Head and Neck Cancers: Understanding Risk Factors, Advances in Treatment, and the HPV Vaccine.

Author: John Fernandez Source: baptisthealth.net The classification is known as “head and neck cancers” — but these cases don’t involve the brain and spine. They do involved just about everything else above the collarbone. April is Head and Neck Cancer Awareness Month, when cancer specialists take extra time to remind the public of the top risk factors: tobacco, alcohol, sun exposure and HPV (human papillomavirus). It’s also the time of year when specialists relay the importance of screenings and healthy living. That’s because head and neck cancers are preventable, said Geoffrey Young, M.D., Ph.D., chief of head and neck surgery at Miami Cancer Institute, part of Baptist Health. Head and neck cancers are more treatable today. “There are been significant developments in surgery, radiation therapy and systemic therapy,” explains Dr. Young. “These include transoral robotic surgery, targeted proton radiation, and immunotherapy. All are changing the face of head and neck cancer with new protocols and clinical trials coming out every day.” Head and neck cancers can involve the mucosal lining of upper aero-digestive tract, including nasal cavity/sinuses, oral cavity (tongue, palate, gums), pharynx (back of the throat) and the voicebox (larynx). Head and neck cancer specialists also treat salivary gland cancers, skin cancers and thyroid cancers. “The treatment of head and neck cancer is very complex and multidisciplinary consultation with head and neck surgery, medical oncology, and radiation oncology is often necessary,” adds Dr. Young. The HPV Vaccine Over the last few years, HPV has been making headlines because of the promising development [...]

2022-04-18T09:53:05-07:00April, 2022|Oral Cancer News|

Early warning signs of oral cancer

Author: MetroCreative Connection Source: www.washtimesherald.com Oral cancer is a significant threat across the globe. Data from the World Health Organization indicates that more than 450,000 new cases of oral cancer are diagnosed each year. The Oral Cancer Foundation notes that oral cancers are part of a group of cancers referred to as head and neck cancers. All cancers in that group are potentially dangerous, but oral cancers account for roughly 85 percent of all head and neck cancer diagnoses, which underscores the importance of routine oral health checkups. The Moffitt Cancer Center® in Florida notes that many dentists perform oral cancer screenings during routine checkups, which dispels the notion that checkups are unnecessary for individuals who practice proper dental hygiene every day. The American Dental Association notes there is not a one-size-fits-all regimen for dental health. However, at least two visits to a dentist per year can ensure teeth stay clean and afford dentists opportunities to screen for oral cancers and detect other issues, including gingivitis. In addition to scheduling routine checkups, individuals can learn to spot the common symptoms of oral cancer. The Moffitt Cancer Center urges individuals to seek medical attention if any of these signs persist for more than two weeks: A sore, irritation or thickness in the mouth or throat • A white or red patch on the inside of the mouth • A feeling that something is caught in the throat • Hoarseness or other vocal changes • Persistent coughing • Difficulty chewing, swallowing or [...]

2022-04-05T07:38:47-07:00April, 2022|Oral Cancer News|

How Marijuana Accelerates Growth of HPV-related Head and Neck Cancer Identified

University of California San Diego School of Medicine researchers have identified the molecular mechanism activated by the presence of tetrahydrocannabinol (THC) — the ingredient that causes people to feel the euphoria or “high” associated with cannabis — in the bloodstream that accelerates cancer growth in patients with human papillomavirus (HPV)-positive head and neck squamous cell carcinoma. “HPV-related head and neck cancer is one of the fastest growing cancers in the United States. While at the same time, exposure to marijuana is accelerating. This is a huge public health problem,” said Joseph A. Califano III, MD, senior author and professor and vice chief of the Division of Otolaryngology in the Department of Surgery at UC San Diego School of Medicine. Head and neck squamous cell carcinoma is the sixth most common cancer worldwide. These cancers begin in the cells that line the mucous membranes inside the mouth, nose and throat. Approximately 30 percent of cases of this disease are related to HPV infection, and it is these cases, in particular that are on the rise. Califano suggested increased marijuana use may be a driving factor. Previous studies have linked daily marijuana exposure to an increased prevalence of HPV-related throat cancer. However, a mechanism linking cannabis exposure to increased growth of the cancer was unknown. Reporting in the January 13, 2020 online edition of Clinical Cancer Research, a journal of the American Association for Cancer Research, researchers outline how the presence of THC in the bloodstream activates the p38 MAPK pathway, which [...]

2020-01-16T15:44:42-07:00January, 2020|Oral Cancer News|

Merck’s Keytruda looks to zoom past Opdivo with fast head and neck cancer review

Source: Fierce Pharma Date: February 11, 2019 Author: Carly Helfand Merck & Co.’s Keytruda is duking it out with Bristol-Myers Squibb’s Opdivo in the head and neck cancer marketplace, but Keytruda just took one step toward a green light that would give it a big edge. The FDA has tagged Merck’s approval application for the immuno-oncology superstar—alone or in tandem with chemo—with its priority review designation in previously untreated patients with head and neck cancer. The move, which Merck announced Monday, sets Keytruda up for a quick trip down the regulatory pathway; the agency expects to have a decision by June 10, Merck said. FDA staffers based their decision on data Merck trotted out at last year’s European Society for Medical Oncology (ESMO) meeting in October. Results showed that solo Keytruda, when pitted against a standard-of-care regimen dubbed by doctors as “Extreme,” could cut the risk of death by 22% in patients testing positive for the biomarker PD-L1. In patients with high levels of PD-L1 in their tumors, that figure shot up to 39%. And when paired with chemo, Keytruda pared down the risk of death by 23% regardless of patients’ PD-L1 status. Based on “the limited interaction we’ve had with key opinion leaders, I think this is seen as practice-changing,” Roy Baynes, Merck SVP and head of global clinical development, said when the data were released. And in addition to shaping opinions on clinical practice, the results also confirmed Keytruda’s place in the second-line setting, where it had previously suffered a narrow trial miss. [...]

2019-02-11T11:48:00-07:00February, 2019|Oral Cancer News|

Immunotherapy extends the life of head and neck cancer patients

Source: Pharmatimes.com Date: 12/3/18 Author: Anna Smith A new immunotherapy can greatly extend the lives of a proportion of people with advanced head and neck cancer, with some living for three years or more, reports a major new clinical trial. The study, by The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, found that the drug – MSD’s Keytruda (pembrolizumab) - has been shown to have significant benefits for patients, with 37% of those who received it surviving for a year or more, compared with only 26.5% of those on standard care. The drug was evaluated in a trial of nearly 500 patients with very advanced head and neck cancer that had spread around the body and already become resistant to platinum chemotherapy, the first-line treatment for the disease. Some 247 patients were randomised to receive Keytruda and 248 to standard of care – chemotherapy or the targeted agent Erbitux (cetuximab). When chemotherapy or targeted therapies stop working, treatment options for people with advanced head and neck cancer are limited, and they are normally expected to survive for less than six months. Patients in the Keytruda arm survived for a median of 8.4 months, compared to 6.9 months with standard treatment. However, a minority of patients responded extremely well to Keytruda – 36 patients saw their cancer partially or completely disappear, and some are still cancer free three years after first receiving the drug. “Our findings show that the immunotherapy pembrolizumab extends the life of people with [...]

2018-12-05T17:20:46-07:00December, 2018|Oral Cancer News|

Study: Immunotherapy better than chemotherapy for subtype of head and neck cancer

Date: November 30th, 2018 Source: Scienmag A randomized clinical trial involving 97 medical centers in 20 countries, including Moores Cancer Center at UC San Diego Health, found that treating patients who have chemotherapy-resistant head and neck cancer with the immunotherapy drug pembrolizumab is more effective and less toxic than standard chemotherapy, reports an international team of researchers in the November 30 online issue of The Lancet. Previous research had shown that pembrolizumab (Keytruda) was safe and effective for treating patients with recurrent or metastatic head and neck squamous cell carcinoma whose disease had progressed while on or after receiving standard chemotherapy. Data from this clinical trial called KEYNOTE-040, a phase III study sponsored by Merck & Co., the manufacturer of the drug, takes the research a step further by comparing the immunotherapy drug head-to-head to three go-to chemotherapy drugs currently used as standard treatment: methotrexate, docetaxel and cetuximab. "We compared pembrolizumab against standard of care to see if it fulfilled the promise of early data for patients who are unlikely to do well on standard therapy," said Ezra Cohen, MD, professor of medicine at University of California San Diego School of Medicine and corresponding author on the study. "In this trial, patients who received pembrolizumab alone had a higher response rate compared to those receiving standard chemotherapy while those responses lasted, on average, one-and-a-half years. Furthermore, the median survival at one year was markedly better. I feel it is safe to say that these types of therapies should be the [...]

2018-12-03T11:14:28-07:00December, 2018|Oral Cancer News|

Penn-led study raises hopes for vaccine to treat head and neck cancer

Date: 09/21/18 Source: The Inquire, philly.com Author: Marie McCullough The patient's head and neck cancer came roaring back, spreading to his lymph nodes and skin, which developed bleeding tumors. Yet despite a grim prognosis, that man is alive and cancer-free more than two years later. In a study led by the University of Pennsylvania and published Friday, researchers hypothesize that his remarkable remission is due to a promising combination: an experimental cancer vaccine that activated his disease-fighting T cells, plus Opdivo, one of the revolutionary "checkpoint inhibitor" drugs that cut a brake on the immune system. "Of course, I'm biased," said Charu Aggarwal, the Penn oncologist who led the study. "In my career, I haven't seen a vaccine as impactful as this." However, the remission may have been due to Opdivo alone; the study lacks data to rule out that possibility. Robert Ferris, director of the University of Pittsburgh Medical Center's Hillman Cancer Center and head of the pivotal study leading to approval of Opdivo, called the Penn-led study "an important intermediate step exploring a strategy that we hope will work." Conventional vaccines prevent diseases by priming the immune system to recognize the distinctive "antigens" on invading microbes. Therapeutic cancer vaccines, like the one in this study, are intended to work after cancer develops by provoking a heightened immune response. Despite decades of research, this approach remains experimental. The only approved product, the prostate cancer vaccine Provenge, was barely effective; the maker filed for bankruptcy in 2015. A major obstacle to treatment vaccines [...]

2018-09-24T09:42:13-07:00September, 2018|Oral Cancer News|

Recommendation Against Routine Thyroid Cancer Screening Retained

Author: Shreeya Nanda Date: 05/23/2017 Source: https://www.medwirenews.com The decision is based on a systematic review of 67 studies, also reported in JAMA, evaluating various aspects of screening, such as the benefits and harms of screening asymptomatic individuals and of treating screen-detected cancers, as well as the diagnostic accuracy of screening modalities. Although there were no trials directly comparing the benefits of early versus late or delayed treatment, two separate observational studies compared the outcome of treatment versus no surgery or surveillance. However, as neither study accounted for confounding variables, robust conclusions could not be drawn, say Jennifer Lin, from Kaiser Permanente Center for Health Research in Portland, Oregon, USA, and colleagues. By contrast, they identified 52 studies, including 335,091 patients, that provided information on the harms of treating screen-detected thyroid cancers. A meta-analysis of the data showed that the incidence of permanent hypoparathyroidism varied between 2% and 6%, while the rate of permanent vocal cord paralysis ranged from around 1% to 2%. Among patients who received radioactive iodine therapy, the excess absolute risk for secondary cancers ranged from 11.9 to 13.3 per 10,000 person–years. And the incidence of dry mouth ranged widely, from approximately 2% to 35%. The USPSTF commissioned the systematic review due to the rising incidence of thyroid cancers against a background of stable mortality, which is suggestive of overdiagnosis. And in view of the results, the task force concluded with “moderate certainty” that the harms outweigh the benefits of screening, upholding the “D” recommendation. The USPSTF emphasizes, [...]

2017-05-23T12:36:12-07:00May, 2017|Oral Cancer News|

Immunotherapies Form New Frontier in Treating Head and Neck Cancers

Source: OncLive.com Date: January 2nd, 2017 In August 2016, the FDA approved pembrolizumab (Keytruda) for patients with platinum-refractory squamous cell carcinoma of the head and neck (SCCHN).1 Not only was it the first immunotherapy approved for head and neck cancer (HNC), but it marked the first new drug approval for HNC in the United States in 20 years. “Now we have an agent that really changes the paradigm—a new class of treatment—and we are seeing amazing benefit in some patients,” said Tanguy Seiwert, MD, during an OncLive Peer Exchange® panel held during the 2016 European Society for Medical Oncology (ESMO) Annual Meeting. Less than a month later, the menu of immunotherapy options expanded as the FDA approved nivolumab (Opdivo) for the treatment of patients with recurrent or metastatic SCCHN with disease progression on or after a platinum-based therapy. During the Peer Exchange, the panelists provided an overview of the immunotherapy terrain in HNC, a discussion that was filled with considerable hope and excitement. “When we try immunotherapies in the second-line setting, we see objective responses—sometimes deep, clinically meaningful, extremely durable responses—and we’re beginning to think that maybe, on some occasions, we may be able to cure patients with relapsed metastatic head and neck cancer,” said Kevin Harrington, MD, PhD. This is especially remarkable since such patients have generally had a survival of ≤1 year. The panelists concurred that the care of patients with HNC will evolve significantly over the next 5 to 10 years, as the tip of the immunotherapy [...]

2017-01-11T16:58:01-07:00January, 2017|Oral Cancer News|

Expert Asserts Pembrolizumab to Play Important Role in Head and Neck Cancer Treatment

Source: www.targetedonc.com Author: Laura Panjwani The FDA approval of pembrolizumab (Keytruda) as a treatment for patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) in August 2016 was extremely significant for this patient population, which previously had limited options following progression on a platinum-based chemotherapy. The approval was based on the phase Ib KEYNOTE-012 study, which demonstrated that pembrolizumab had an overall response rate (ORR) of 18% and a stable disease rate of 17% in patients with recurrent/metastatic HNSCC. Several other studies are further evaluating the immunotherapy agent in HNSCC.Preliminary results of the phase II KEYNOTE-055 study—which included 92 evaluable patients who received pembrolizumab after failing platinum and cetuximab therapies—were presented at the 2016 ASCO Annual Meeting. In an interview with Targeted Oncology, lead study author Joshua M. Bauml, MD, an assistant professor of Medicine, Hospital of the University of Pennsylvania and the Veteran's Administration Medical Center, discusses the impact of pembrolizumab’s success in HNSCC, the results of the KEYNOTE-055 study, and what he sees on the horizon for the PD-1 inhibitor in this field. TARGETED ONCOLOGY: What role do you envision pembrolizumab having in this patient population? Baumi: It is going to play a critical role in head and neck cancer. The other agents that are available have limited efficacy, and are associated with significant toxicities. This is a clear improvement for our patient population with limited options. TARGETED ONCOLOGY: What were the key takeaways from KEYNOTE-055? Baumi: Patients with recurrent/metastatic head and neck cancer that [...]

2016-09-22T14:29:26-07:00September, 2016|Oral Cancer News|
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