Early findings suggest clinical and lab-based approach critical to tracking head and neck cancer recurrence

Source: medicalxpress.com Author: Anna Megdell, University of Michigan Early findings of two studies from the University of Michigan Rogel Cancer Center shed light on new ways to anticipate recurrence in HPV-positive head and neck cancer sooner. The papers, published in Cancer and Oral Oncology, offer clinical and technological perspectives on how to measure if recurrence is happening earlier than current blood tests allow, and provide a framework for a new, more sensitive blood test that could help in this monitoring. "When metastatic head and neck cancer returns, it impacts their quality of life and can be disfiguring, interfering with the ability to talk, swallow, and even breathe," said Paul Swiecicki, M.D., associate medical director for the Oncology Clinical Trials Support Unit at Rogel. "As of now, there's no test to monitor for its recurrence except watching for symptoms or potentially using a blood test which may not detect cancer until shortly before it clinically recurs." The paper in Cancer aims to identify different clinical ways that providers can more strategically track for recurrence. To do this, Swiecicki and his team needed to first understand what patient population was at the highest risk to then figure out an appropriate monitoring pattern. The team examined 450 patients with metastatic head and neck cancer, including people with HPV-positive and HPV-negative cancer. HPV-positive cancer is caused by the human papillomavirus and is increasingly more common in head and neck cancer patients. The team identified some predictors of when recurrences would happen, and to what [...]

2023-09-08T05:39:02-07:00September, 2023|Oral Cancer News|

Coping With Fear of Cancer Recurrence

Source: health.clevelandclinic.org Author: staff Making it through cancer treatment can be a grueling process. And when it’s done, people want to “get back to their lives” as much as possible. But the fear of cancer coming back — or recurring — can make that process difficult. It’s natural for people who’ve lived (or are currently living) with cancer to be afraid of a recurrence. And it’s equally natural to want to get rid of that fear, especially when it interferes with quality of life. But well-meaning advice to “stay positive” may fall short. We spoke with psychologist Karen Hurley, PhD, about cancer anxiety: How to recognize it, tips for addressing it and what to do if it’s gotten bigger than you can handle. Redefining fear According to Dr. Hurley, the process of getting back on track after cancer treatment isn’t always easy. “There may be ways which you can re-engage with your goals, and there may be some goals that need to be changed or dropped altogether, which is a painful process, and one that requires time to sort through. “Making plans or cultivating hopes again feels vulnerable,” she continues. “If those dreams have been knocked over to the side once, what’s to stop that from happening again? It may have always been there, but there’s a new sensitivity to how vulnerable our plans for the future really are.” Dr. Hurley elaborates, “You may feel lost because no one can promise you that it won’t come back, even if you [...]

Can liquid biopsy predict oropharyngeal cancer recurrence?

Source: www.medscape.com Author: Liam Davenport A liquid biopsy test may accurately predict recurrence of human papillomavirus (HPV)-driven oropharyngeal squamous cell carcinoma (OPSCC) earlier than standard clinical and imaging assessments, a new analysis indicates. Of 80 patients who tested positive for circulating tumor tissue-modified viral (TTMV)-HPV DNA during surveillance, 74% (n = 59) had no other evidence of disease or had indeterminate disease status. And of those patients, 93% (n = 55) "later had proven recurrent, metastatic disease on imaging and/or biopsy," according to Glenn Hanna, MD, from the Dana-Farber Cancer Institute, Boston, who presented the results February 24 at the 2022 Multidisciplinary Head and Neck Cancers Symposium. "This is the first study to demonstrate broad clinical utility and validity of the biomarker in HPV-driven oropharyngeal cancer," Hanna said in a press release. Although patients with HPV-driven OPSCC generally have favorable outcomes, up to 25% will experience recurrence after treatment. Posttreatment surveillance currently relies on physical examinations and imaging, but Hanna and colleagues wanted to determine whether a routine circulating cell-free TTMV-HPV DNA test could detect occult recurrence sooner. Hanna and colleagues analyzed the records of 1076 patients with HPV-driven OPSCC at 118 sites in the US who had completed therapy more than 3 months previously and undergone an TTMV-HPV DNA test (NavDx, Naveris) between June 2020 and November 2021. The results of the test, which used ultrasensitive digital droplet PCR to identify HPV subtypes 16, 18, 31, 33, and 35, were compared with subsequent clinical evidence of OPSCC via nasopharyngolaryngoscopy, [...]

Wirral, UK cancer patient trials vaccine

Source: www.wirralglobe.co.uk Author: Craig Manning, Chief Reporter A Wirral man has become the first in the UK to trial a 'vaccine' that is hoped will stop his recurring head and neck cancer from returning. The clinical research team at The Clatterbridge Cancer Centre has given patient Graham Booth an injection of a therapy tailor-made to his personal DNA and designed to help his own immune system ward off cancer permanently. Graham first had head and neck cancer in 2011 and it then returned four times, each time meaning he needed grueling treatment, including facial surgery, reconstruction and radiotherapy. He is now hoping this new treatment – part of the Transgene clinical research study – will mean it does not come back. Dad-of-five Graham, 54, will have a year-long course of immunotherapy injections in a bid to keep him cancer-free, part of a research project designed to reduce deaths and recurrence in head and neck cancers, including of the throat, neck, mouth and tongue. Graham, from West Kirby, said he was not worried about being the first person in the UK to receive this pioneering treatment and that it "opened new doorways" which gave him hope that the cancer would not come back. He added: "When I had my first cancer treatment in 2011, I was under the impression that the cancer would not return. "My biggest fear was realised in 2016 when it came back and then in 2019 and then two cases in 2021. "Last year I had the [...]

2022-02-07T13:33:09-07:00February, 2022|Oral Cancer News|

“Sleeping” cancer cells could prevent tumour metastasis

Source: www.drugtargetreview.com Author: Anna Begley (Drug Target Review) Researchers at Icahn School of Medicine at Mount Sinai, US, have developed a new therapeutic approach by preventing the growth of metastatic tumours in mice to force cancer cells into a dormant state in which they are unable to proliferate. They hope that their findings will lead to new treatments that prevent the recurrence or spread of various cancer types, including breast cancer and head and neck squamous cell carcinoma (HNSCC). In a previous study, scientists discovered that the ability of cancer cells to remain dormant is controlled by a protein called NR2F1. This receptor protein can enter the cell nucleus and turn numerous genes on or off to activate a programme that prevents the cancer cells from proliferating. NR2F1 levels are usually low in primary tumours but are elevated in dormant disseminated cancer cells. Levels of the NR2F1 protein then decline once more when cancer cells start proliferating again and form recurrent or metastatic tumours. “We therefore thought that activating NR2F1 using a small molecule could be an attractive clinical strategy to induce cancer cell dormancy and prevent recurrence and metastasis,” explained Dr Julio Aguirre-Ghiso. In the new study, detailed in the Journal of Experimental Medicine (JEM), the researchers used a computer-based screening approach to identify a drug, named C26, that activates NR2F1. The researchers found that treating patient-derived HNSCC cells with C26 boosted the levels of NR2F1 and arrested cell proliferation. The researchers then tested whether C26 would prevent metastasis [...]

Less intense treatment safe for HPV+ throat cancer

Source: www.miragenews.com Author: public release, University of Pittsburgh School of Medicine A less intense treatment for human papillomavirus positive (HPV+) throat cancer—using robotic surgery followed by low-dose radiation—could provide as much benefit as standard higher-dose radiation and chemotherapy while preserving a patient’s throat function, and with potentially less toxicities, according to researchers at UPMC Hillman Cancer Center and Yale Cancer Center. The results of their randomized phase two clinical trial will be presented virtually this week at the American Society of Clinical Oncology (ASCO) annual meeting during the Head and Neck Oral Abstract Session (Abstract 6500). “These results present a promising deintensification approach that has proven to be safe in patients with intermediate risk, locally advanced oropharynx cancer,” said Robert Ferris, M.D., Ph.D., director, UPMC Hillman Cancer Center and a surgical oncologist specializing in head and neck cancer, who was lead investigator of the trial. The results are not yet published in a peer-reviewed journal. About 60% of oropharynx cancer, in which cancer cells form in the back of the throat, base of the tongue and tonsils, is associated with HPV infection. The incidence has been increasing in recent years, especially in individuals under the age of 45. Following robotic surgery, patients with HPV-associated throat cancer would typically undergo high dose radiation and chemotherapy. While robotic surgery allows for more precise and optimal preservation of the organs and surrounding tissue, there is still concern with the toxicities from the chemotherapy and consequences of tissue damage from radiation therapy, particularly in [...]

Liquid biopsy accurately detects HPV+ oropharyngeal cancer recurrence

Source: www.medpagetoday.org Author: Zeena Nackerdien PhD, CME Writer, MedPage Today In general, HPV-positive OPSCC has a favorable prognosis as compared with HPV-negative disease, which has supported efforts to de-intensify treatment regimens to reduce exposure to potentially toxic therapies. Positron emission tomography/computed tomography (PET/CT) imaging 3 months after definitive treatment is standard for response assessment in many cases. However, the disease will recur in up to 25% of patients, depending on clinical risk factors and tumor biology. The latency period prior to OPSCC recurrence is 2 years for many patients, but rare case reports have described latency periods exceeding 5 years. Currently, National Comprehensive Cancer Network (NCCN) guidelines recommend surveillance of patients with HPV-associated OPSCC every 1 to 3 months for the first year, every 2 to 6 months for the second year, every 4 to 8 months for years 3 to 5, and then once a year thereafter. Because the oropharynx can be a difficult anatomic location to evaluate -- a process that may be further obscured by treatment-related tissue changes -- radiologic imaging studies have been used in cancer surveillance for this disease. According to study findings published in the Journal of Clinical Oncology, a blood test for tumor-associated HPV-DNA had near-perfect accuracy for identifying OPSCC patients at high risk of recurrence after treatment. The findings have clear and immediate implications for clinical practice, including earlier initiation of salvage therapy for patients with recurrent disease, reported Bhishamjit S. Chera, MD, of the UNC Lineberger Comprehensive Cancer Center in Chapel [...]

Absent p53, oral cancers recruit and reprogram nerves to fuel tumor growth

Source: medicalxpress.com Author: by University of Texas M. D. Anderson Cancer Center Loss of an important tumor-suppressing gene allows head and neck cancer to spin off signals to nearby nerves, changing their function and recruiting them to the tumor, where they fuel growth and cancer progression, researchers from The University of Texas MD Anderson Cancer Center report in the journal Nature today. By cracking the mechanism that launches neuronal invasion of tumors, a known marker of poor prognosis for patients, the team has uncovered possible avenues to block the process, including the use of drugs commonly used to treat blood pressure and irregular heartbeat. "Tons of studies show that patients who have lots of nerves in their tumor are doing worse—recurrence rates are higher, survival is shorter," says co-first author Moran Amit, M.D., Ph.D., assistant professor of Head and Neck Surgery. "Nerve endings found in surgically removed tumors can't be easily characterized or tracked back to their source, so it's been a neglected field, a neglected hallmark of cancer." "When surgeons remove head and neck cancers and find a high degree of nerve invasion, post-surgical radiation sometimes is effective," said co-senior author Jeffrey Myers, M.D., Ph.D., chair of Head and Neck Surgery. "But we really haven't understood whether the tumor was growing into the nerves or the nerve growing into the tumor and what signaling drove those interactions." Co-senior author George Calin, M.D., Ph.D., professor of Experimental Therapeutics and an expert on non-coding RNAs added that the paper "puts together [...]

2020-02-13T08:56:02-07:00February, 2020|Oral Cancer News|

Surveillance of ctDNA in HPV-positive head and neck cancers may predict recurrence

Source: www.targetedonc.com Author: Nichole Tucker The detection of circulating tumor DNA (ctDNA) in human papillomavirus (HPV) with an experimental blood test has been associated with high positive predictive value (PPV) and negative predictive value (NPV) for identifying disease recurrence in HPV-positive oropharyngeal cancer, according to a press release from the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center.1 “The major utility of this test is it’s going to improve our ability to monitor patients after they complete treatment,” said Bhisham Chera, MD, associate professor in the UNC School of Medicine Department of Radiation Oncology. “Currently, our methods to assess whether the cancer has recurred are invasive, expensive and not always accurate.” In a prospective biomarker clinical trial published in the Journal of Clinical Oncology, investigators obtained 1006 blood samples for their analysis, 999 of which were evaluable for plasma circulating tumor human papillomavirus DNA (ctHPVDNA). The goal was to determine if surveillance of ctHPVDNA can facilitate earlier detection of recurrence compared with normal clinical follow-up.2 Patients were followed for a median of 23.7 months (range, 6.1-54.7 months), and out of 115 patients, 13% developed disease recurrence (n = 15). Of these recurrences, 1 was local only, 1 was regional only, 10 were distant only, 1 was local and distant, and the remaining 2 were regional and distant. Following treatment, 87 patients had undetectable ctHPVDNA, and none developed recurrence (95% CI, 96%-100%). The development of a positive ctHPVDNA occurred in 28 patients during post-treatment surveillance. The median time to abnormal [...]

2020-02-07T08:57:22-07:00February, 2020|Oral Cancer News|

HPV blood test shows promise for tracking head and neck cancer after treatment

Source: www.eurekalert.org Author: from UNC Lineberger Comprehensive Cancer Center A new blood test developed by University of North Carolina Lineberger Comprehensive Cancer Center researchers shows promise for tracking HPV-linked head and neck cancer patients to ensure they remain cancer-free after treatment. Researchers will present preliminary findings at the 60th Annual Meeting of the American Society for Radiation Oncology in San Antonio on Tuesday, Oct. 23. Their study evaluated a blood test for HPV-linked oropharyngeal squamous cell carcinoma, which is a cancer of the back of the throat. The findings demonstrated the test could be an effective and less costly alternative for monitoring for cancer recurrence after radiation treatment. "The goal of this study was to evaluate whether this test can be used to track patients who are completely asymptomatic, and thought to have no active cancer," said UNC Lineberger's Gaorav P. Gupta, MD, PhD, assistant professor in the UNC School of Medicine Department of Radiation Oncology. "We already knew that our test was very sensitive and specific, but we did not know the degree to which it would be useful in early detection of disease recurrence in patients who are otherwise thought to be disease-free." HPV, or the human papillomavirus, is the most common cause of sexually transmitted infection in the United States, according to the U.S. Centers for Disease Control and Prevention. Infection with certain strains of HPV can cause cervical cancer in women, genital cancers in both men and women, and cancer of the oropharynx, which is the [...]

Go to Top