metastases – Oral Cancer News

Can lymph nodes boost the success of cancer immunotherapy?

Source: medicalxpress.com Author: from University of California, San Francisco Cancer treatment routinely involves taking out lymph nodes near the tumor in case they contain metastatic cancer cells. But new findings from a clinical trial by researchers at UC San Francisco and Gladstone Institutes shows that immunotherapy can activate tumor-fighting T cells in nearby lymph nodes. The study, published in Cell, suggests that leaving lymph nodes intact until after immunotherapy could boost efficacy against solid tumors, only a small fraction of which currently respond to these newer types of treatments. Most immunotherapies are aimed only at reinvigorating T cells in the tumor, where they often become exhausted battling the tumor's cancer cells. But the new research shows that allowing the treatment to activate the immune response of the lymph nodes as well can play an important role in driving positive response to immunotherapy. "This work really changes our thinking about the importance of keeping lymph nodes in the body during treatment," said Matt Spitzer, Ph.D., an investigator for the Parker Institute for Cancer Immunotherapy and Gladstone-UCSF Institute of Genomic Immunology and senior author of the study. Lymph nodes are often removed because they are typically the first place metastatic cancer cells appear, and without surgery, it can be difficult to determine whether the nodes contain metastases. "Immunotherapy is designed to jump start the immune response, but when we take out nearby lymph nodes before treatment, we're essentially removing the key locations where T cells live and can be activated," Spitzer said, [...]

Oral Cancer Foundation News Team - A2023-03-21T08:10:55-07:00March, 2023|Oral Cancer News|

Late stage head and neck cancer in the U.S. sees increasing incidence

Source: www.cancernetwork.com Author: Hannah Slater A study released in Cancer indicates that there is an increasing incidence of late stage head and neck cancer (HNC) in the U.S., mostly due to an increasing incidence of oropharyngeal cancer, most likely due to HPV-related disease in patients diagnosed at stage IVC.1 Blacks, males, those who are underinsured or uninsured, and those who are unmarried tend to fare worse than others. The presented research highlights the need for continuous public health efforts toward the early detection of HNC. In this cohort of 57,118 patients with stage IV HNC, the age-adjusted rates for stage IV HNC significantly increased by 26.1% (6.11 per 100,000 person-years in 2004 to 7.70 per 100,000 person-years in 2015). Despite a decreasing overall incidence of stage IV HNC in black patients (adjusted OR, 1.28; 95% CI, 1.22-1.34), they along with males (adjusted OR, 3.95; 95% CI, 3.80-4.11) had significantly increased risks of being diagnosed with late-stage HNC. “In the absence of a mortality benefit for asymptomatic mass screenings, as per the U.S. Preventive Services Task Force oral cancer screening guideline, it is critical that there is sustained public awareness and education regarding the early detection of HNC, and prevention through cancer risk mitigation practices,” the researchers wrote. Although black males had the highest risk of being diagnosed, the most significant change in annual incidence patterns was driven by white males (annual percent changes, 3.13; P 50 years, with males [...]

Oral Cancer Foundation News Team - A2019-11-27T06:35:45-07:00November, 2019|Oral Cancer News|

Machine learning improves the diagnosis of patients with head and neck cancers

Source: www.sciencedaily.com Author: materials from Charité - Universitätsmedizin Berlin Researchers from Charité -- Universitätsmedizin Berlin and the German Cancer Consortium (DKTK) have successfully solved a longstanding problem in the diagnosis of head and neck cancers. Working alongside colleagues from Technische Universität (TU) Berlin, the researchers used artificial intelligence to develop a new classification method which identifies the primary origins of cancerous tissue based on chemical DNA changes. The potential for introduction into routine medical practice is currently being tested. Results from this research have been published in Science Translational Medicine. Every year, more than 17,000 people in Germany are diagnosed with head and neck cancers. These include cancers of the oral cavity, larynx and nose, but can also affect other areas of the head and neck. Some head and neck cancer patients will also develop lung cancer. "In the large majority of cases, it is impossible to determine whether these represent pulmonary metastases of the patient's head and neck cancer or a second primary cancer, i.e. primary lung cancer," explains Prof. Dr. Frederick Klauschen of Charité's Institute of Pathology, who co-led the study alongside Prof. Dr. David Capper of Charité's Department of Neuropathology. "This distinction is hugely important in the treatment of people affected by these cancers," emphasizes Prof. Klauschen, adding: "While surgery may provide a cure in patients with localized lung cancers, patients with metastatic head and neck cancers fare significantly worse in terms of survival and will require treatments such as chemoradiotherapy." When trying to distinguish between metastases [...]

Oral Cancer Foundation News Team - A2019-09-13T05:44:12-07:00September, 2019|Oral Cancer News|

Changes in cancer staging: what you should know

Source: health.clevelandclinic.org Author: staff When you learn you have cancer, you want to know what to expect: How will doctors treat your illness? How effective is treatment likely to be? Much depends on the way doctors first classify, or “stage,” your cancer, using the official staging manual from the American Joint Committee on Cancer. Staging guidelines continue to evolve as knowledge about individual tumor growth and innovative technologies come into play. An ever-evolving system “Historically, we staged cancers according to tumor size, lymph node involvement and the presence of metastases,” says oncologist Dale Shepard, MD, PhD. “The latest staging manual incorporates new findings on the importance of changes in molecular DNA and tumor genomic profiling. This will affect many patients going forward.” Among those most impacted by changes in staging are people newly diagnosed with breast cancer; head and neck cancer caused by human papillomavirus (HPV); or sarcoma. How staging works “Staging allows us to stratify patients into groups based on anatomic and other criteria. It gives us a framework for understanding the extent of disease,” Dr. Shepard explains. Cancers are staged clinically and pathologically: The clinical stage is determined during the initial workup for cancer. The pathologic stage is determined by studying a surgically removed tumor sample under the microscope. Adds Tumor Registry Manager Kate Tullio, MPH, MS, “Staging helps physicians and other researchers to compare patients with the same types of cancer to each other in a consistent way — so that we might learn more about these cancers and [...]

Oral Cancer Foundation News Team - A2018-07-05T07:45:14-07:00July, 2018|Oral Cancer News|

Smoking associated with elevated risk of developing a second smoking-related cancer

Source: medicalxpress.com Author: staff Results of a federally-funded pooled analysis of five prospective cohort studies indicate that cigarette smoking prior to the first diagnosis of lung (stage I), bladder, kidney or head and neck cancer increases risk of developing a second smoking-associated cancer. This is the largest study to date exploring risk of second cancers among current smokers. An analysis of five large, prospective cohort studies indicates that lung (stage I), bladder, kidney and head and neck cancer survivors who smoked 20 or more cigarettes a day prior to their cancer diagnoses have an up to five-fold higher risk of developing a second smoking-associated cancer compared to survivors of the same cancers who never smoked. The association between smoking and developing a second primary smoking-associated cancer was similar to the association between smoking and developing a first primary smoking-associated cancer (patients who smoked more than 20 cigarettes per day had a 5.41-fold higher risk of developing cancer than individuals who have never smoked). Notably, current smoking at any level increased the risk of overall mortality across all cancer disease sites. The study, published on November 10 in the Journal of Clinical Oncology, affirms the 2014 Surgeon General report's conclusion that patients and survivors who smoke are at a higher risk of developing a second cancer. Clinicians term an individual's initial diagnosis a first primary cancer. A second primary cancer is one diagnosed at some point after the first diagnosis. Second primary cancers are not metastases of the first cancer but [...]

Oral Cancer Foundation News Team - A2014-11-12T06:41:24-07:00November, 2014|Oral Cancer News|

PET/MRI detects head/neck lymph node metastases

Source: www.drbicuspid.com Author: DrBicuspid Staff PET/MRI outperformed diffusion-weighted MRI (DWI-MRI) for detecting lymph node metastases in the staging of head and neck cancer patients, according to a study presented November 25 at the Radiological Society of North America (RSNA) annual meeting in Chicago. Researchers from the University of Düsseldorf found that PET/MRI achieved accuracy of 93%, compared with 88% for DWI-MRI. PET/MRI also reached sensitivity of 72%, compared with 36% for DWI-MRI. Lymph node status has prognostic value in head and neck cancer because patients with metastases need neck dissection and adjuvant treatment. Therefore, precise lymph node staging is a necessity, noted lead author Christian Buchbender, MD. "Currently available imaging modalities are restricted in their diagnostic performance for lymph node metastases detection," he added. "For example, CT and MRI fall short in sensitivity when compared to FDG-PET or FDG-PET/CT. On the other hand, FDG-PET/CT suffers from a large amount of false-positive results." Thus, new modalities or a combination of modalities are needed to improve lymph node metastases detection in these cancer patients, he said. The prospective study included 14 head and neck cancer patients with a mean age of 67 years. Prior to surgery, the patients received both FDG-PET/CT and 3-tesla MRI, including diffusion-weighted imaging. The patients then underwent bilateral neck dissection. Using image fusion software, the researchers created two sets of images. One set consisted of PET/MR images, which were created by fusing FDG-PET results with contrast-enhanced, T1-weighted, fat-saturated MR images. The second set consisted of DWI-MR images, created [...]

Oral Cancer Foundation News Team - A2012-11-28T10:25:22-07:00November, 2012|Oral Cancer News|

New indicator may help Identify patients with increased risk from throat cancer

Source: www.onclive.com Author: staff Patients with oropharyngeal squamous cell carcinoma who had "matted" lymph nodes -- nodes that are connected together -- are more likely to metastasize than those without matted lymph nodes, according to a study published online in the journal Head & Neck. Metastases account for about 45% of the deaths among patients with oropharyngeal carcinoma, wrote Douglas B. Chepeha, MD, MPH, an associate professor of Otolaryngology Head and Neck Surgery at the University of Michigan Medical School in Ann Arbor. "Our findings may help doctors identify patients who are at higher risk for having their cancer metastasize and who would benefit from additional systemic therapy," he said, adding that the opposite was also true -- those without matted nodes might benefit from reducing therapy. The researchers tracked 78 patients who were part of a clinical trial evaluating 2 cancer drugs with intensity-modulated radiation therapy. All of the treatment-naive patients had stage III-IV squamous cell carcinoma of the oropharynx. Sixteen of the 78 patients had matted nodes. They found that patients with matted nodes had a 69% survival rate over 3 years, compared with 94% for patients without matted nodes. The risk was independent of other prognostic factors, such as the patient's history of smoking, alcohol use, or human papillomavirus (HPV) infection. Matted nodes appear to be an especially strong indicator of increased risk among patients who are HPV-positive. However, HPVpositive patients had better overall outcomes than HPV-negative patients did. The patients with the best outcomes were HPV-positive [...]

Oral Cancer Foundation News Team - A2012-03-19T07:12:42-07:00March, 2012|Oral Cancer News|

Head and neck cancer guidelines ‘streamlined’

Source: www.medscape.com Author: Fran Lowry Modest changes in the 2011 National Comprehensive Cancer Network (NCCN) Head and Neck Cancers Guidelines will refine and improve the treatment of these complex, challenging, and relatively rare cancers, according to the panel chief reporting here at the NCCN 16th Annual Conference. One of the main changes is a new "suggestion" that the workup for cancer of the oropharynx include testing of the tumor for human papillomavirus (HPV). "Immunohistochemical testing for HPV p16 is recommended," said David G. Pfister, MD, from Memorial Sloan-Kettering Cancer Center in New York City, and chair of the NCCN Head and Neck Cancers Guidelines Committee. "Although not used to guide treatment, HPV testing is valuable prognostically. The results should not change management decisions," he emphasized. HPV-related oropharyngeal cancer appears to be a new and distinct disease entity, and is associated with better survival than non-HPV head and neck cancers, Dr. Pfister noted. HPV Has a Clear Impact on Prognosis "Our understanding of the human papillomavirus as a risk factor for head and neck cancer has evolved. Now we see that it has a clear impact on prognosis," Dr. Pfister said in an interview with Medscape Medical News. Because of their improved prognosis, these patients might require different treatment, he said. "There is a great interest in better understanding HPV-related cancers and how we treat the disease down the road. Right now we have insufficient data to change how we treat these patients, but clinical trials are being designed to assess the optimal treatment [...]

Oral Cancer Foundation News Team - A2011-03-18T12:17:56-07:00March, 2011|Oral Cancer News|

Radiation aids local control of head and neck mucosal melanoma

Source: www.oncolink.org ( from Reuters Health Information) Author: staff Radiotherapy after surgery for head and neck mucosal melanoma (HNMM) can help prevent local spread of the disease, according to a retrospective study from France. The study covered 160 patients treated over 28 years at 13 centers in the Groupe d'Etude des Tumeurs de la Tete et du Cou (GETTEC). It's the largest analysis to date of this rare cancer, according to lead author Dr. Adil Benlyazid of the Claudius Regaud Institute in Toulouse and colleagues. HNMM accounts for 3% of melanoma cases and 0.4% to 10% of melanomas of the head and neck, the researchers said in the December Archives of Otolaryngology and Head and Neck Surgery. Treatment typically involves surgery with or without postoperative radiotherapy, or radiotherapy alone if surgery is not feasible. Previous studies involving fewer subjects (i.e., 59 and 69 patients) found a benefit to adjuvant radiotherapy, but "there remains great skepticism, mostly among head and neck surgeons," according to Dr. Benlyazid and colleagues. Between 1980 and 2008, 82 HNMM patients had surgery at the GETTEC hospitals, and another 78 had surgery followed by radiotherapy. There was a nonsignificant trend toward more locally advanced tumor stage in patients who had adjuvant radiation. Overall and relapse-free survival didn't differ between the two groups. But the radiotherapy patients were significantly less likely to have locoregional recurrence as a first event, with a five-year cumulative rate of 55.6% with surgery alone vs 29.9% with surgery plus radiotherapy. After adjustment for [...]

Oral Cancer Foundation News Team - A2011-01-07T11:54:27-07:00January, 2011|Oral Cancer News|

Metabolic activity of head and neck cancer may help guide treatment

Source: www.oncologystat.com Author: Staff The metabolic activity of head and neck squamous cell carcinoma on pretreatment imaging independently predicts outcomes in patients who undergo intensity-modulated radiation therapy, new data show. This imaging information can be used to tailor treatment, especially to reduce the risk of distant metastases, lead investigator Dr. Min Yao said at a head and neck cancer symposium sponsored by the American Society for Radiation Oncology. Higher standardized uptake value (SUV) of the primary tumor and of the lymph nodes predicted worse outcomes in multivariate analyses presented by Dr. Yao, a radiation oncologist at the Case Western Reserve University, Cleveland. "Several papers have shown that the standardized uptake value (SUV) is a prognostic factor in head and neck cancer," Dr. Yao told attendees. Most of these studies were small series, involved patients receiving conventional radiation therapy, and did not evaluate SUV of the primary tumor and lymph nodes separately. Dr. Yao and his colleagues analyzed outcomes in 177 patients treated for head and neck squamous cell carcinoma with intensity-modulated radiation therapy (IMRT) between 1999 and 2006. The patients had a pretreatment positron emission tomography scan using fluorodeoxyglucose as the tracer (FDG-PET), and the maximal SUV was determined for both the primary tumor and the involved lymph nodes. The patients then underwent IMRT with curative intent. Seventy-seven percent of the patients were male. Twenty-nine percent were receiving IMRT postoperatively, whereas the rest were receiving it as definitive therapy. The cancer was most commonly located in the oropharynx (49%) and [...]

Oral Cancer Foundation News Team - A2010-04-18T10:24:49-07:00April, 2010|Oral Cancer News|