cancer, and there is now more focus on competing causes of death and comorbidities, he explained. There is also more focus on the increased risk for acute and late toxicities, which needs to be addressed as the rate of survival increases.

Osazuwa-Peters pointed out that there are “a lot of unmet psychosocial needs and struggles with functionality in this population. The overall risk of suicide among cancer survivors is 50% higher than in the general population.”

Findings from a recent study presented in 2017 at the European Psychiatric Association Congress found that a diagnosis of cancer significantly increases an individual’s risk of dying by suicide by 55% as compared to those without cancer.

“Throughout the lifetime of a survivor, the risk of suicide consistently remains higher,” Osazuwa-Peters pointed out.

Suicide Risk Significantly Higher in HNC

In this study, Osazuwa-Peters and colleagues sought to estimate the incidence of HNC-associated suicide in comparison with other common cancers and to quantify the suicide rate among HNC survivors compared with survivors of cancers other than HNC.

They used data from the Surveillance, Epidemiology and End Results (SEER) database from 2000-2014 to identify all cancer deaths that were confirmed as suicide. The death rates from suicide were estimated for the 21 most common cancers, including HNC.

SEER data revealed that there were 4513 suicides among 4,235,657 cancer survivors during that time frame. This extrapolates to an incidence rate of 23.6 suicides per 100,000 person-years.

For cancers in all other sites combined, the suicide rate was 45% lower than for HNC for both males (mortality rate ratios [MRRs] = 0.55; 95% confidence interval [CI], 0.48 – 0.64) and females (MRR = 0.55; 95% CI, 0.37 – 0.81).

Pancreatic cancer was the only cancer type in which the suicide rate was higher than for HNC (86.4 suicides per 100,000 person-years for pancreatic cancer vs 63.4 suicides per 100,000 person-years for HNC). When stratified by sex, this finding held true only for males; the suicide MRR was significantly higher for male pancreatic cancer survivors compared to that of HNC survivors (MRR = 1.54; 95% CI, 1.23 – 1.90). For females, the suicide MMR was highest with HNC compared with all other cancer types.

“A lot of conversation revolves around depression and fear, but depression does not equate to suicide, and data show that even patients who screen okay for depression still commit suicide,” said Osazuwa-Peters. “There are other factors, such as pain and fear, that may heighten the risk of suicide.”

It is important “that suicide is tackled as a problem” when guidelines are developed by the National Comprehensive Cancer Network and other major players, he said.

“Misery Index”

In a discussion of the paper, Christopher J. Recklitis, PhD, MPH, director of research at the Perini Family Survivors’ Center, Dana-Farber Cancer Institute, Boston, Massachusetts, noted that the suicide risk among cancer survivors has been studied for a while, and it has previously been suggested that HNC survivors are particularly at risk.

 

“This study is important because it focused on head and neck cancers, which isn’t often seen, and we can say that these data are largely confirmatory showing the elevated risk,” he said. “My take on this is that it highlights the need for better integration of mental health care into medical survivorship care.”

Not only does the risk for suicide need to be considered, but in general, the psychosocial needs of this population need to be considered more broadly, because suicide is something of a “misery index,” he commented.

“The number of people who are unfortunately ending their lives through suicide suggests that there is large group of people who are quite miserable and thinking about suicide and suffering in a way that needs attention,” he said.

But the study opens the door to several questions, he noted, namely, what is it about HNC that explains this excess risk?

“HNC survivors face poor prognosis, pain, disfigurement, and functional impairments, but that can be said of other cancer survivors,” he pointed out. He added that this group also has a higher risk for substance abuse and depression, but it is not known whether that risk contributes to risk for suicide.

“We need to understand these risks better so we can identify patients at risk and provide effective interventions, and also support the medical providers caring for this high-risk group,” Recklitis added. “We also need to move beyond registry data and study the risk over the course of survivorship, as it can change over time.”

Dr Osazuwa-Peters and Dr Recklitis have disclosed no relevant financial relationships.

Cancer Survivorship Symposium (CSS) Advancing Care and Research. Abstract 146, presented February 17, 2018.

 

 

February, 2018|Oral Cancer News|

Anti-smoking plan may kill cigarettes–and save Big Tobacco

Date: January 19, 2018
Author: Matthew Perrone
Source: www.apnews.com

WASHINGTON (AP) — Imagine if cigarettes were no longer addictive and smoking itself became almost obsolete; only a tiny segment of Americans still lit up. That’s the goal of an unprecedented anti-smoking plan being carefully fashioned by U.S. health officials.

But the proposal from the Food and Drug Administration could have another unexpected effect: opening the door for companies to sell a new generation of alternative tobacco products, allowing the industry to survive — even thrive — for generations to come.

The plan puts the FDA at the center of a long-standing debate over so-called “reduced-risk” products, such as e-cigarettes, and whether they should have a role in anti-smoking efforts, which have long focused exclusively on getting smokers to quit.

“This is the single most controversial — and frankly, divisive — issue I’ve seen in my 40 years studying tobacco control policy,” said Kenneth Warner, professor emeritus at University of Michigan’s school of public health.

The FDA plan is two-fold: drastically cut nicotine levels in cigarettes so that they are essentially non-addictive. For those who can’t or won’t quit, allow lower-risk products that deliver nicotine without the deadly effects of traditional cigarettes.

 

US health officials are pushing ahead with an unprecedented plan to make cigarettes less addictive and provide lower-risk alternative products to US smokers. (Jan. 19)

This month the government effort is poised to take off. The FDA is expected to soon begin what will likely be a years-long process to control nicotine in cigarettes. And next week, the agency will hold a public meeting on a closely watched cigarette alternative from Philip Morris International, which, if granted FDA clearance, could launch as early as February.

The product, called iQOS (pronounced EYE-kose), is a penlike device that heats Marlboro-branded tobacco but stops short of burning it, an approach that Philip Morris says reduces exposure to tar and other toxic byproducts of burning cigarettes. This is different from e-cigarettes, which don’t use tobacco at all but instead vaporize liquid usually containing nicotine.

For anti-smoking activists these new products may mean surrendering hopes of a knockout blow to the industry. They say there is no safe tobacco product and the focus should be on getting people to quit. But others are more open to the idea of alternatives to get people away from cigarettes, the deadliest form of tobacco.

Tobacco companies have made claims about “safer” cigarettes since the 1950s, all later proven false. In some cases the introduction of these products, such as filtered and “low tar” cigarettes, propped up cigarette sales and kept millions of Americans smoking. Although the adult smoking rate has fallen to an all-time low of 15 percent, smoking remains the nation’s leading preventable cause of death and illness, responsible for about one in five U.S. deaths.

Anti-smoking groups also point to Big Tobacco’s history of manipulating public opinion and government efforts against smoking: In 2006, a federal judge ruled that Big Tobacco had lied and deceived the American public about the effects of smoking for more than 50 years. The industry defeated a 2010 proposal by the FDA to add graphic warning labels to cigarette packs. And FDA scrutiny of menthol-flavored cigarettes — used disproportionately by young people and minorities — has been bogged down since 2011, due to legal challenges.

“We’re not talking about an industry that is legitimately interested in saving lives here,” said Erika Sward of the American Lung Association.

But some industry observers say this time will be different.

“The environment has changed, the technology has changed, the companies have changed — that is the reality,” said Scott Ballin, a health policy consultant who previously worked for the American Heart Association.

Under a 2009 law, the FDA gained authority to regulate certain parts of the tobacco industry, including nicotine in cigarettes, though it cannot remove the ingredient completely. The same law allows the agency to scientifically review and permit sales of new tobacco products, including e-cigarettes. Little has happened so far. Last year, the agency said it would delay the deadline for manufacturers to submit their vapor-emitting products for review until 2022.

The FDA says it wants to continue to help people quit by supporting a variety of approaches, including new quit-smoking aids and opening opportunities for a variety of companies, including drugmakers, to help attack the problem. As part of this, the FDA sees an important role for alternative products — but in a world where cigarettes contain such a small amount of nicotine that they become unappealing even to lifelong smokers.

“We still have to provide an opportunity for adults who want to get access to satisfying levels of nicotine,” but without the hazards of burning tobacco, said FDA Commissioner Dr. Scott Gottlieb. He estimates the FDA plan could eventually prevent 8 million smoking-related deaths.

“SMOKE-FREE FUTURE”

Philip Morris International and its U.S. partner Altria will try to navigate the first steps of the new regulatory path next week.

At a two-day meeting before the FDA, company scientists will try and convince government experts that iQOS is less-harmful than cigarettes. If successful, iQOS could be advertised by Altria to U.S. consumers as a “reduced-risk” tobacco product, the first ever sanctioned by the FDA.

Because iQOS works with real tobacco the company believes it will be more effective than e-cigarettes in getting smokers to switch.

Philip Morris already sells the product in about 30 countries, including Canada, Japan and the United Kingdom.

iQOS is part of an elaborate corporate makeover for Philip Morris, which last year rebranded its website with the slogan: “Designing a smoke-free future.” The cigarette giant says it has invested over $3 billion in iQOS and eventually plans to stop selling cigarettes worldwide — though it resists setting a deadline.

Philip Morris executives say they are offering millions of smokers a better, less-harmful product.

Matthew Myers of the Campaign for Tobacco-Free Kids still sees danger. He says FDA must strictly limit marketing of products like iQOS to adult smokers who are unable or unwilling to quit. Otherwise they may be used in combination with cigarettes or even picked up by nonsmokers or young people who might see the new devices as harmless enough to try.

“As a growing percentage of the world makes the decision that smoking is too dangerous and too risky, iQOS provides an alternative to quitting that keeps them in the market,” Myers says.

It’s unclear whether existing alternatives to cigarettes help smokers quit, a claim often made by e-cigarette supporters. Research from the Centers for Disease Control and Prevention suggests about 60 percent of adult e-cigarette users also smoke regular cigarettes.

THE CASE FOR LOWER NICOTINE

Experts who study nicotine addiction say the FDA plan is grounded in the latest science.

Several recent studies have shown that when smokers switch to very low-nicotine cigarettes they smoke less and are more likely to try quitting. But they also seek nicotine from other sources, underscoring the need for alternatives. Without new options, smokers would likely seek regular-strength cigarettes on the black market.

Crucial to the FDA proposal is a simple fact: nicotine is highly addictive, but not deadly. It’s the burning tobacco and other substances inhaled through smoking that cause cancer, heart disease and bronchitis.

“It’s hard to imagine that using nicotine and tobacco in a way that isn’t burned, in a non-combustible form, isn’t going to be much safer,” said Eric Donny, an addiction researcher at the University of Pittsburgh.

A study of 800 smokers by Donny and other researchers showed that when nicotine was limited to less than 1 milligram per gram of tobacco, users smoked fewer cigarettes. The study, funded by the FDA, was pivotal to showing that smokers won’t compensate by smoking more if nicotine intake is reduced enough. That was the case with “light” and “low-tar” cigarettes introduced in the 1960s and 1970s, when some smokers actually began smoking more cigarettes per day.

Still, many in the anti-smoking community say larger, longer studies are needed to predict how low-nicotine cigarettes would work in the real world.

LEGAL RISKS

Key to the FDA plan is the assumption that the two actions will happen at the same time: as regulators cut nicotine in conventional cigarettes, manufacturers will provide alternative products.

But that presumes that tobacco companies will willingly part with their flagship product, which remains enormously profitable.

Kenneth Warner, the public policy professor, said he would be “astonished” if industry cooperates on reducing nicotine levels.

“I don’t think they will. I think they will bring out all of their political guns against it and I’m quite certain they will sue to prevent it,” he said.

In that scenario, the FDA plan to make cigarettes less addictive could be stalled in court for years while companies begin launching FDA-sanctioned alternative products. Tobacco critics say that scenario would be the most profitable for industry.

“It’s like Coke, you can have regular Coke, Diet Coke, Coke Zero, we’ll sell you any Coke you like,” said Robin Koval, president of the Truth Initiative, which runs educational anti-tobacco campaigns.

But the FDA’s Gottlieb says the two parts of the plan must go together. “I’m not going to advance this in a piecemeal fashion,” he said.

When pressed about whether industry will sue FDA over mandatory nicotine reductions, tobacco executives for Altria and other companies instead emphasized the long, complicated nature of the regulatory process.

“I’m not going to speculate about what may happen at the end of a multiyear process,” said Jose Murillo, an Altria vice president. “It will be science and evidence-based and we will be engaged at every step of the way.”

 

January, 2018|Oral Cancer News|

HPV vaccine is safe, effective after 10 years: study

Author: AFP/RelaxNews
Date: November 30, 2017
Source: Globalnews.ca

New research looking into the long-term effects of the human papillomavirus (HPV) vaccine has found it to be both safe and effective in protecting against the most virulent strains of the virus.

Led by Dr. Daron G. Ferris, professor in the Department of Obstetrics and Gynecology at the Medical College of Georgia and at the Georgia Cancer Center at Augusta University, the study is the longest followup to date on the vaccine, looking at data from 1,661 male and female participants who were followed for just under 10 years.

Of these participants, around two-thirds received a three-dose regimen of the vaccine when they were ages nine to 15 and sexually inactive.

Initially about one-third received a placebo — not a vaccine — however, the placebo group also received the vaccine 30 months into the study, meaning that these individuals were followed a shorter period of time.

Ferris found that the vaccine was virtually 100 per cent effective in preventing the disease, although vaccinating earlier produced the most robust initial and long-term antibody response, the proteins found in the blood which help fight infection.

“We needed to answer questions like if we vaccinate earlier in life, will it last,” explained Ferris, “The answer is yes, this cancer prevention vaccine is working incredibly well 10 years later. A booster vaccine likely will not be needed by these young people. I think now we have come full circle.”

The new finding also supports previous research which suggests that a more widespread and earlier administration of the HPV vaccine, before teens and preteens are exposed to the infection, is the preferred option.

Although the disease can be cleared in around two-thirds of infected individuals, the virus can persist in the remaining one-third, potentially causing a wide range of further health problems.

The quadrivalent vaccine, which protects against HPV types 6, 11, 16 and 18, is designed to better arm the immune system to eliminate the virus.

According to the National Cancer Institute, HPV types 16 and 18 account for essentially all cervical cancer and for most other HPV-related cancers such as penile and anal cancers. Types 6 and 11 account for about 90 per cent of genital warts as well as non-cancerous tumour growths in the respiratory tract.

 

HPV is the most sexually transmitted infection in the U.S.A. Around 79 million Americans, most in their late teens and early 20s, are infected according to the Centers for Disease Control and Prevention (CDC). HPV is also the most common cause of cervical cancer.

The Food and Drug Administration approved the first quadrivalent vaccine, Gardasil, in June 2006, with the vaccine currently approved for patients ages nine to 26.

 

Although the CDC reports that around 43 per cent of U.S. teens are up to date on recommended doses of the HPV vaccine, Ferris added that, “Now we need to push for more young people to get vaccinated. We are doing miserably in the United States.”

The HPV researchers added that the vaccine can be given along with the meningococcal and tetanus, diphtheria and pertussis vaccines, to 11- and 12-year-olds.

The results can be found published online in the journal Pediatrics.

November, 2017|Oral Cancer News|

Superseed? Apricot kernels, touted as cancer cure, linked to cyanide poisoning

Author: Catherine Solyom
Date: November 22, 2017
Source: flipboard.com

Brendan Brogan had just returned from a shopping trip on the Plateau laden with exotic snacks.

On a visit to Montreal from California, he stood in the doorway of his buddy Mike Guetta’s room, munching away on something as they discussed the absurdities of the day.

Then Guetta looked up.

“Those better not be almonds,” he said. “You know I’m allergic to those.”

“No, no,” Brogan replied, “I would never do that. These are apricot pits.”

“What?!? Don’t eat those! They’re poisonous!”

Brogan pooh-poohed the warning, arguing the kernels were organic and he’d bought them at the health food store.

“Look! It’s the superseed of the Hunza people, with Vitamin B17!”

Then he turned the bag over and read the fine print. His face went grey: “Caution: Do not consume more than 2-3 kernels per day. Keep out of the reach of children. Pregnant and nursing women should not consume apricot kernels. Health Canada warns that eating too many apricot kernels can lead to acute cyanide poisoning.”

After a quick call to poison control, Brogan rushed to the nearest emergency room. He had eaten a third of the bag.

Apricot kernels, like cherry pits and apple seeds, contain a product called amygdalin, also known as laetrile and marketed as Vitamin B17.

Bitter apricot kernels — the pits of the pits — are widely available in Montreal health food stores, including at Rachelle-Béry branches across the city, where Brogan bought some. They are gluten-free, pesticide-free, vegan and organic.

They are also potentially lethal, as Brogan found out.

The kernels, like cherry pits and apple seeds, contain a product called amygdalin, also known as laetrile and marketed as Vitamin B17, though it’s more like an anti-vitamin.

When the seeds are chewed and digested, the amygdalin is converted to cyanide in the stomach. Eat too much of them — more than three apricot kernels for an adult and just one kernel for a toddler — and cyanide poisoning can occur.

Cyanide cuts off oxygen supply. Symptoms include headache, dizziness, mental confusion, weakness, difficulty breathing, abdominal pain, nausea, vomiting, seizures, coma and, eventually, death.

That’s why Australia, for one, has banned the sale of apricot kernels. But that didn’t stop a Melbourne man from slowly poisoning himself by ingesting 17 mg of homemade apricot kernel extract per day, in the mistaken belief that it would cure his prostate cancer. When doctors performed routine surgery on him in September, they found cyanide levels in his blood that were 25 times the accepted level.

Germany and the United Kingdom have also restricted the sale of apricot kernels, after a number of cases of children hospitalized for cyanide poisoning. In 2011, for example, a 28-month old girl was rushed unconscious to hospital in Turkey. She died in hospital of acute cyanide poisoning 22 days later. She had eaten 10 kernels.

The U.S. Food and Drug Administration has prohibited the sale of apricot kernels if  “intended for use in the cure, mitigation, treatment, or prevention of disease.”

The Canadian Food Inspection Agency, for its part, issued a recall and health hazard alert for Our Father’s Farm brand of apricot kernels in 2009, after a reported case of cyanide poisoning.

Since then the agency has received two more complaints of illness.

Packaging must now carry Health Canada’s warning label. But other brands have filled the void left by Our Father’s Farm.

 

Brogan bought the Organic Traditions brand of the kernel. Manually harvested and imported from Uzbekistan, the kernels are perhaps the “prized superseed” of the Hunza people. It says so right there on the packaging, along with the following claims: “contains vitamin B17” and “used in Ancient Asian medicine for centuries.”

In texts dating back to the 1930s that are rehashed by consumer direct and alternative health websites, the Hunza or Burusho people of the Himalayan region of northern Pakistan are said to live to be 140 and never get sick.

It must be because of the kernels, the story goes.

For example, a Facebook site liked by  997,744 people — titled “The truth about cancer” — says the Hunzas enjoyed near-perfect health.

“Some lived to be over 135 years old and no one in their clan had any of the conditions so common in the modern world, such as diabetes, obesity, heart attack, and cancer.” The website continues in bold lettering, noting that “they ate massive quantities of apricot seed kernels.”

Numerous other websites also claim that apricot kernels can prevent or cure cancer. The kernels are said to treat arthritis, boost your immune system and even serve as an aphrodisiac.

The truth about apricot seeds — and the Hunza people — is less rosy, however. A New York Times reporter who travelled to this Shangri-La in 1996 discovered a beautiful place indeed. But the elderly men who looked to be 140 were probably more like 70.

“The great Hunza secret to old age turned out to be its absence of birth records,” John Tierney wrote.

By  modern accounts, Hunza life expectancy is similar to other people in remote mountain regions who go through cycles of food scarcity — 50 to 60 years old.

On the seeds themselves, the science has been conclusive. Numerous studies show that amygdalin does kill cancer cells — and all other cells too.

Joe Schwarcz, the director of McGill University’s Office for Science and Society, said the initial idea — generating small amounts of cyanide to kill fast-multiplying cancer cells — was not a bad one. But it just doesn’t work, he said.

The sale of apricot seeds “clearly should not be allowed,” he said, surprised at how readily they are found on store shelves in Montreal.

Schwarcz says Health Canada is overwhelmed and useless at stopping the sale of bogus health remedies.

“With dietary supplements, they tend to say well, it’s not really dangerous, and let them be,” Schwarcz said, vowing to confront Health Canada about the sale of the seeds as a vitamin. “But this one is not in that category. You don’t need a lot of these kernels to do a lot of harm.”

A spokesperson for Health Canada said it is powerless to stop the sale of a product if its distributor does not claim any health benefits. It referred the Montreal Gazette to the Canadian Food Inspection Agency.

The CFIA said it merely enforces Health Canada directives.

Neither agency would comment on why apricot seeds are sold in Canada at all — as vitamins or snacks — given their known toxicity.

 

Upon arrival at Hôtel-Dieu Hospital, Brogan was given a tall Styrofoam cup of charcoal then placed on a gurney in the hallway to monitor his condition.

No one, from the person who answered the phone at poison control to the triage nurse to the doctor on duty, could believe that apricot seeds were being sold in Montreal.

Eight hours later, Brogan was released from hospital with a $1,125 bill. He had no health insurance, he explained.

“Those seeds were the most expensive snack I’ve ever eaten.”

Guetta went back to Rachelle-Béry to alert them of the danger. The store manager seemed alarmed and immediately took all the remaining packages off the shelves.

But when Guetta returned a few weeks later, there they were again. The superseed of the Hunza people.

 

 

 

 

 

November, 2017|Oral Cancer News|

3 Lessons From An Alarming Case Of Mistaken Cancer Gene Test Results And Surgery

Date: October 28, 2017
Source: Forbes.com
Author: Elaine Schattner

A horrifying story broke last week about a 36-year-old Oregon woman who had elective surgery to remove her uterus and breasts. Elisha Cooke-Moore underwent a prophylactic total hysterectomy and bilateral mastectomy, with nipple-sparing reconstruction and implants, after medical practitioners informed her she had cancer-causing genes. Only later, she learned she didn’t have the abnormality about which she’d been informed. There’s a lawsuit.

As reported in The Washington Post, Cooke-Moore expressed concerns to a doctor about her family’s cancer history before getting tested for mutations in BRCA-1, BRCA-2 and related genes in 2015. A nurse practitioner reviewed the results and erroneously told her she had Lynch syndrome because of an MLH1 mutation. BRCA testing was “negative.” It’s not clear if any doctor directly reviewed the lab report. An obstetrician-gynecologist informed Cooke-Moore that her chances of developing breast cancer were 50% and for uterine cancer up to 80%. In 2016, at least two surgeons operated.

Cooke-Moore discovered the mistake while looking over her medical records: The MLH1 result was “negative,” she noted in 2017. “I am damaged for the rest of my life,” Cooke-Moore told The Washington Post.

Never mind the specifics. While it sounds like the plaintiff received egregious care, and I am sympathetic, I see this as a larger story of confusion over genetic test results leading to irreversible harm. My aim here is not to probe Cooke-Moore’s results or the circumstances of her decisions, but to consider the lessons for other patients and doctors. This case should be a wake-up call about the quality of DNA testing and what variable guidance patients receive about their results. The implications are broad.

Checking genes for presence or absence of mutations is not straightforward as you might think. Mutations vary: They’re rarely “positive” or “negative,” end of story. Some doctors may not fully appreciate the nuances of genetic findings. While some DNA abnormalities are clearly linked to disease, such as mutations tied to cystic fibrosis or sickling of hemoglobin, often there’s a range of severity of illness and pathology among affected patients. Among the cancer risk genes, BRCA-1 and -2 are probably the best studied. Yet even for those, doctors don’t yet understand why some people who inherit BRCA mutations don’t develop cancer, i.e., what mitigates disease risk. Some changes are deemed variants of uncertain significance.

Given the enormity of this subject, I’ll focus on three practical measures to reduce regrettable outcomes after testing for cancer genetic risk.

  1. If you consider getting tested for familial cancer risk, ask where your sample will be evaluated, and exactly what genes will be tested.

The practitioner may or may not know the answer to these questions. But part of the point of asking is to ensure that the responsible physician or genetics counselor is clued in to the details because gene testing companies vary in their methods, which gene variants they report, how fully they report on those, and how they interpret any detected abnormalities.

Some companies, like Myriad Genetics, focus on BRCA and related cancer risk-associated genes. Myriad offer various testing panels to assess hereditary cancer risk. Some large and more general commercial laboratories, like LabCorp and Quest Diagnostics, offer BRCA-related panels (BRCAssure and BRCAdvantage, respectively). Ambry is another player in this field. More recently Color Genomics, a San-Francisco based company, entered the fray; they’ll check your BRCA status for less. Some universities and hospitals offer “in house” testing.

These labs (and this is not a comprehensive list) use distinct and sometimes proprietary ways of extracting DNA from samples, amplifying and analyzing genetic material. They employ different scientists who develop methods and interpret results variously in context of the rapidly-growing literature on cancer risk and cancer-related mutations. The doctor who orders genetic tests should be aware of these possible differences.

At the minimum, before making any decisions I’d want to know that my test was performed in a CLIA-certified laboratory.

  1. Before taking any treatment based on a genetic test result, hit the pause button. Get a copy of the full report and keep it. Ask questions. Try to get a second opinion.

Before agreeing to anything so drastic as prophylactic surgery, or taking medication aimed at reducing cancer risk, you might want to have the test repeated, to confirm or supplement initial results. Even nonprescriptive changes, like adjusting your diet, or participating in a clinical trial for people with specific genetic variants, carries possible benefits and risks. You might wind up taking a medicine, or getting screened in a way that you would not have otherwise.

Among the questions I’d want to ask a doctor are these: “How confident are you about the accuracy of my test result?” and “What are the implications for my health?”

Whenever possible, get a second opinion before a major procedure or treatment is implemented. Ideally, advice would come by a physician familiar with both the nitty-gritty of DNA testing and the relevant medical condition. Keep in mind, experts may have informed but distinct and biased perspectives on the significance of an abnormality, such as an MLH1 mutation. The most knowledgeable physicians may not have ready answers when it comes to interpreting DNA findings in context of an individual patient with a unique medical history and concerns. Consulting with a genetics counselor may also be helpful.*

  1. Use the web and other resources, including patient-oriented organizations, to learn what you can about your genetic results.Here’s a partial list of societies and websites that provide information about genetic testing for cancer risk:

Cancer.net offers information about hereditary cancer syndromes that is provided by the American Society of Clinical Oncology;

FORCE (Facing Our Risk of Cancer Empowered) is a patient-oriented organization with many resources and detailed information for people affected by a familial disposition to developing breast, ovarian and other cancers;

The National Cancer Institute’s Genetics of Cancer page includes numerous links to NIH resources for particular cancer risk genes and syndromes;

National Society of Genetic Counselors details the role of genetic counselors and refers to several resources for patients;

The American Society for Human Genetics is a professional organization that offers general information on gene testing and links to additional resources.

I’m constantly amazed at the explosive field of diagnostic human genetic testing. Despite my concerns about the quality and guidance of interpreting results, I’m impressed by the power of diagnostic human genetic testing. For people who are ill, gene testing can be enormously helpful in establishing the cause of disease, pinpointing a diagnosis, and in some situations knowing how best to treat a medical condition. For those who have reason to worry about inheriting a disposition to disease, gene testing could offer life-saving information about pre-emptive or risk-reducing interventions. In each of these circumstances, informed guidance provided by doctors — in interpreting results and in clinical decision-making — is crucial.

 

October, 2017|Oral Cancer News|

A Wellness Blogger Who Lied About Having Cancer Has Been Fined $322,000

Source: Motherboard.vice.com
Author: Kaleigh Rogers
Date: September 28, 2017

There are serious consequences that come from hawking pseudoscience online, including harming your readers or yourself. But in case physical harm isn’t enough motivation to quit slinging shady “wellness” advice online, here’s another reason: you could wind up getting fined.

That’s what happened to disgraced Australian wellness blogger Belle Gibson, who has been fined $322,000 for claiming she treated her brain cancer without conventional medicine. Gibson had said she overcame an inoperable brain tumor, stroke, and cardiac arrests through clean eating, and avoiding dairy, gluten, and coffee. Conveniently, these claims helped her to sell her book The Whole Pantry, and app of the same name, raking in nearly half a million AUD. But in 2015, an investigation by Australian Women’s Weekly—complete with Gibson’s confession—revealed it was all a hoax.

In response, Consumer Affairs Victoria brought a case to federal court, and in March Gibson was found guilty of five breaches of consumer law. On Thursday, Gibson was ordered to pay the fine of $410,000 AUD ($322,000 USD).

It’s not the first time shady wellness tips have caused controversy for bloggers. Gwyneth Paltrow’s venture, Goop—the epitome of pseudoscience profiteering—has been called out for flogging all kinds of questionable goods, including a jade vagina egg that some gynecologists warned could cause infections.

Or the wellness trend of eating whole aloe vera leaves that led one vlogger to be hospitalized after eating a poisonous agave plant by mistake.

When wellness bloggers tell the truth, and really do try to fight off cancer without any conventional treatment, it doesn’t usually work out so well. A popular 30-year-old blogger died in 2015 after she tried to cure her cancer with coffee enemas and raw juices. And in case you’re inclined to trust your blogger of choice, lest we forget the former naturopath who told us how easy it was to create and sell a detox diet scam.

Wellness blogging is a trendy, profitable market right now, but let this be a warning: all that easy money can come at a price.

September, 2017|Oral Cancer News|

Cancer is a fungus’?! We need to get serious about evidence-based treatment

Source: http://www.telegraph.co.uk
Date: August 3rd, 2017
Author: Judith Potts

Over the last few years I have come across myriad myths about cures for breast cancer – indeed all cancers.  Of course, everyone is looking for a treatment which does not involve chemotherapy, a diagnostic test which does not use radiation, or a treatment without side effects.

While thermography may be an innovative concept, there is little good evidence that it is effective in detecting breast cancer at an early stageEluned Hughes, head of public health and information at Breast Cancer Now

But I have lost count of the number of times I have heard that ‘Cancer is a fungus and Sodium Bicarbonate is the cure’.  I have even been sent an amateur video of a man mixing his sodium bicarbonate potion in an extremely unhygienic-looking  kitchen. Part of the Cancer Research UK’s website carries ‘10 Persistent Cancer Myths Debunked’ which makes an interesting read –  . Alternative therapies abound and all are described as ‘natural’.

The word is applied to food, to beauty products and to fabrics – but, all too often, the list of ingredients denies the description. Last week, an email dropped into my inbox introducing me to Dr Nyjon Eccles and describing his work at his clinic in London’s Harley Street – The ‘Natural’ Doctor.  Was it referring to his treatments as being ‘natural’ in the sense of pure, unadulterated and complementary, or did he mean that he was born a ‘natural’ doctor?

I discovered that Dr Eccles is offering a breast cancer screening clinical test called ThermoCheck, a computer-assisted thermography which is ‘a 15 minute, painless, non-invasive, state of the art clinical test without any exposure to radiation’.  Dr Eccles believes the test can be used on women as young as 20 and it will “identify metabolic changes in the tissue and is a much earlier indicator of breast health compromise than traditional mammograms”.

He says that thermography may identify pre-cancerous changes; thermography, the website script goes, “looks for physiological irregularities, whereas mammography looks for anatomical irregularities.  The infra-red camera takes thermal images of the breasts which show a heat map of the surface of the skin detecting any metabolic changes and signs of abnormal blood vessels- which give off more heat than the surrounding tissue – at an early stage, possibly 6-10 years before a tumour is big enough to be seen on a mammogram.”

Needless to say, there is a price to this test – the initial breast thermography and consultation (up to 90 min) is £395, with a breast thermography scan (up to 30 mins) at £245. Added to this is Dr Eccles’ Breast Nutricheck, which is a home test kit which ‘identifies several nutrients that seem to impact on breast tissue health’. This costs £425.

With so much written about breast cancer, particularly about the genetic varieties, I am concerned that many women (I note that men are not included) – particularly the young – may be persuaded to undertake this test on a regular and expensive basis.  So I turned to Breast Cancer Now to find out whether or not thermography was an accepted and proven way to detect early breast cancer.

It seems to me that not enough has been done to compare thermography to mammography with ultrasound

Eluned Hughes, head of public health and information at Breast Cancer Now told me: “While thermography may be an innovative concept, there is little good evidence that it is effective in detecting breast cancer at an early stage – let alone that it could replace traditional mammography.  Any new screening test would need to demonstrate even greater sensitivity than mammography, as well as better accuracy in detecting breast tumours and distinguishing between cancerous and healthy cells.  Unfortunately, there is currently no evidence to suggest that thermography is capable of either.”

This lack of evidence has led to the Royal College of Radiology, the Royal Australian and New Zealand College of Radiologists and The American Society of Breast Imaging specifically not endorsing the process.

One of the concerns raised is that women who undergo thermography may delay visiting their doctor with a significant symptom, or attending for screening, if they believe that thermography is an adequate replacement for a visit to the GP or a mammogram.

I brought these concerns to Dr Eccles, who said that thermography has been shown to have a better sensitivity for detecting existing cancers than mammography, and that the variable results may be because “some thermographic studies have not used accepted standardised protocols.”

Arguing that thermography should be offered by doctors alongside other structural scans, he told me: “It is simply not true that there is no evidence for thermography’s usefulness. It time for doctors to make honest and correct statements about mammography screening based on the latest evidence – i.e. the risks outweigh the benefits. Thermography is at the very least, a valuable non-invasive adjunctive tool to identify women at risk and help detect pre-cancerous changes in the breast. If used correctly, it has the potential to help us significantly reduce breast cancer incidence.”

Studies continue to be conducted in the USA to explore the potential of infrared imaging of the breast, but it seems to me that not enough has been done to compare thermography to mammography with ultrasound, breast MRI, or nuclear imaging. One day there might be and perhaps the results will vindicate Dr Eccles but, until we can be assured that thermography will give an accurate diagnosis, please remember that if you have a family history of breast cancer, regular screening or other interventions can be offered by the NHS at a younger age than the 49-50 age group at which invitations for mammograms arrive.

August, 2017|Oral Cancer News|

Personalized cancer vaccines successful in first-stage human trials

Source: http://newatlas.com/cancer-personalized-vaccine-success-trial/50402/
Author: Rich Haridy
Date: July 9, 2017

A cancer vaccine is one of the holy grails of modern medical research, but finding a way to stimulate the immune system to specifically target and kill cancer cells has proven to be a difficult task. Now two recent clinical trials that have produced encouraging results in patients with skin cancer are are providing hope for the development of personalized cancer vaccines tailored to individual patient’s tumors.

Both studies focus on neoantigens, which are mutated molecules found only on the surface of cancer cells. Neoantigens prove to be ideal targets for immunotherapy as they are not present on healthy cells. A vaccine’s challenge is to train the body’s immune cells, known as T cells, to hunt and kill only those specific tumor cells that hold the target neoantigens.

In the first trial, at Boston’s Dana-Farber Cancer Institute, samples of tumors were taken from six patients with melanoma. The patients were identified as having a high risk for recurrence after first having their tumors removed by surgery. For each individual patient the researchers identified up to 20 neoantigens specific to a subject’s tumor.

Computer algorithms were then utilized to help the researchers select which specific neoantigens would best stimulate the body’s T cells. Those neoantigens were then synthesized, mixed with an adjuvant to stimulate immune response, and injected into the individual patients.

Four out of the six patients in this first trial displayed no recurrence of their cancer 25 months after vaccination. The other two patients did have a recurrence of cancer, although in those cases the cancer had already spread into their lungs. After a secondary treatment with the drug pembrolizumab, they also entered complete remission.

The second trial, by Biopharmaceutical New Technologies (BioNTech) in Germany, used a similar strategy that targeted neoantigens in 13 patients with melanoma. These vaccines targeted up to 10 specific neoantigens in each individual patient, and after 12 to 23 months eight subjects were cancer-free.

The vaccines in both studies successfully stimulated both kinds of cancer-killing T cells: the CD8+ cells and their CD4+ helper cells. The studies also found that the T cells were able to specifically target a patient’s tumor.

It’s still early stages in research terms, but these results are incredibly promising. With more, and broader, clinical trials set for the near future, it is yet to be seen how effective these kinds of personalized vaccines are across a wide range of different cancers. A larger clinical trial that also targets bladder and lung cancers is currently underway.

One of the big challenges to overcome, should this form of personalized treatment prove broadly successful, is the cost and time in developing these customized vaccines. Current estimates claim a single patient’s neoantigen vaccine costs up to $US60,000 to produce. In tandem with other new drug innovations, some patients could be paying several hundred thousand dollars for these treatments should they reach the market.

The time it takes to produce an individual vaccine is also a concern when considering how this treatment could be rolled out on a mass scale. It took several months to produce the vaccines in both studies, but the researchers are confident this time frame could be reduced to six weeks or less. However, this is still a significant amount of time if the process was to be rolled out on a large scale.

Pragmatic challenges aside though, these neoantigen vaccines could pave the way for an exciting new form of personalized cancer treatment. One that allows for specific tumors to be targeted by the immune system through customized vaccines.

The results of the Dana-Farber Cancer Institute trial were published in the journal Nature, as were the results of the second trial by Biopharmaceutical New Technologies (BioNTech).

July, 2017|Oral Cancer News|