Henderson throat cancer patient rallies after cutting-edge treatment

Source: www.reviewjournal.com Author: Mary Hynes, Las Vegas Review-Journal In February, a cancerous tumor caused extreme swelling in Ruben Solis’ neck and face, blocking his airway. After an emergency tracheotomy, an incision to his windpipe that allowed him to breathe, Solis had to decide whether he wanted to enter a clinical trial to receive an experimental treatment. The 54-year-old Henderson resident was skeptical. But with stage 4 laryngeal cancer that had spread to his lungs, he was running out of options. Three months later, after three treatments, the tumors in his throat and lungs have dramatically shrunk and the swelling subsided. “I feel much better,” Solis said Monday. The father and grandfather, who worked in banquets and as a food and beverage manager on the Strip before falling ill, is the first person in the world to receive a combination of two experimental drugs, Enoblituzumab and Retifanlimab, as part of a new clinical trial for head and neck cancer, according to Comprehensive Cancer Centers of Nevada, the local site participating in the global study. Solis and his oncologist, Dr. Anthony Nguyen, spoke with reporters prior to the patient receiving his fourth infusion of the two drugs. The treatment is a new form of immunotherapy, which boosts the body’s immune system to combat the cancer. “So his immune system is actually being manipulated, turned on, to actually fight the cancer from inside,” Nguyen said. In this way it is different from traditional chemotherapy. “When we think of chemotherapy and cancer medicine, we [...]

New therapy shortens treatment for HPV-related cancers of the tonsils, tongue

Source: medicalxpress.com Author: From Mayo Clinic News Network, Mayo Clinic News Network Patients with HPV-related oropharyngeal cancer who undergo surgery and are treated with chemotherapy, may be able to forgo significant radiation therapy without increasing the risk of their cancer spreading, according to the results of a clinical trial led by researchers at Mayo Clinic. "We found that decreasing the amount of radiation therapy after a minimally invasive robotic surgery improved the quality of life of patients with HPV-related oropharyngeal cancer while delivering excellent cure rates," says Dr. Eric Moore, a Mayo Clinic otolaryngologist. "In essence, we found exactly the right amount of treatment to deliver without over-treating these patients." Dr. Moore and his colleagues compared 79 patients treated at Mayo Clinic for HPV-related tonsil and tongue cancer with surgery and two weeks of radiation therapy to a group of 115 patients with the same cancer who were treated with surgery, and the standard six weeks of radiation therapy and chemotherapy. Dr. Moore and his colleagues found no decrease in survival or cancer recurrence in the group that received two weeks of radiation therapy, compared to the group that received six weeks of radiation therapy. He says that by decreasing the amount of radiation therapy after minimally invasive robotic surgery, physicians were able to improve the quality of life of patients and achieve excellent cure rates. "In essence, we found exactly the right amount of treatment to deliver without overtreating," says Dr. Moore. Dr. Moore says Mayo Clinic now offers [...]

Deal-making in head and neck cancer to start yielding dividends for patients

Source: www.thepharmaletter.com Author: staff A frenzy of deal-making activity in head and neck cancer is bringing late-stage clinical candidates into view, according to GlobalData. Intelligence from the data and analytics provider shows that there have been some 340 licensing agreements since 2004 in head and neck cancer, amounting to an approximate total value of $35 billion. Aarohi Rede, oncology analyst at GlobalData, said: “The past few years have seen several licensing deals globally for clinical development in head and neck cancer. Merck KGaA’s collaboration with Debiopharm has the potential to transform the current treatment paradigm for head and neck squamous cell carcinoma (HNSCC) by combining xevinapant, a new molecular entity, with Merck KGaA’s strong commercialization capabilities.” Of the total licensing agreements signed, the highest recorded licensing agreements took place in North America, followed by Asia-Pacific, while the lowest recorded number of deals belonged to South and Central America. Dr Rede added: “Head and neck cancer is largely a chemotherapy-dominated market, but the past few years have seen effective use of Keytruda (pembrolizumab) and Bristol Myers Squibb’s Opdivo (nivolumab) in the recurrent or metastatic settings. The current clinical development pipeline has around 20 late-stage agents in the immuno-modulating therapy or cell inhibitor classes, thus revealing a robust late-stage pipeline that is highly conducive to future partnerships for licensing and commercialization, and is expected to contribute to significant market growth over the next ten years.” Many of these licensing deals involve strategic partnerships between Asia-Pacific, namely Chinese manufacturers, and US pharmaceuticals for [...]

On treating advanced head and neck cancer without cisplatin – an oncology grand rounds discussion

Source: www.medpagetoday.com Author: Mark L. Fuerst An oncology grand rounds discussion with Sachin Jhawar, MD. Head and neck squamous cell carcinoma (HNSCC) represents a heterogeneous set of diseases with different features and treatment recommendations. Physicians face challenges in initial treatment decision-making and response assessments, including the changing role of surgery, the incorporation of human papilloma and Epstein Barr virus status, as well as the potential for treatment de-escalation using patient-related and tumor-related factors. A recent "Oncology Grand Rounds" article in the Journal of Clinical Oncology provides an overview of treating advanced HNSCC when cisplatin is not an option, including concurrent chemotherapy, cetuximab, targeted therapy, and immunotherapy. In the following interview, the paper's lead author, Sachin Jhawar, MD, of Ohio State University Comprehensive Cancer Center in Columbus, reviews the main issues. What is the focus of the article? Jhawar: We focused on patients with locally advanced disease who would be receiving definitive non-surgical treatment when possible treatment with concurrent cisplatin, delivered either every 3 weeks or weekly, is always the preferred treatment. We specifically wanted to delve into the subset of patients who we would not recommend to receive cisplatin because of age or comorbidities. This could be concurrent chemotherapy (carboplatin/paclitaxel), concurrent cetuximab, and altered or standard fractionation radiation schedules without systemic therapy, as well as when to consider immunotherapy and palliative radiation for those with recurrent or metastatic disease. There is also a great deal of institutional preference involved. At our institution, we prefer concurrent carboplatin/paclitaxel in patients who cannot [...]

Thousands of Britons with deadly mouth cancer will be spared gruelling chemotherapy thanks to immune-boosting drug

Source: www.dailymail.co.uk Author: Eve Simmons for The Mail on Sunday Thousands of Britons with deadly mouth cancer will now be spared grueling chemotherapy thanks to an immune-boosting drug. The treatment, given the green light by health chiefs last week, offers fresh hope to patients whose cancer has either spread or deemed inoperable. Currently, these patients have two options to prolong their life – chemotherapy and weekly infusions of potent cancer drugs, which often leave patients debilitated and confined to bed for the short time they have left. But now immunotherapy drug pembrolizumab can help some patients with the disease live up to 30 per cent longer than they would with chemotherapy, with 50 per cent fewer side effects. Last week's ruling by UK health watchdog NICE, which was based on the results of final-stage international trials, permits the treatment not only for advanced mouth cancer but also cancers of the nose, sinuses and salivary glands, known collectively as head and neck cancers. Doctors must first test patients' tumours for a protein called PD-L1, which limits the immune system's ability to find and destroy the cancer. Immunotherapy drugs such as pembrolizumab blocks PD-L1, helping the body's fighter cells to attack tumours.The majority of people with advanced head and neck cancer will test positive for PD-L1. Roughly 12,000 Britons are diagnosed with these cancers every year – mostly men over the age of 70. In the majority of cases, head and neck cancers are spotted at a late stage as they are [...]

Home-based chemo skyrockets at one US center

Source: www.medscape.com Author: Nick Mulcahy In the fall of 2019, the University of Pennsylvania in Philadelphia started planning a pilot program of home-based chemotherapy for two treatment regimens (one via infusion and one via injection). Six months later, the Cancer Care at Home program had referred 40 patients. The uptake within the university's large regional health system was acceptable but not rapid, admitted Amy Laughlin, MD, a hematology-oncology fellow involved with the program. Then COVID-19 arrived, along with related travel restrictions. Suddenly, in a 4-week period (March 10 to April 7), an additional 135 patients had been referred ― a 300% increase from earlier. The list of chemotherapies delivered went from two to seven, with more coming. "We're not the pilot anymore ― we're the standard of care," Laughlin told Medscape Medical News. "The impact [on patients] is amazing," she said. "As long as you are selecting the right patients and right therapy, it is feasible and even preferable for a lot of patients." For example, patients with hormone-positive breast cancer who receive leuprolide (to shut down the ovaries and suppress estrogen production) ordinarily would have to visit a Penn facility for an injection every month, potentially for years. Now, a nurse can meet patients at home (or before the COVID-19 pandemic, even at their place of work) and administer the injection, saving the patient travel time and associated costs. This home-based chemotherapy service does not appear to be offered elsewhere in the United States, and a major oncology organization [...]

Gabapentin shows efficacy as opioid alternative for patients with head and neck cancer

Source: www.healio.com Author: Jennifer Byrne For many patients with head and neck cancer, treatment-associated oral mucositis is a source of severe pain. Managing this pain is a priority for physicians and interdisciplinary care teams. Although opioid painkillers historically have been used for this purpose, researchers at Roswell Park Comprehensive Cancer Center investigated the use of gabapentin, a drug used to alleviate nerve pain, as an alternative to narcotics for this patient population. “Virtually all patients will require some type of pain relief or analgesic medication during the course of chemotherapy and radiation,” study author Anurag K. Singh, MD, professor of oncology and director of radiation research at Roswell Park, told Healio. “We’ve been studying better ways to improve pain control in this population because standard narcotics just don’t work that well. Patients tend to use a lot and they still experience pain, but they are sleepier.” A dose-dependent effect In their study, published in Cancer, Singh and colleagues randomly assigned 60 patients with head and neck squamous cell carcinoma to one of two treatment regimens: high-dose gabapentin (2,700 mg daily), progressing sequentially to hydrocodone-acetaminophen and fentanyl when needed (n = 31), or low-dose gabapentin (900 mg daily) progressing to methadone as needed (n = 29). Safety and toxicity served as the study’s primary endpoints. Pain, opioid requirement and quality of life served as secondary endpoints. Results showed no difference in pain between the treatment groups, but more patients in the high-dose gabapentin group did not need an opioid while receiving [...]

Survivorship clinic helps patients with what comes after head and neck cancer

Source: www.pittwire.pitt.edu/ Author: Gavin Jenkins, excerpted from the fall 2019 issue of Pitt Med magazine Jonas Johnson presses his hand on Edward Christopher’s neck. The examination room at the UPMC Head and Neck Cancer Survivorship Clinic is chilly on this June morning as Johnson, chair of the University of Pittsburgh Department of Otolaryngology, glides his fingers along the left side of Christopher’s throat. “Your skin is stiff,” Johnson says. “Scar tissue doesn’t go away.” Five years ago, Christopher was diagnosed with human papillomavirus (HPV) positive cancer on the base of his tongue, left tonsil and the lymph nodes on the left side of his neck. After undergoing surgery to remove the tumors, he received radiation treatment and chemotherapy, followed by another procedure to remove his lymph nodes. When he completed the treatment, he posted a picture on Facebook holding a sign that read “cancer free!” That night, he and his family celebrated with dinner at an Italian restaurant. Christopher felt lucky to be alive and grateful to Pitt doctors. He had no idea how difficult the years to come would be. He credits Marci Lee Nilsen, a nurse who is an assistant professor in Pitt’s School of Nursing, with opening his eyes. In 2016, Johnson and Nilsen created the Survivorship Clinic to help patients like Christopher improve their quality of life after beating head and neck cancer. Most patients grapple with dysphagia—difficulty swallowing—and trismus, commonly known as lockjaw. They might experience a loss of taste, tooth decay, dry mouth and [...]

2019-11-19T14:11:06-07:00November, 2019|Oral Cancer News|

Pembrolizumab: New standard of care in head and neck cancer

Source: www.medscape.com Author: Roxanne Nelson, RN, BSN Immunotherapy with pembrolizumab (Keytruda, Merck & Co), either as monotherapy or in combination with chemotherapy, offers a new standard of care for patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC), say experts discussing the results from the company-sponsored KEYNOTE-48 trial. Pembrolizumab plus chemotherapy yielded a significant survival benefit in comparison with standard therapy for both the total patient population and for patients whose tumors were positive for programmed cell death–ligand-1 (PD-L1). Monotherapy with pembrolizumab yielded a significant overall survival benefit for patients with tumors that were PD-L1 positive; and in the total study population, overall survival was noninferior. "Thus, pembrolizumab monotherapy is a new standard of care, first-line therapy option for patients with PD-L1-positive recurrent or metastatic HNSCC. Pembrolizumab with chemotherapy is also a new option for all patients, regardless of PD-L1 status," comment Robert L. Ferris, MD, PhD, from the University of Pittsburgh, Pennsylvania, and Lisa Licitra MD, from the University of Milan, Italy, in a commentary that accompanies article in the Lancet. "The positive results of KEYNOTE-048 represent substantial progress for patients with recurrent or metastatic HNSCC," Ferris and Licitria add. These comments echo the reactions from experts when the study was presented earlier this year at the annual meeting of the American Society for Clinical Oncology (ASCO), as reported by Medscape Medical News at that time. Presenter Danny Rischin, MD, from the Peter MacCallum Cancer Center, Melbourne, Australia, said: "These data support pembrolizumab plus platinum-based CT [...]

2019-11-18T07:13:03-07:00November, 2019|Oral Cancer News|

Year in review: Head and neck cancer

Source: www.medpagetoday.com Author: Ian Ingram, Deputy Managing Editor, MedPage In 2019, headlines in head and neck cancer were dominated by a new first-line approval in squamous cell carcinoma (SCC), further attempts at treatment deintensification in the lower-risk human papillomavirus (HPV) population, and a provocative trial looking at patients' quality of life following either robotic surgery or radiation. Immunotherapy OK'd in First-line Based on data from the three-arm KEYNOTE-048 trial, the FDA approved pembrolizumab (Keytruda) for the first-line treatment of metastatic or unresectable recurrent head and neck SCC. The PD-1 immune checkpoint inhibitor was approved in combination with chemotherapy for all patients, or as monotherapy for those with PD-L1 expression. Final results of the study demonstrated a 23% reduction in the hazard for death for the group treated with pembrolizumab plus platinum chemotherapy (cisplatin or carboplatin) and 5-fluorouracil. This group had a median overall survival of 13.0 months, as compared with 10.7 months for those treated with the EXTREME regimen of platinum chemotherapy plus 5-fluorouracil and cetuximab (Erbitux). A pembrolizumab monotherapy arm of KEYNOTE-048 showed non-inferiority to EXTREME in all comers and superiority in patients with a PD-L1 combined positive score (CPS) ≥1, as represented by a 22% reduction in the hazard for death over the study period. In this CPS ≥1 population, which made up about 85% of the study population, median overall survival was 12.3 with pembrolizumab alone versus 10.3 months with EXTREME. ORATOR Trial Upends Assumption of Surgical Superiority In the first randomized trial to pit transoral robotic [...]

2019-11-16T13:32:00-07:00November, 2019|Oral Cancer News|
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