hypoxia – Oral Cancer News

Treatment paradigms are shifting for locally advanced HPV-positive head and neck cancers

Source: www.onclive.com Authors: Kaveh Zakeri, MD, MAS, Nancy Y. Lee, MD The standard of care for patients with locally advanced head and neck squamous cell carcinomas does not substantially differ according to human papillomavirus (HPV) status in the National Comprehensive Cancer Network guidelines.1 Resectable tumors can be treated with surgery followed by adjuvant therapy. Alternatively, definitive chemoradiation therapy with cisplatin is the other dominant treatment paradigm. Incidence of HPV-associated oropharyngeal squamous cell carcinoma has increased rapidly and is associated with higher overall survival (OS) compared with cancers caused by smoking and alcohol.2,3 Given the unique biology of HPV-associated oropharyngeal disease, a separate staging system was developed for these tumors.4 HPV-associated oropharyngeal cancers are more radiosensitive and chemosensitive than cancers caused by smoking and alcohol, yet the traditional treatment paradigms—including high doses of radiation and chemotherapy—were developed prior to the epidemic of HPV-associated disease. De-escalation of therapy has been proposed for HPV-associated oropharyngeal cancer based on data demonstrating high OS and progression-free survival (PFS).5 De-escalation of therapy has been investigated for both definitive surgical and chemoradiation therapy paradigms. Most de-escalated approaches focus on selecting patients according to clinical features, such as disease stage and smoking status, whereas personalized de-escalation reduces treatment intensity for patients according to treatment response. Transoral Robotic Surgery Followed by Adjuvant Radiotherapy Transoral robotic surgery (TORS) is a minimally invasive approach that reduces morbidity compared with traditional, open surgery for patients with oropharyngeal cancers. TORS is a standard of care option for patients with resectable tonsil or base [...]

Oral Cancer Foundation News Team - A2021-11-23T08:16:08-07:00November, 2021|Oral Cancer News|

Five genetic subgroups revealed in head and neck tumor analysis

Source: www.onclive.com Author: Ben Leach Oncologists who treat patients with head and neck cancer are aware that those whose disease has been caused by human papillomavirus (HPV) have significantly better outcomes than those whose disease is caused by other factors such as smoking. However, new research suggests that there may be five distinct subgroups in which specific genetic profiles may be utilized to guide treatment decisions in patients. “Currently, we treat all patients with head and neck cancer in essentially the same way,” said Ezra E. W. Cohen, MD, co-director of the Head and Neck Cancer Program at the University of Chicago Medical Center. “But we do know that the prognosis for patients who are HPV-positive is much better.” To determine whether patients’ genetic profiles differed, Cohen and his colleagues at the University of Chicago, led by researcher Tanguy Seiwert, MD, took approximately 130 tumor samples from patients with stage IV squamous cell carcinoma of the head and neck and performed gene expression (mRNA) analysis. The samples were gathered before patients received therapy, and all of the participants subsequently were treated with a 5-fluorouracil, hydroxyurea, and concurrent radiation (FHX)-based regimen. This way, the researchers could determine the outcome as a function of gene expression in the groups identified through the analysis, since patients received the same treatment across all the subgroups eventually identified. Cohen said that patients were enrolled regardless of whether they were HPV-positive or HPV-negative. Based on these findings, the University of Chicago team was able to classify [...]

Oral Cancer Foundation News Team - A2013-03-01T15:37:52-07:00March, 2013|Oral Cancer News|

Molecular imaging allows individualized ‘dose painting’ for head and neck cancers

Source: www.eurekalert.org Author: public release According to research revealed at Society of Nuclear Medecine's 57th Annual Meeting, a multi-tracer molecular imaging technique using positron emission tomography (PET) provides detailed information about the physiological processes of cancerous tumors—and could one day help radiation oncologists treat head and neck cancers with precision external-beam radiation therapy and improve the outcomes of therapy. "The research that we are conducting with Philips is extending the use of molecular imaging for radiotherapy planning, moving closer to more personalized treatment of hard-to-treat cancers based on the biology of each individual patient's tumor," said Kristi Hendrickson, Ph.D., lead author of the study and medical physicist at the University of Washington Medical Center, Seattle, Wash. "By modeling the data acquired from PET scans, we can potentially reduce damage to surrounding healthy tissue, as well as provide the ability to do 'dose painting,' delivering a highly customized form of radiation therapy for each patient." Cancers of the head and neck are notoriously difficult to treat, not only because of their proximity to sensitive anatomical structures, but also because of their tendency to recur. Researchers are working to find the best way to image these tumors in order to provide the most effective treatment. Several forms of radiation therapy are currently available. An approach called intensity modulated radiation therapy (IMRT) is a sophisticated technique which is used to maximize dose delivery to tumors while sparing adjacent normal tissues such as the salivary glands. This therapy uses an external beam of radiation [...]

Oral Cancer Foundation News Team - A2010-06-07T15:05:46-07:00June, 2010|Oral Cancer News|

HPV virus helps cervical and head and neck cancer grow and spread

Source: www.newswise.com Author: staff The human papillomavirus (HPV) allows infected cervical and head and neck cancer cells to maintain internal molecular conditions that make the cancers resistant to therapy and more likely to grow and spread, resulting in a poor prognosis for patients, researchers with UCLA’s Jonsson Cancer Center found. Virtually all human cancers experience a state called intratumoral hypoxia, or a low amount of oxygen within the tumor. In the UCLA study, researchers showed that the HPV-positive cancers adapted to and took advantage of the hypoxic environment by expressing a protein that activates a cell signaling pathway that helps the cancers survive, grow and spread. The study is published in the Nov. 4, 2008 issue of the journal Cancer Cell. The research, done on cells in culture and in animal models, may lead to the development of new therapies that target the cell signaling pathway, thereby interrupting ability of the cancer cells to thrive, said Dr. Matthew Rettig, senior author of the study and a researcher at UCLA’s Jonsson Comprehensive Cancer Center. “There is potential for therapeutic intervention based on this finding,” said Rettig, an associate professor of urology and medicine. The finding is crucial because 90 to 98 percent of cervical cancers are caused by HPV. Cervical cancer is the second most common cancer in women worldwide, with more than 500,000 cases diagnosed annually. In all, 200,000 women die from cervical cancer every year. In oral cavity and pharynx cancers, the HPV virus is linked to about 20 [...]

Oral Cancer Foundation News Team - A2008-11-03T13:08:17-07:00November, 2008|Oral Cancer News|