human papillomavirus

Throat cancer is becoming a national health epidemic say oral fitness experts

Source: californianewswire.com
Author: Raychel Harvey-Jones

As a dentist in practice for over 30 years, Dr. Gary Glassman (“Dr. G”) thought he had seen it all. “I have removed maggots from a child’s gums and a tomato plant that was growing from a seed in another patient. Oral fitness is as important as physical fitness, this week a young man died in California from a tooth infection that spread to his lungs,” says Dr. G.

I will admit I am a little nervous when it comes to visiting the dentist, over the years I have been lucky enough to find very patient dentists who have gradually rid me of my fear. After interviewing Dr. G, I plan on making it a priority to regularly visit the dentist. There is a much bigger problem in the U.S. that’s slowly becoming an epidemic – throat cancer.

Dr. G is concerned about the growing numbers of mouth and throat cancer caused by the Human Papillomavirus (HPV) that is transmitted during oral sex.

Dr. G, a leading global oral fitness expert, says, “The scary part about the growing concern of oral cancer among men is that we think of oral sex as a safer alternative to intercourse.”

According to the Centers For Disease Control and Prevention (CDC), the HPV virus is the most sexually transmitted infection in the United States, and it’s showing up in men aged 40-60 years old. Skeptical? Just ask actor Michael Douglas.

In an interview published in The Guardian newspaper in London, Douglas mentioned that his throat cancer could have been brought on by oral sex, a common way to become infected with HPV. (Douglas later admitted he actually had tongue cancer and “regrets blaming his wife’s vagina.”)

“We are seeing the HPV-positive throat cancer more in older men as they produce less saliva. Saliva acts as a natural coating that protects the mouth from infections. Also, there are a plethora of medications used everyday by older guys that cause dry mouth; medications like Ibuprofen and Amoxicillin,” says Dr. G.

There are about 200 different strains of HPV. Some cause common warts when they invade the skin. Others are the cause of sexually transmitted diseases.

“HPV can cause cervical cancer, as well as cancer in the back of the throat, including the base of the tongue and tonsils, though these are not the same strains of the virus. Cancer often takes years, even decades, to develop after a person gets HPV. More than half of American men who are having sex will get HPV at some point in their lives,” adds Dr. G.

According to the CDC, there is no approved test to check for HPV in the mouth or throat; this is why regular visits to your dentist are critical. A dentist can monitor any changes in your mouth. There are HPV tests that can be used to screen for cervical cancer.

“Your mouth is crucial when it comes to your overall general health. Treat your dentist’s chair as an extension of your trips to the gym; it’s just as vital to your health and fitness,” adds Dr. G.

The HPV vaccine is a must before you are sexually active. However, if you haven’t had the vaccine there are measures you can take, ask your dentist. “It’s not worth the risk,” concludes Glassman.

February, 2017|Oral Cancer News|

Game changer’ HPV vaccine is now just 2 shots – not 3 – in bid to simplify

Source: www.dailymail.co.uk
Author: Mary Kekatos for dailymail.com

  • HPV vaccines will now be administered in two doses instead of three
  • The virus is the most common sexually transmitted infection in the US
  • But only 28% of boys and 42% of girls received the advised three doses in 2015
  • Doctors hope the new guidelines increase the number of kids who get the shot

The HPV vaccine will now be administered in two doses instead of three, new guidelines declare. The new rules, published on Monday, come after years of campaigns from cancer experts insisting an easier schedule would encourage more people to protect themselves from the sexually-transmitted infection.

Human papillomavirus (or, HPV) is the most common STI in the United States, affecting around 79 million people. It has been linked to numerous cancers – including prostate, throat, head and neck, rectum and cervical cancer.

Experts claim more widespread vaccine coverage of middle school children could prevent 28,000 cancer diagnoses a year. Currently, fewer than half the children eligible for the vaccine – given out as three doses over six months – are covered. Experts blame the lengthy, arduous schedule.

The American Cancer Society today endorsed the updated recommendations, which were released by the Advisory Committee on Immunization Practices (ACIP).  Dr Debbie Saslow, Senior Director, HPV Related and Women’s Cancers for the American Cancer Society, said: ‘In the past several years, studies have shown the vaccine is even more effective than expected.

‘This new two-dose regimen is easier to follow, and we now know is very effective in preventing HPV, which is linked to a half dozen types of cancer.’

Each year, about 14 million people become newly infected with HPV. According to the CDC, each year about 19,000 cancers caused by HPV occur in women in the US, with cervical cancer being the most common. And about 8,000 cancers caused by HPV occur each year in men in the US and oropharyngeal (throat) cancers are the most common. Besides cervical cancer, HPV has been linked to vaginal, vulvar, oropharyngeal, anal, and penile cancers.

Despite strong evidence of safety and effectiveness, vaccination rates in the US remains very low compared to other countries. Only 28 percent of boys and 42 percent of girls aged 13 to 17 years receiving the recommended three doses in 2015. The skewed figures between genders are largely attributable to the fact that the jab was only offered to boys as a standard vaccine as of last year.

Previously, it was believed HPV was most strongly linked with cervical cancer in women. Research since has shown links with penile, anal, mouth, throat and other cancers in men. However, the gender divide does not fully account for the staggeringly low levels of coverage overall.

Despite the three vaccines that are widely available, the number who choose to be vaccinated remains low, and the age they wait to do so has increased. Only Rhode Island, Virginia and the District of Columbia require the vaccine for students.

In response to these figures last year, the ACIP, along with the Centers for Disease Control and Prevention (CDC), conducted a thorough review of clinical trial data on HPV vaccines. They found that the vaccine in younger adolescents (aged nine to 14 years) produced an immune response similar or higher than the response in young adults (aged 16 to 26 years) who received three doses.

Generally, preteens receive the HPV vaccine at the same time as whooping cough and meningitis vaccines and it is administered before the likely chance of sexual contact.

The new schedule, approved by the FDA in October 2016, states that two doses of HPV vaccine given at least six months apart at ages 11 and 12 will provide ‘safe, effective, and long-lasting protection against HPV cancers’. Even adolescents between ages 13 and 14 are able to receive the HPV vaccination on the new two-dose schedule.
For patients who did not receive HPV vaccination before age 15, three doses are still required and may be given to females up to age 26 and males up to age 21.

February, 2017|Oral Cancer News|

Feds, cancer centers aim to boost HPV vaccinations

Source: www.dispatch.com
Author: JoAnne Viviano

Faced with getting her daughter the HPV vaccine, which helps protect against cervical and other cancers, Anaraquel Sanguinetti paused.

The human papillomavirus is spread through sexual contact, and the Westerville mom didn’t want her now-18-year-old daughter to think she was promoting promiscuity. So Sanguinetti did some research. And she had a long talk with her daughter, and another with her doctor.

In the end, daughter Celine got the vaccine last year.

“We are discovering every day new reasons why people obtain cancer, so it’s just another added layer of protection for my daughter for her future, because you just never know,” Sanguetti said. “ I didn’t want to have a regret.”

Sanguetti is in the minority. Though vaccinating against HPV is recommended by the Centers for Disease Control and Prevention, and countless cancer centers and health-care providers, most children in the United States have not been vaccinated against HPV.

Calling that “a serious public health threat,” dozens of cancer centers released a joint statement on Wednesday urging more parents and pediatricians to get onboard.

The statement endorses the CDC’s recent revisions to its HPV vaccine recommendations. Vaccinating, the statement says, could help prevent the nearly 40,000 cases of HPV-associated cancers diagnosed in the United States each year.

“Get the HPV vaccine for your child so they don’t have to hear those words: ‘You have cancer,’ “ said Electra Paskett, co-leader of cancer control at Ohio State University’s Comprehensive Cancer Center, which is among the institutions participating in the effort.

The CDC estimates that as many as 79 million Americans are infected with HPV, which can cause cervical, genital, anal, rectal and throat cancers as well as genital warts. Fourteen million new infections occur each year.

A 2016 CDC report says that only about 42 percent of girls and 28 percent of boys had completed the recommended vaccination series. In Ohio, 35 percent of girls and 23 percent of boys have completed the vaccination course.

In all, 69 National Cancer Institute-designated cancer centers are participating in the effort.

The recommendations issued last year say that kids who are 11 or 12 should receive two shots of the HPV vaccine, delivered at least six months apart. The previous recommendation was for three shots, which is still advised for people 15 to 26 years old.

Simplifying the process likely will increase participation and move the nation toward the U.S. Department of Health and Human Service’s goal of having 80 percent of young people vaccinated by 2020, said Dr. Li Li, associate director for prevention research at Case Western Reserve’s Comprehensive Cancer Center.

“This is one of the few preventable cancers,” he said. “There’s a very unique opportunity for us nationwide to get together to put this forward.”

Li said he’d like to see the state mandate that children receive the vaccine at age 11 or 12 to enroll in school. That’s the rule in three states, he said.

Paskett said recommendations also call for bundling the HPV vaccine with other vaccines given at that age.

“The public has been clamoring for a cancer vaccine for decades, and we now have one and we need to use it,” she said.

Sanguetti said she wanted to make sure her daughter was vaccinated before going off to college. She said she would recommend that other parents do their own research and have their children vaccinated even if it is uncomfortable thinking about their sons or daughters having sex.

“It’s for their future,” she said. “It’s more toward their well-being. It’s not promoting anything other than a preventative for cancer.”

For more information, go to www.cdc.gov/hpv.

January, 2017|Oral Cancer News|

Blood-borne HPV antibodies indicate head, neck cancer prognosis

Source: medicalxpress.com
Author: provided by Brown University

People with head and neck cancers with evidence of human papillomavirus (HPV) infection generally have a better prognosis than people without evidence of infection. A new study in JAMA Oncology suggests that to produce a strong, reliable prognostic signal, all that’s needed is a blood serum test for two specific HPV antibodies, rather than lab work on a biopsy. Further, the researchers said, the study shows that this blood-based biomarker is predictive of outcome for all types of head and neck cancer.

bloodbornehp

The human papillomavirus causes not only cervical cancer but also cancers of the head and neck. Credit: National Cancer Institute

“What this adds is that it helps us know how best to measure clinically the HPV contribution to this disease,” said study senior author Karl Kelsey, a professor of epidemiology and of pathology and laboratory medicine at Brown University. Kelsey collaborated with lead author Heather Nelson of the University of Minnesota Masonic Cancer Center in making the findings.

Moreover, Nelson, Kelsey and their colleagues wrote, referring to the common HPV16 strain of the virus: “These data are among the first to demonstrate a convincing relationship between HPV16 and improved patient survival for tumors of the larynx and oral cavity.”

Appraising antibodies
The study examined blood serum samples and five-year survival rates among more than 1,000 Boston-area head and neck cancer patients diagnosed between 1999 and 2011. Overall, those who tested positive for antibodies to the oncogenic HPV proteins E6 or E7 were less likely to die during the five year follow-up period after diagnosis compared to those who tested negative for the antibodies. Based on the analysis, the researchers estimated that those with evidence of an immune response to HPV were 25% less likely to die during the course of follow-up compared to those with no immune response to HPV.

The study’s purpose was to determine whether the antibodies provide a reliable indication of prognosis. In ongoing trials, doctors are testing whether patients with HPV-associated cancers can be treated less aggressively—and hopefully with fewer negative side effects—than people with non-HPV-associated cancers, Kelsey said. If trials prove successful, then it will be particularly important to determine whether cancers are HPV-associated.

“The assessment of a patient’s HPV status likely will affect treatment,” he said. “That’s why there’s real interest in getting it right; for instance, how do you test?”

Better prognosis across the board
Prior studies have focused primarily on the role of HPV in the oropharynx—the area of the throat right behind the mouth. An important contribution of the current study, Nelson said, is demonstration that an immune response to HPV is important for all forms of head and neck cancer, although the benefit does show some variance based on the exact cancer location. Those patients with an HPV immune response with tumors located in the oropharynx and larynx had a similar risk of dying during the follow-up period, though the reduced risk was slightly attenuated for those patients with tumors located in the oral cavity.

The results didn’t depend significantly on whether people had high or low levels of the antibodies, so long as they had some, the researchers found, though testing positive for both E6 and E7 was better than for just one.

The reduced chance of dying by five years carried through for people who tested positive for the antibodies even if they consumed tobacco and alcohol. But the worst prognoses in the study were among smokers whose cancers could not be traced to HPV.

In all, the findings controlled for the statistical influences not only of tobacco and alcohol exposure, but also of age, race, gender, education and how far advanced the cancer was.

Relates to broader advances
Kelsey said the findings could help bring head and neck cancer treatment closer into line with two emerging practices of fighting the disease: personalized medicine and immunotherapy.

“To me, personalized medicine really reflects using all the information you can glean about an individual tumor to treat it appropriately,” Kelsey said. “Here HPV is an example of a causal factor that delineates the mechanism of the tumor suppressor genes that drive the tumor and that gives you insight into the differences in the tumor.”

Meanwhile, the study might help shed light on why immunotherapy—in which the body’s immune system is marshaled to attack cancer—appears to help for some head and neck cancers, Kelsey said. It may not be coincidence, for instance, that the prognosis is better among people whose cancers are associated with a virus that promotes a robust immune response, in the form of antibodies, than among people without a viral cause for their cancer.

If HPV-related cancers can indeed be treated differently, Kelsey said, then serum-based testing to determine the role of the virus could soon be available, too.

December, 2016|Oral Cancer News|

Curbing oral cancer

Source:.businessmirror.com.ph
Author: Henrylito D. Tacio

“Cancer is the third leading cause of death in the country today. Most of it can be prevented since its risk factors are lifestyle and environmentally related. Early detection of cancer is a crucial key to the survival and recovery of its victims. The earlier you detect the malignancy the higher the survival rate of the patient.”
—Dr. Vic Fileto Chua of Movement for Early Detection of Cancer

What’s the leading cause of oral cancer? Is it smoking or heavy drinking? Although smoking and drinking may cause oral cancer, the leading cause is oral sex, a sexual act that involves the stimulation of the genitalia using the mouth.

Studies have shown that 64 percent of cancers of the oral cavity, head, and neck in the United States are caused by human papillomavirus (HPV), which is commonly spread via oral sex. The more oral sex you have – and the more oral sex partners you have – the greater the risk of developing these potentially deadly cancers.

oral_cancer

“An individual who has six or more lifetime partners—on whom they’ve performed oral sex—has an eightfold increase in risk compared to someone who has never performed oral sex,” explained Dr. Maura Gillison, an oncologist at Ohio State University. Gillison headed a team of researchers who examined 271 throat-tumor samples collected over 20 years ending in 2004. They found that the percentage of oral cancer linked to HPV surged to 72 percent from about 16 percent.

The study, which was published in the Journal of Clinical Oncology, said that by 2020, the virus-linked throat tumors—which mostly affected men—will more common than HPV-caused cervical cancer.

“The burden of cancer caused by HPV is going to shift from women to men in this decade,” observed Gillison. “What we believe is happening is that the number of sexual partners and exposure to HPV has risen over that same time period.”

In his weekly column in Philippine Daily Inquirer, Dr. Rafael D. Castillo noted: “Previously, it was well established that smoking (three-fold increase) and drinking alcohol (2.5 times) increased the risk for oral cancer, but even if you combine them, the risk is no match compared to that seen in those who frequently engage in oral sex.”

The government doesn’t have any data on the prevalence of oral cancer in the country but what alarms Castillo is that oral cancer might be rampant among young people. A study done by the University of the Philippines Population Institute showed that more than four million teenagers and young Filipinos are already engaged in sexual practices.

The findings of the third Young Adult Fertility Survey revealed that a total of 4.32 million Filipinos aged 15 to 24 are already sexually active. Another finding is that oral sex has become a common practice “among most sexually adventurous teens.”

“Doing simple math, if the expected prevalence of oral cancer in the general population is 1.5 percent, and with a nine-fold increase in risk, that means that we have approximately 583,000 young Filipinos aged 15 to 24 who are likely candidates to develop oral cancer,” Dr. Castillo surmised.

“Today’s teens consider oral sex to be casual, socially acceptable, inconsequential, and significantly less risky to their health than ‘real’ sex,” said Gillison. Teens simply think oral sex is “not that a big a deal,” added Dr. Bonnie Halpern-Felsher, professor of pediatrics at the University of California, San Francisco. “Parents and health educators are not talking to teens about oral sex. Period.”

Members of the Philippine Medical Association (PMA) and the Philippine Dental Association (PDA) also noted that the practice of oral sex can lead to infections of the oral cavity, which may result to cancer of the tonsils, tongue or throat.

“Any lesion in the mouth should be seriously considered,” said Dr. Anne Camus, PDA’s Manila dental chapter president. “Not all can develop to cancer but malignancy must always be taken as an imminent possibility.”

A regular check-up with a dentist would help detect malignancies in the mouth. “The dentists are usually the first to see lesions in the mouth of our patients,” Camus said. “At this early point, if the lesion turns out to be malignant, then chances are it is still curable.”

Oral cancer, or cancer of the mouth, most commonly involves the lips or the tongue. It may also occur on the: cheek lining, floor of the mouth, gums, and roof of the mouth (palate). Most oral cancers are a type called squamous cell carcinomas, which tend to spread quickly.

Aside from oral sex, smoking, and drinking, other factors that add to the risk of oral cancer include repeated irritation from the sharp edges of broken teeth, fillings, or dental prostheses (dentures). “The research regarding their involvement is uncertain. It is likely that there is a complex interaction of many external and internal factors that play a role in the development of oral cancer,” points out the Oral Cancer Foundation in the United States.

“Oral cancers are usually painless for a considerable length of time but eventually do cause pain,” notes “The Merck Manual of Medical Information.” “Pain usually starts when the cancer erodes into nearby nerves. When pain from cancer of the tongue or roof of the mouth begins, it usually occurs with swallowing as with a sore throat.”

The early growth of salivary gland tumors may or may not be painful. “When these tumors do become painful, the pain may be worsened by food, which stimulates the secretion of saliva,” the Merck manual informs. “Cancer of the jawbone often causes pain and a numb or pins-and-needles sensation, somewhat like the feeling of a dental anesthetic wearing off. Cancer of the lip or check may first become painful when the enlarged tissue is inadvertently bitten.”

Discolored areas on the gums, tongue, or lining of the mouth may be signs of cancer. “An area in the mouth that has recently become brown or darkly discolored may be a melanoma (malignant tumor),” the Merck manual states. “Sometimes, a brown, flat, freckle-like area (smoker’s patch) develops at the site where a cigarette or pipe is habitually held in the lips.”

“Keep in mind that your mouth is one of your body’s most important early warning systems,” reminds the Oral Cancer Foundation. “Don’t ignore any suspicious lumps or sores. Should you discover something, make an appointment for a prompt examination. Early treatment may well be the key to complete recovery.”

According to the US National Cancer Institute, oral cancer treatments may include surgery, radiation therapy or chemotherapy. Some patients have a combination of these treatments.

November, 2016|Oral Cancer News|

GlaxoSmithKline pulls Cervarix from U.S. market

Source: www.managedcaremag.com
Author: staff

In response to “a very low market demand,” GlaxoSmithKline has decided to stop selling its human papillomavirus (HPV) vaccine Cervarix in the United States, according to FiercePharma. The move gives Merck’s Gardasil unchallenged dominance of the HPV vaccine market in this country.

Last year, Cervarix earned only about $3.7 million in the U.S. out of a $107 million worldwide total. In contrast, the global total for Merck’s Gardasil franchise was $1.9 billion.

Figures from the Centers for Disease Control and Prevention (CDC) last year placed HPV vaccination rates at 42% of girls and 28% of boys ages 13 to 17 years––far short of the U.S. Department of Health and Human Services’ goal of 80% for both boys and girls by 2020.

To combat the public’s lukewarm response, the CDC and other cancer organizations are urging health care providers to promote the cancer-prevention benefits of HPV vaccines rather than stressing that they protect against sexually transmitted infections, which puts off some parents who worry the vaccine will promote promiscuity or who feel that their preteens are too young to need the shots, according to the Wall Street Journal.

HPV, which is transmitted sexually, can cause at least six types of cancer as well as genital warts. The vaccine is recommended for boy and girls at age 11 or 12 and is also given at other ages.

Experts are urging pediatricians to present the vaccine as routine, rather than different from other preteen shots. They are also stressing completion of the vaccine series by age 13.

Merck, the maker of Gardasil, is currently airing an ad on national television that puts the onus on parents to get their children vaccinated.

Sources: FiercePharma; October 21, 2016; and Wall Street Journal; October 17, 2016.

October, 2016|Oral Cancer News|

The startling rise in oral cancer in men, and what it says about our changing sexual habits

Source: www.washingtonpost.com
Author: Ariana Eunjung Cha

Oral cancer is on the rise in American men, with health insurance claims for the condition jumping 61 percent from 2011 to 2015, according to a new analysis.

oc2

The most dramatic increases were in throat cancer and tongue cancer, and the data show that claims were nearly three times as common in men as in women during that same period with a split of 74 percent to 26 percent.

The startling numbers — published in a report on Tuesday by FAIR Health an independent nonprofit — are based on a database of more than 21 billion privately billed medical and dental claims. They illustrate both the cascading effect of human papillomavirus (HPV) in the United States and our changing sexual practices.

The American Cancer Society estimates that nearly 50,000 Americans will be infected this year, with 9,500 dying from the disease. In past generations, oral cancer was mostly linked to smoking, alcohol use or a combination of the two. But even as smoking rates have fallen, oral cancer rates have remained about the same, and researchers have documented in recent studies that this may be caused by HPV.

HPV infects cells of the skin and the membranes that lines areas such as the mouth, throat, tongue, tonsils, rectum and sexual organs. Transmission can occur when these areas come into contact with the virus. HPV is a leading cause of cervical, vaginal and penile cancers.

Surveys have shown that younger men are more likely to perform oral sex than their older counterparts and have a tendency to engage with more partners.

“These differences in sexual behavior across age cohorts explain the differences that we see in oral HPV prevalence and in HPV-related oropharyngeal cancer across the generations and why the rate of this cancer is increasing,” Gypsyamber D’Souza, an associate professor in the Viral Oncology and Cancer Prevention and Control Program at the Johns Hopkins Bloomberg School of Public Health, said at the time. The work was published in the Journal of Infectious Diseases.

In February, researchers at the American Association for the Advancement of Science meeting reported that men are not only more likely to be infected with oral HPV than women but are less likely to clear the infection. It’s not known why oral HPV is more aggressive in men.

oc1

HPV is an extremely common virus that has infected nearly 80 million, or one in four, people in the United States. Fortunately, the risk of contracting HPV can be greatly reduced by a vaccine. HPV has become a public health priority in recent years with dozens of countries recommending universal vaccination. The Centers for Disease Control and Prevention recommends that children get it at the age of 11 or 12, although they may get vaccinated as early as 9 years old. The CDC said earlier this month that young people who get it before the age of 15 need two doses rather than the typical three.

A CDC study has found that although fewer teenagers and young adults are having sex than in previous years, more are engaging in oral sex than vaginal intercourse under the assumption that it’s safer.

“However, young people, particularly those who have oral sex before their first vaginal intercourse, may still be placing themselves at risk of STIs or HIV before they are ever at risk of pregnancy,” the researchers wrote in the 2012 report.

October, 2016|Oral Cancer News|

Oral cancer in the crosshairs at San Antonio Dental School

Source: tpr.org
Author: Wendy Rigby

San Antonio researchers are working on a new therapy for a stealthy killer: oral cancer. Visits to the dentist are your number one protection against the disease. In a lab at the University of Texas Health Science Center at San Antonio, dental researcher Cara Gonzales, DDS, Ph.D., shared promising news on a new approach to healing.

“It was very exciting,” Gonzales said. “These patients have not had any new therapeutic options in 40 years.”

The discovery of a new gene that’s turned on in oral cancers gave Gonzales and her colleagues a new target at which to aim. It’s a gene that’s also found in lung cancers.

So-called nude mice are used in the oral cancer experiments. Webdt Rigby / Texas Public Radio

So-called nude mice are used in the oral cancer experiments.
Wendy Rigby / Texas Public Radio

Gonzales works in a sprawling space filled with lab equipment and cell lines used in many molecular biology projects. One of her research assistants brought in a cage of lab animals with some strange lumps on their backs.

“These are called nude mice because they don’t have a complete immune system,” Gonzales explained.

These mice are at the center of a successful experiment. First, scientists used human oral cancer cells to grow large tumors on the animals. They tried one oral cancer drug already on the market. Not much action. Then, they tried a lung cancer drug, also already approved by the Food and Drug Administration. Not that effective on its own. Finally, they used a combination of two drugs. What happened made the medical profession take notice.

“When we combined the two, then we saw a 50 percent reduction in the tumor volumes after 14 days,” Gonzales described.

That kind of success could help thousands of patients whose cancers aren’t caught until the later stage, patients like Paige Lewis of San Antonio who was only 35 when she got the results of a biopsy from her doctor.

“I walked in and she said the words I’ll never forget,” Lewis recalled. “‘Sweetie, it’s cancer.’”

Lewis had tried for a year to get various doctors and her dentist to examine and biopsy the strange spot under her tongue. But no one really thought she was at risk for the disease.

“I was told it’s most likely nothing because I’m young. I was only 35 years old. I was a female non-smoker, non-drinker,” Lewis said.

While smoking, drinking and age are big risk factors for oral cancer, so is the presence of the human papillomavirus in the body. Some cases, like Lewis’, are simply unexplained.

Since her cancer was so advanced, Lewis, a single mother of three children, faced a massive surgery and weeks of radiation. Paige still bears scars on her arm from a major surgery where doctors removed her tumor and rebuilt her tongue.

“They removed half of my tongue,” she described. “They harvested part of my arm in order to place a flap in my mouth. And then a part of my leg to cover part of my arm.”

Lewis spent 20 days in the intensive care unit. If her cancer had been detected earlier, or if doctors had the ability to shrink her tumor, her ordeal would have been less painful and less risky. Only slightly more than half of all oral cancer patients are alive five years after their treatment. Lewis is four years out.

U.T. Health Science Center researchers are trying to secure funding for human trials which may take place in San Antonio. The pills used in this new combination target tumors specifically, so patients would not suffer as many side effects as they do with conventional chemotherapy, side effects like hair loss and gastrointestinal issues.

Dr. Cara Gonzales’ oral cancer paper was published in the journal Oral Oncology.
“If we can find something that would treat these advanced tumors, we could potentially increase the survival rate of approximately 25 percent of all oral cancer patients,” Gonzales stated.

Lewis is coping well with the side effects of surgery and radiation, but it hasn’t been easy. “Cancer takes over your life during that period of time. And it affects every single person you know,” Lewis said. “All of this could have been avoided with an early diagnosis.”

An oral cancer screening at the dentist only takes two minutes, and checking for oral cancer should be part of a regular dental screening. Like Lewis and thousands of others, though, you may have to insist the hygienist or dentist examine your mouth, tongue and gums in detail. Having a medical professional look for signs and symptoms of the disease is still the best defense against oral cancer which claims an average of one American life every hour.

October, 2016|Oral Cancer News|

Merck KGaA, Pfizer and Transgene team up on cancer vaccine

Source: www.biopharmadive.com
Author: Joe Cantlupe

Dive Brief:

  • Transgene announced Tuesday it is teaming up with Merck KGaA of Darmstadt, Germany, and Pfizer to evaluate the possibilities of the combination of its human papillomavirus (HPV)-positive head and neck cancer vaccine TG40001 with big pharma’s avalumab in a Phase 1/2 study.
  • The incidence of HPV-related head and neck cancers has increased significantly, with one variation, HPV-16 accounting for 90% of all HPV-related head and neck cancers. HPV-16 is a subset of head and neck squamous cell carcinoma (HNSCC), a group of cancers that can affect the mouth and throat. Global spending on head and neck cancer indications amounted to $1 billion in 2010, according to the companies’ recent estimates.
  • Current treatments for the disease include surgical resection with radiotherapy or chemo-radiotherapy; the companies say they are exploring better options for advanced and metastatic HPV and HNSCC.

Dive Insight:
The current deal between the big pharma partners and Transgene highlights the industry’s efforts to create combination therapies to treat cancer. Virtually every company in the space has embraced the idea that using multiple modes of attack could be the only way to eventually find cures for the many forms of cancer; companies have been teaming up in hopes of finding that crucial pairing.

In previous clinical trials, TG4001 has demonstrated promising activity in terms of HPV viral clearance and was well tolerated, according to Transgene. TG4001 is one of the few drugs targeting HPV-associated cancers that can be combined with an immune checkpoint inhibitor such as avelumab.

TG4001 is an active immunotherapeutic designed by Transgene to express the coding sequences of the E6 and E7 tumor associate antigens of HPV-16, and the cytokine, L IL-2. Avelumab is an investigational fully human antibody specific for a protein found on tumor cells called PD-L1. It is considered to have a mechanism that may enable an immune system to locate an attack cancer cells. In 2014, Merck KGaA and Pfizer signed a strategic alliance to co-develop and commercialize avelumab.

“The preclinical and clinical data that have been generated with both TG4001 and avelumab individually suggest this combination could potentially demonstrate a synergistic effect, delivering a step up in therapy for HPV- positive HNSCC patients,” said Philippe Archinard, chairman and CEO of Transgene, in a statement.

Christophe Le Tourneau, the principal investigator of the study, said HPV-induced head and neck cancers are now treated with the same regimen as non-HPV-positive HNSCC tumors, and that is not enough. “Their different etiology clearly suggests that differentiated treatment approaches are needed for HPV-positive patients,” he said in a statement. “Targeting two distinct steps in the immune response could deliver improved efficacy for patients who have not responded to or have progressed after a first line of treatment,” added Le Tourneau, who is also head of the Early Phase Program at Institut Curie.

This trial is expected to begin in France, with the first patients expected to be recruited in the beginning of 2017, said Le Tourneau. The companies will seek to recruit patients with recurrent and/or metastatic virus-positive oropharyngeal squamous cell carcinoma that have progressed after definitive local treatment or chemotherapy, and cannot be treated with surgical resection and/or re-irradiation.

October, 2016|Oral Cancer News|

Particular HPV strain linked to improved prognosis for throat cancer

Source: medicalxpress.com
Author: provided by University of North Carolina Health Care

When it comes to cancer-causing viruses like human papillomavirus, or HPV, researchers are continuing to find that infection with one strain may be better than another.

In an analysis of survival data for patients with a particular type of head and neck cancer, researchers from the University of North Carolina Lineberger Comprehensive Cancer Center confirmed findings that a particular strain of HPV, a virus linked to a number of cancers, resulted in better overall survival for patients with oropharyngeal cancer than patients with other strains of the virus in their tumors.

They believe their findings, reported in the journal Oral Oncology, are particularly important as physicians move to lessen treatment intensity for patients with HPV-linked oropharyngeal cancer in clinical trials to try to spare them negative side effects of radiation or drugs. They also found that a test used widely to determine patients’ HPV status may not be sensitive enough to select patients for de-intensification.

“What we demonstrate in this study is that the type of HPV can help us to better determine a patient’s prognosis,” said the study’s senior author Jose P. Zevallos, MD, MPH, an associate member of UNC Lineberger and an associate professor in the UNC School of Medicine. “We think this is important because HPV positive patients do so well generally, and there’s been a huge move nationally to take treatment down a couple notches to limit morbidity and side effects. The risk is that if you de-intensify too much, and you happen to have a high-risk tumor because you have a different type of HPV, then this could be harmful to patients who don’t warrant it.”

The UNC study was based on an analysis of survival data for 238 patients in North Carolina diagnosed between January 2002 and February 2006 with oropharyngeal cancer, a type of head and neck cancer in the throat at the back of the mouth, as part of the Carolina Head and Neck Cancer Study, or CHANCE. The Centers for Disease Control and Prevention estimates that more than 15,600 cases of HPV-associated oropharyngeal cancer are diagnosed in the United States each year.

Previous studies have shown that patients with HPV-linked oropharyngeal cancer have higher survival and lower recurrence rates compared to those with HPV-negative oropharyngeal cancer. As those patients tend to respond better to treatment, researchers are studying whether patients with HPV-linked oropharyngeal cancer can receive less intensive treatment with good outcomes. The researchers point out, however, that there has been limited research that tracks outcomes for oropharyngeal cancer based on the particular strain of HPV that patients have.

Zevallos and his colleagues confirmed earlier findings that patients with oropharyngeal cancer tumors infected with HPV16 had improved overall survival. They also determined that patients whose cancer was infected with other HPV strains had similar survival rates as patients whose cancer did not have HPV at all.

They found that 71.4 percent of patients with HPV16-linked oropharyngeal cancer lived at least five years. Meanwhile, the five-year survival-rates for patients with other strains of the virus in their tumors, and for patients who were HPV-negative, were lower: 57 percent for patients with other types of HPV and 50 percent for HPV-negative patients.

Zevallos said the finding of a lower survival rate for patients positive for HPV strains other than HPV16 is important in that it indicates that those patients may not be good candidates for treatment de-intensification.

“The finding that non-HPV16 types are closer to the HPV-negative group in terms of survival differences suggests that those patients should definitely not be considered for anything other than standard aggressive therapy,” he said.

The researchers noted that additional research needs to be done in a larger sample size to rule out the possibility that characteristics other than HPV status are driving survival differences, and to clarify whether the patients found to have other HPV strains were not false-positives.

The also cautioned that based on their findings, a commonly used clinical test that measures for the presence of the p16 protein may not be specific enough to identify HPV-linked oropharyngeal cancer patients who are good candidates for treatment de-intensification. To determine whether patients had HPV-positive tumors, they compared the results of the p16 test with results of a more specific genetic test.

They found that 4.3 percent of the patients were positive for p16, but negative for HPV according to the genetic test. Another approximately 11 percent of p16-positive cases had HPV strains other than HPV16, according to the genetic tests. Zevallos said this is an important finding because patients whose cancer was not infected with HPV16 had a lower 5-year survival rate, meaning they would not be good candidates for treatment de-escalation.

Yet the researchers report that many of the clinical trials that de-intensify treatment use p16 expression alone to determine if a patient’s cancer is HPV-positive, and whether they should be considered for treatment de-intensification.

“Even though we rely almost exclusively around the country on p16 positivity as a surrogate for HPV16 presence, this sheds some light on the fact that maybe we should be considering HPV genotyping because of the survival differences we saw here,” Zevallos said.

September, 2016|Oral Cancer News|