tobacco

Dentists may soon start asking about your sex life in a bid to control staggering HPV rates

Source: www.dailymail.co.uk
Author: Jaleesa Baulkman for DailyMail.com

Your dentist may be interested in more than just your flossing habits, but for a good reason. Dentists and dental hygienists are being encouraged to assess patients’ risk of developing oral cancers from HPV, the most common sexually-transmitted disease.

According to experts, they will likely skirt around the topic of their patients’ sex life and ask about potential symptoms of cancer like jaw pain and swelling.

But a new report published in the Journal of the American Dental Association insists it is imperative that dentists to play a more active role in detecting the disease, which is linked to seven types of cancer.

‘What we’re going to find over time is that HPV is going to be a more common cause of cancer over time,’ Ellen Daley, a public health professor at the University of South Florida, told Daily Mail Online. ‘We need to worry about how to prevent it.’

HPV is responsible for about 70 percent of oropharyngeal cancers in the US, according to the Centers for Disease Control and Prevention. The most common sexually transmitted infection in the US, it affects more than half of American adults. In fact, Dr Daley says it’s as common as the common cold.

However, asking about a patient’s sex life isn’t necessary to preventing HPV-related oral cancers.

‘If [dentists] want to [ask patient’s about their sex life], they can, Dr Daley explained. ‘But that’s not relevant since HPV is so common. We need to get pass how it’s transmitted and worry about preventing cancers.’

There have been nearly 16,000 annual cases of oropharyngeal cancers — cancer of the tongue, tonsils and pharyngeal wall — between 2008 and 2012, with HPV being the cause of approximately 72 percent of those diagnoses, according to data.

For the study, Dr Daley and her team conducted four focus groups with a total of 33 dentists.

Research showed that most dentists knew HPV was a risk factor for oropharyngeal cancer, but several were not sure about what causes HPV-related oral cancer.

The study found that many dentists don’t know how to approach the subject of HPV and lack the communication skills needed to educate patients effectively.

Most dentists said they were concerned their patients would think they were judging their personal behaviors. In other words, asking patient’s about their sex lives is out of the question. However, dentists and dental hygienists are trained to screen for oral cancers.

Examining the area under the tongue and looking in the back of a patients’ mouth are ways dentists screen for oral cancer. However, HPV-related oral cancers are difficult to detect because they develop in the throat at the back of the tongue, or in the folds of the tonsils, according to the American Dental Association.

HPV oral and oropharyngeal cancers are harder to discover than tobacco related cancers because the symptoms are not always obvious to the individual who is developing the disease, or to professionals that are looking for it. They can be very subtle and painless

HPV, which is transmitted through vaginal, anal and oral sex, is the most commonly sexually transmitted infection in the US, according to the CDC, affecting more than 79 million Americans. There are more than 40 types of HPV that can affect the mouth and genitals, but HPV 16 and 18 are the two most common cancer-causing types. According to the CDC, HPV type 16 is responsible for 60 percent of all oropharyngeal cancers. Non-cancer types of HPV can cause warts in the mouth or throat.

Some symptoms to look out for include, a persistent sore throat, earaches, enlarged lymph nodes, unexplained weight loss and painful swallowing. However, some people have no signs or symptoms, according to the CDC.

The HPV vaccine, which is administered to children aged nine and 12 years old in the US and the UK, is a preventive measure against HPV and HPV-related cancers. The vaccine is offered as a three doses in the US, and two doses in the UK. Condoms and dental dams also serve as protective barriers against the disease.

January, 2018|Oral Cancer News|

Smokeless tobacco, snuff, chew not safe substitutes for cigarettes

Source: www.bnd.com
Author: staff

As many people are aware, the use of any type of tobacco can lead to major health risks. Many individuals think using smokeless tobacco or chew can be a safe substitute for cigarettes.

A mock model of how dangerous and destructive tobacco products, specifically smokeless tobacco, can be to someone’s health and well-being. Navy photo by Douglas H. Stutz, Naval Hospital Bremerton Public Affairs

Tobacco companies often lead people to believe this; however, this is not true. There is no proof that any smokeless tobacco products help smokers quit smoking.

Smokeless tobacco has four times the amount of nicotine than a cigarette and also contains 30 chemicals known to cause cancers.

A few of these cancers include mouth, tongue, cheek, and gum cancer. Additionally, cancer can be found in the esophagus and pancreas. Along with these health risks there are other problems, including mouth and teeth problems and tooth loss.

Many studies have shown that high rates of leukoplakia in the mouth were found where individuals hold the chew.

Leukoplakia is a white patch in the mouth that could potentially turn into cancer. The white patches, sometimes called sores, within the mouth cannot be scraped off but usually do not cause pain. The longer the use of oral tobacco, the more prone an individual is to develop leukoplakia.

Stopping tobacco use usually allows leukoplakia to heal, however, treatment may be needed if there are signs of early cancer. Along with these issues, there are many others such as bad breath, teeth stains, receding gums, gum disease, cavities and tooth decay.

As well as the health risks one is providing for themselves, children, pets and animals can also suffer health risks from tobacco substances. Children, pets and animals often mistake these substances for candy, gum or something they should put in their mouth.

Ingesting smokeless tobacco can lead to nicotine poisoning and even death. Most children affected by this are under the age of 6 and more than 70 percent are under 1 year of age according to a study in Pediatrics, the journal of the American Academy of Pediatrics.

Smokeless tobacco affects everyone.

November, 2017|Oral Cancer News|

Penn surgeons become world’s first to test glowing dye for cancerous lymph nodes

Source: www.phillyvoice.com
Author: Michael Tanenbaum, PhillyVoice Staff

Surgeons at the University of Pennsylvania have achieved a global first with the use of a fluorescent dye that identifies cancerous cells in lymph nodes during head and neck cancer procedures.

The study, led by otorhinolaryngologist Jason G. Newman, seeks to test the effectiveness of intraoperative molecular imaging (IMI), a technique that illuminates tumors to provide real-time surgical guidance.

More than 65,000 Americans will be diagnosed with head and neck cancers in 2017, accounting for approximately 4 percent of all cancers in the United States, according to the National Cancer Institute. About 75 percent of these cancers are caused by tobacco and alcohol use, followed by human papillomavirus (HPV) as a growing source for their development.

Common areas affected by these cancers include the mouth, throat, voice box, sinuses and salivary glands, with typical treatments including a combination of surgery, radiation and chemotherapy.

Lymph nodes, which act as filters for the immune system, are often among the first organs affected by head and neck cancers as they spread or resurface. Initial surgeries may leave microscopic cancerous cells undetected in the lymphoid tissue, heightening the risk that a patient’s condition will return after the procedure.

“By using a dye that makes cancerous cells glow, we get real-time information about which lymph nodes are potentially dangerous and which ones we can leave alone,” Newman said. “That not only helps us remove more cancer from our patients during surgery, it also improves our ability to spare healthy tissue.”

With the aid of a fluorescent dye, surgeons are able to key in on suspicious tissue without removing or damaging otherwise healthy areas. Previously adopted for other disease sites in the lungs and brain, the practice now allows Newman’s team to experiment with indocyanine green (ICG), an FDA-approved contrast agent that responds to blood flow.

Newman explained that since tumor cells retain the dye longer than most other tissues, administering the dye prior to surgery singles out the areas where cancer cells are present.

The current trial at Penn will enable researchers to determine whether ICG is the most suitable dye for head and neck cancers and provide oncologists with a deeper understanding of how cancer spreads in the lymph nodes.

October, 2017|Oral Cancer News|

Alcohol industry ‘playing down’ risk of cancer by using tobacco industry tactics

Source: news.sky.com
Author: Paul Kelso, Health Correspondent

The alcohol industry is misleading the public by downplaying the risk of cancer through similar tactics to the tobacco industry, researchers say.

Liquor bottles in grocery store

A study led by the London School of Hygiene and Tropical Medicine (LSHTM) and Sweden’s Karolinska Institutet found the industry is using “denying, distortion and distraction” strategies to minimise evidence.

Researchers analysed information relating to cancer on the websites and documents of 28 alcohol industry organisations between September and December last year, finding that most showed “some sort of distortion or misrepresentation” of evidence.

The industry most commonly presented the relationship between alcohol and cancer as highly complex, implying there was no evidence of a consistent or independent link, according to the study.

Other tactics included denying that any relationship existed or claiming that there was no risk for light or moderate drinking, as well as presenting alcohol as just one risk among many.

Alcohol consumption is an established risk factor for a range of cancers, including oral cavity, liver, breast and colorectal cancers, and accounts for about 4% of new cancer cases annually in the UK.

The latest British government advice on alcohol, issued last year, makes an explicit link between cancer and alcohol.

It states: “The risk of developing a range of health problems (including cancers of the mouth, throat and breast) increases the more you drink on a regular basis.”

During the consultation phase the alcohol industry challenged the link with cancer.

The authors of the report, published in the Drug and Alcohol Review journal, said it was important to highlight that those who drink within the recommended guidelines – not more than 14 units a week for both men and women – “shouldn’t be too concerned when it comes to cancer”.

Mark Petticrew, Professor of Public Health at the LSHTM and the study’s lead author, told Sky News: “The information, on balance, across organisations we looked at seems to be quite extensively inaccurate or misrepresents the evidence.

“The evidence linking alcohol consumption and cancer is reasonably clear and has firmed up over recent years. The information on these websites, given out by alcohol bodies, appears to be not representing that evidence base, which is quite consistent.

“We know the tobacco industry attempted to confuse the relationship between lung cancer and smoking and put out a lot of very distracting information. We see similar types of argument use in these alcohol industry websites.”

Institute of Alcohol Studies chief executive Katherine Brown said: “This report shows that, like the tobacco industry before them, alcohol companies are misleading consumers about the evidence linking their products to cancer.

“We cannot rely on a profit-driven industry to promote public health. Consumers have a right to know the truth about alcohol and cancer, so they can make fully informed decisions about their drinking.”

The alcohol industry denied the report’s findings.

Glasses of light and dark beer on a pub background.

Drinkaware, a charitable trust funded by drinks manufacturers, said: “Its recent review of Drinkaware’s cancer information, which is extensive, has confirmed that the information we are providing accurately reflects the most recent research evidence.”

Henry Ashworth, president of the International Alliance for Responsible Drinking, said: “We do not agree with the conclusions reached in this paper. We believe in sharing the current state of the scientific evidence and stand by the information that we publish on drinking and health.”

Chris Snowdon, head of lifestyle economics at the Institute of Economic Affairs, said: “This is a diatribe disguised as a study that seeks to create a false narrative in which businesses always lie and anti-alcohol campaigners always tell the truth.

“We need to have sensible and evidence-based information about the risks of alcohol. The risks associated with cancer are not the biggest risks when it comes to drinking, the bigger risks are to do with violence, drink-driving and liver cirrhosis.

“It’s not cancer, so I’m not convinced that actually people understood fully what the risks associated with drinking are in terms of cancer when it doesn’t have an effect on people’s consumption of it at all.”

September, 2017|Oral Cancer News|

Smoking Scenes in Movies Have Increased … Why?

Source: www.healthline.com
Author: Shawn Radcliffe

After several years of decline, tobacco use depicted in movies is on the rise again. Does it matter? Where there’s smoke, there’s … probably a PG-13 rated movie.

A new study shows that tobacco incidents depicted in top-grossing movies in the United States are once again on the rise, breaking an earlier decline. This is true despite public health efforts outside theaters to reduce smoking by children and teens.

“If the progress that we had seen between 2005 and 2010 had continued, all of the youth-rated films would have been smoke-free in 2015,” said study author Stanton Glantz, PhD, professor of medicine, and director of the University of California San Francisco (UCSF) Center for Tobacco Control Research and Education.

The July 7 study in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report (MMWR) found that the total number of tobacco incidents in top-grossing movies increased 72 percent between 2010 and 2016. It also increased 43 percent in PG-13 movies. Tobacco incidents are defined as use or implied use, by an actor, of cigarettes, cigars, pipes, hookah, smokeless tobacco products, or electronic cigarettes. This increase comes as the number of movies showing tobacco declined — meaning fewer movies account for a greater number of tobacco scenes.

In 2016, 41 percent of the top-grossing movies had tobacco incidents, down from 45 percent in 2010. In addition, 26 percent of youth-rated movies had tobacco incidents in 2016, a decline from 31 percent in 2010. Tobacco incidents in top-grossing movies peaked in 2005. The lowest number of tobacco incidents on record occurred in 1998. Tobacco depictions are now rare in PG and G movies — only four of these films in 2015 included tobacco use.

The study was a collaboration between UCSF, the Centers for Disease Control and Prevention (CDC), and Breathe California of Sacramento-Emigrant Trails, which provided the data.

The potential harm:
Like on-screen violence, tobacco depicted in youth-rated movies can have a profound effect on children and teens.

“It’s very concerning because five years ago in 2012 the surgeon general concluded that exposure to smoking on-screen in movies causes kids to start smoking,” Glantz told Healthline.

There’s also a dose-response — the more often kids see tobacco use depicted in movies, the more likely they are to pick up the habit. According a National Cancer Institute (NCI) report, youths who are heavily exposed to smoking depicted in movies are two to three times more likely to start, compared with kids who have little exposure.

“An increase in the amount of exposure means that more kids are going to be smoking and dying from tobacco-induced diseases,” said Glantz.

Tobacco use is linked to lung cancer, mouth cancer, emphysema, and other diseases. The NCI report also cited studies showing that cigarette smoking in movies can influence adults’ and teens’ beliefs about smoking. For example, when stars are shown smoking, or when the health consequences of tobacco don’t show up in the film, viewers may develop pro-smoking beliefs and intentions.

What’s causing the increase?
The increase in the number of on-screen tobacco incidents since 2010 runs counter to overall smoking trends in the United States. According to the CDC, overall smoking rates in adults have been falling for decades, and in high school students since the late 1990s. The researchers write that starting in 2001 public health officials became more concerned about tobacco use in movies. This might account for the decline of tobacco incidents in youth-rated movies between 2005 and 2010.

So what has shifted in recent years?
Some public health experts put the blame squarely on the motion picture companies that continue to produce youth movies depicting smoking.

“I think the [public health] messaging is fine,” said Glantz. “It’s been the recalcitrance on the part of the media companies to act responsibly and protect kids.”

The major studios have policies to help reduce the amount of smoking in movies that they release, but all of the polices have what Glantz calls “loopholes.” Paramount Pictures “discourages” depiction of tobacco use in youth-rated films, but also takes into account the “creative vision of the filmmakers.” Universal Pictures “presumes that no smoking incidents should appear” in youth-rated films, but leaves it as an option if there is a “substantial reason for doing so.”

Modernizing movie rating system:
Currently, the Motion Picture Association of America (MPAA), which rates movies in the United States, has a smoking “rating descriptor” that is supposed to alert viewers and parents to tobacco use in a film. However, this descriptor was missing from 89 percent of top-grossing, youth-rated movies that depicted tobacco use, according to a 2015 report by the UCSF Center for Tobacco Control Research and Education.

Public health experts are calling for a more consistent approach.

“The six studios that control the rating system through the MPAA need to modernize the rating system to reflect the science,” said Glantz, “and give an R-rating for smoking, which would get it out of all the youth-rated movies.”

A 2012 study in the journal Pediatrics estimated that this could reduce the number of teen smokers by 18 percent. A related CDC fact sheet estimated that this change would save the lives of a million youth. Advocacy group Smokefree Movies recently ran a two-page statement in The Hollywood Reporter and Variety demanding that MPAA update the rating system by June 1, 2018. The statement was signed by the American Academy of Pediatrics, the American Heart Association, and other health organizations.

So far, the major studios have been unwilling to update the rating system to take into account on-screen tobacco use. Some health experts have proposed running anti-smoking messages before movies to counteract the effect of on-screen tobacco use. These are somewhat effective but would require much more effort than reducing children’s on-screen tobacco exposure.

“It would cost nothing to [update the rating system],” said Glantz. “There’s no public health intervention that would be cheaper and have a bigger effect.”

House Committee Looks to Dilute Tobacco Control Act

Source: www.medpagetoday.com
Date: July 12, 2017
Author: Salynn Boyles

The U.S. House Appropriations Committee made a move Wednesday to greatly weaken the FDA’s authority to regulate tobacco products, including flavored cigars and electronic cigarettes, and health advocacy groups were quick to condemn it.

The committee approved a rider to the agriculture funding bill that would exempt certain cigars from FDA’s authority and weaken its regulatory oversight over e-cigarettes, little cigars, and hookah tobacco.

Prior to the vote, the House committee defeated an amendment by Rep. Nita Lowey (D-N.Y.) to remove language from the bill that will effectively eliminate FDA’s authority to review the health hazards of thousands of tobacco products.

A second rider would exempt from FDA authority certain cigars, including many that are cheap, flavored and are most likely to appeal to children, said American Lung Association (ALA) President Harold Wimmer.

“These dangerous riders were added to this bill for the benefit of the tobacco industry and come at a time when e-cigarettes are the most commonly used tobacco product among kids,” Wimmer said in a written press statement.

The riders are similar to those passed by the House Appropriations Committee last year, but the language restricting FDA’s authority under the Tobacco Control Act was dropped from the final FY2017 bill later in the appropriations process. New language in the FY2018 bill does require the FDA to develop standards for the flavors added to e-cigarettes.

ALA spokesperson Erika Sward told MedPage Today that it is not clear if the riders will suffer the same fate this time around.

“Last year there was a President committed to the Tobacco Control Act in the White House,” she said. “This year not only do you have the House attempting to undermine the Tobacco Control Act, but you also have the FDA delaying the deeming rule.”

Nancy Brown, CEO of the American Heart Association, said the cigar rider exempting certain cigars from FDA regulation was particularly troubling.

“Our association strongly believes that the FDA should regulate all products, since tobacco in any form presents health risks. Further, we are particularly concerned that this could create a loophole that would allow tobacco manufacturers to manipulate their products to evade the agency’s oversight,” she said in a written statement.

Brown noted that the tobacco product grandfather rider could allow thousands of tobacco products to skip FDA review.

“While we appreciate that House members included a requirement that the FDA develop a product standard for flavors in e-cigarettes, changing the grandfather date puts e-cigarette users’ health at risk,” she said.

Chris Hansen, president of the American Cancer Society Action Network, charged that the legislation would benefit the cigar and e-cigarette industries at the expense of the nation’s public health.

“Congress made a commitment to protect the health of the American people when it passed the Tobacco Control Act. Today’s committee action is a serious breach of that promise,” he said.

July, 2017|Oral Cancer News|

Novel vaccine therapy can generate immune responses in patients with HPV-related head and neck cancer

Source: www.news-medical.net
Author: staff

A novel vaccine therapy can generate immune responses in patients with head and neck squamous cell carcinoma (HNSCCa), according to researchers at the Abramson Cancer Center of the University of Pennsylvania. The treatment specifically targets human papillomavirus (HPV), which is frequently associated with HNSCCa, to trigger the immune response. Researchers will present the results of their pilot study during the 2017 American Society of Clinical Oncology Annual Meeting in Chicago (Abstract #6073).

HNSCCa is a cancer that develops in the mucous membranes of the mouth, and throat. While smoking and tobacco use are known causes, the number of cases related to HPV infection – a sexually transmitted infection that is so common, the Centers for Disease Control says almost all sexually active adults will contract it at some point in their lifetimes – is on the rise. The CDC now estimates 70 percent of all throat cancers in the United States are HPV-related. Sixty percent are caused by the subtype known as HPV 16/18.

“This is the subtype we target with this new therapy, and we’re the only site in the country to demonstrate immune activation with this DNA based immunotherapeutic vaccine for HPV 16/18 associated head and neck cancer,” said the study’s lead author Charu Aggarwal, MD, MPH, an assistant professor of Hematology Oncology in the Perelman School of Medicine at the University of Pennsylvania.

The vaccine is delivered as an injection of antigens – which leads the immune system to start producing antibodies and activate immune cells. At the time of injection, physicians use a special device to deliver a pulse of electricity to the area, which stimulates the muscles and speeds the intake of the antigens. Aggarwal noted that this study represents a multidisciplinary approach involving the lab and the clinic.

“This is truly bench-to-bedside and shows the value of translational medicine within an academic medical center,” Aggarwal said.

Penn researchers treated 22 patients with the vaccine. All of the patients had already received therapy that was intended to be curative – either surgery or chemotherapy and radiation. When doctors followed up an average of 16 months later, 18 of those patients showed elevated T cell activity that was specific to HPV 16/18. All of the patients in the study are still alive, and none reported any serious side effects.

“The data show the therapy is targeted and specific, but also safe and well-tolerated,” Aggarwal said.

Because of the positive activity, Aggarwal says the next step is to try this therapy in patients with metastatic disease. A multi-site trial will open soon that combines the vaccine with PD-L1 inhibitors, which target a protein that weakens the body’s immune response by suppressing T-cell production.

European Commission approves Bristol-Myers Squibb’s Opdivo (nivolumab) for squamous cell cancer of the head and neck in adults progressing on or after platinum-based therapy

Source: pipelinereview.com
Author: Bristol-Myers Squibb

Bristol-Myers Squibb Company today announced that the European Commission (EC) has approved Opdivo (nivolumab) as monotherapy for the treatment of squamous cell cancer of the head and neck (SCCHN) in adults progressing on or after platinum-based therapy. Opdivo is the first and only Immuno-Oncology (I-O) treatment that demonstrated in a Phase 3 trial a significant improvement in overall survival (OS) for these patients.

“Adult patients with squamous cell cancer of the head and neck that progresses on or after platinum-based therapy are fighting a debilitating and hard-to-treat disease that is associated with a very poor prognosis,” said Kevin Harrington, M.D., Ph.D., professor in Biological Cancer Therapies at The Institute of Cancer Research, London, and a consultant clinical oncologist at The Royal Marsden NHS Foundation Trust in London. “As an oncologist who helps patients deal with this terrible disease, I hope that nivolumab will now be made available as widely as possible, offering this group of patients a new treatment option that can potentially improve their overall survival.”

The approval was based on results from CheckMate -141, a global Phase 3, open-label, randomized trial, first published in The New England Journal of Medicine last October, which evaluated Opdivo versus investigator’s choice of therapy in patients aged 18 years and above with recurrent or metastatic, platinum-refractory SCCHN who had tumor progression during or within six months of receiving platinum-based therapy administered in the adjuvant, neo-adjuvant, primary or metastatic setting. Investigator’s choice of therapy included methotrexate, docetaxel, or cetuximab. The primary endpoint was OS. The trial’s secondary endpoints included progression-free survival (PFS) and objective response rate (ORR).

“The European Commission’s approval of Opdivo marks not only the first new treatment option in 10 years for patients with advanced cancers of the head and neck, but also the first Immuno-Oncology treatment for SCCHN,” said Murdo Gordon, executive vice president and chief commercial officer, Bristol-Myers Squibb. “Bristol-Myers Squibb remains committed to redefining survival for patients with cancer, and now that Opdivo is approved in Europe, we will work collaboratively with EU health authorities to ensure it is available for these patients as quickly as possible.”

In the interim analysis of the pivotal trial, Opdivo demonstrated statistically significant improvement in OS with a 30% reduction in the risk of death (HR=0.70 [95% CI: 0.53-0.92; p=0.0101]), and a median OS of 7.5 months (95% CI: 5.5-9.1) for Opdivo compared with 5.1 months (95% CI: 4.0-6.0) for the investigator’s choice arm. There were no statistically significant differences between the two arms for PFS (HR=0.89; 95% CI: 0.70, 1.13) or ORR (13.3% [95% CI: 9.3, 18.3] vs 5.8% [95% CI: 2.4, 11.6] for Opdivo and investigator’s choice, respectively. The EC approval was based on updated study results, which will be presented at the 53rd Annual Meeting of the American Society of Clinical Oncology (ASCO).

Patient reported outcomes (PROs) were evaluated using the following European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Assessment: EORTC QLQ-C30, EORTC QLQ-H&N35, and 3-level EQ-5D instruments. Patients treated with Opdivo exhibited stable PROs, while those assigned to investigator’s choice therapy exhibited significant declines in functioning (e.g., physical, role, social) and health status as well as increased symptomatology (e.g., fatigue, dyspnoea, appetite loss, pain and sensory problems).

The safety profile of Opdivo in CheckMate -141 was consistent with prior studies in patients with melanoma and non-small cell lung cancer. Serious adverse reactions occurred in 49% of patients receiving Opdivo. The most frequent serious adverse reactions reported in at least 2% of patients receiving Opdivo were pneumonia, dyspnea, aspiration pneumonia, respiratory failure, respiratory tract infection, and sepsis.

About Head & Neck Cancer
Cancers that are known as head and neck cancers usually begin in the squamous cells that line the moist mucosal surfaces inside the head and neck, such as inside the mouth, the nose and the throat. Head and neck cancer is the seventh most common cancer globally, with an estimated 400,000 to 600,000 new cases per year and 223,000 to 300,000 deaths per year. The five-year survival rate is reported as less than 4% for metastatic Stage IV disease. Squamous cell cancer of the head and neck (SCCHN) accounts for approximately 90% of all head and neck cancers with global incidence expected to increase by 17% between 2012 and 2022. Risk factors for SCCHN include tobacco and alcohol consumption. Human Papilloma Virus (HPV) infection is also a risk factor leading to rapid increase in oropharyngeal SCCHN in Europe and North America.

About Opdivo
Opdivo is a programmed death-1 (PD-1) immune checkpoint inhibitor that is designed to uniquely harness the body’s own immune system to help restore anti-tumor immune response. By harnessing the body’s own immune system to fight cancer, Opdivo has become an important treatment option across multiple cancers.

Opdivo’s leading global development program is based on Bristol-Myers Squibb’s scientific expertise in the field of Immuno-Oncology and includes a broad range of clinical trials across all phases, including Phase 3, in a variety of tumor types. To date, the Opdivo clinical development program has enrolled more than 25,000 patients. The Opdivo trials have contributed to gaining a deeper understanding of the potential role of biomarkers in patient care, particularly regarding how patients may benefit from Opdivo across the continuum of PD-L1 expression. In July 2014, Opdivo was the first PD-1 immune checkpoint inhibitor to receive regulatory approval anywhere in the world. Opdivo is currently approved in more than 60 countries, including the United States, the European Union and Japan. In October 2015, the company’s Opdivo and Yervoy combination regimen was the first Immuno-Oncology combination to receive regulatory approval for the treatment of metastatic melanoma and is currently approved in more than 50 countries, including the United States and the European Union.

U. S. FDA approved indications for Opdivo
Opdivo® (nivolumab) as a single agent is indicated for the treatment of patients with BRAF V600 mutation-positive unresectable or metastatic melanoma. This indication is approved under accelerated approval based on progression-free survival. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.

Opdivo® (nivolumab) as a single agent is indicated for the treatment of patients with BRAF V600 wild-type unresectable or metastatic melanoma.

Opdivo® (nivolumab), in combination with YERVOY® (ipilimumab), is indicated for the treatment of patients with unresectable or metastatic melanoma. This indication is approved under accelerated approval based on progression-free survival. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.

Opdivo® (nivolumab) is indicated for the treatment of patients with metastatic non-small cell lung cancer (NSCLC) with progression on or after platinum-based chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving OPDIVO.

Opdivo® (nivolumab) is indicated for the treatment of patients with advanced renal cell carcinoma (RCC) who have received prior anti-angiogenic therapy.

Opdivo® (nivolumab) is indicated for the treatment of patients with classical Hodgkin lymphoma (cHL) that has relapsed or progressed after autologous hematopoietic stem cell transplantation (HSCT) and post-transplantation brentuximab vedotin. This indication is approved under accelerated approval based on overall response rate. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials.

Opdivo® (nivolumab) is indicated for the treatment of patients with recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN) with disease progression on or after platinum-based therapy.

Opdivo® (nivolumab) is indicated for the treatment of patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy or have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy. This indication is approved under accelerated approval based on tumor response rate and duration of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials.

April, 2017|Oral Cancer News|

Epigenetic modification discovered in adult throat cancers

Source: www.specialtypharmacytimes.com
Author: Lauren Santye, Assistant Editor

An epigenetic modification may be the cause of 15% of adult head and neck cancers that are linked to tobacco and alcohol use, according to a study published in Nature Genetics.

Although the body is made up of a large number of different types of cells––neurons, skins cells, fat cells, immune cells–– they all have the same DNA or genome. It was not until recently that scientists discovered their differences can be explained by epigenetics.

“This discovery was absolutely unexpected since it seemed highly improbable that the kind of alterations of the epigenome that we had previously found in other types of tumors in children and young adults could also target an epithelial tumor like throat cancer that occurs only in adults,” said Dr Nada Jabado.

There are already some promising drug molecules currently on the market for other diseases that could be tested for head and neck cancers, as well as other cancer types, according to the study. Additionally, the investigators hope that the findings could help in developing treatments for pediatric patients.

“Now that we’ve identified this cohort of patients, we can move quite quickly since the case of adults, as opposed to children, there are more patients and lots of clinical trials,” Dr Jabado said. “The medicines could then be tested on children afterward.”

Dr Jabado’s work focuses on epigenetics in pediatric cancers, particularly on the mutations of the histone H3 protein. In particular, the investigators were interested in a 2015 publication by the Tumor Cancer Genome Atlas Consortium on head and neck cancer that included 1 of the genes that regulates H3.

“We made use of the same data but took a completely different approach,” said principal study author Dr Jacek Majewski. “Instead of concentrating on genetic mutations, we looked at the effect of these mutations on histone H3 proteins. That’s when we discovered that the histone H3 protein was abnormal or incorrectly modified in about 15% of patients with head and neck cancer. The data were there, but this fact had gone unnoticed.”

An essential part of the study was collaboration between scientists and access to the vast genomic databases of patients around the globe, according to the investigators.

“It’s crucial to have access to public data, because it allows us to advance faster and go further in our analyses,” Dr Jabado said. “In our case, this discovery revealed a sub group of patients who might benefit from a therapy that targets the epigenome. This could improve the treatment of more than 1 in 5 patients suffering from devastating oropharyngeal cancer. We are currently collaborating with 2 big groups specializing in head and neck cancer with the goal of finding treatments.”

The investigators are hopeful that the results of the study will open a variety of treatment options in the future.

January, 2017|Oral Cancer News|

Genetic variants are associated with susceptibility to mouth and throat cancer

Source: www.eurekalert.org
Author: news release

A number of genetic variants associated with susceptibility to oral cavity and pharyngeal cancer have been described in an international study published in the journal Nature Genetics.

The most noteworthy finding was an association between cancer of the oropharynx and certain polymorphisms (alternative versions of a given DNA sequence) found in the human leukocyte antigen (HLA) genomic region. HLAs, proteins found on the surface of most cells in the body, play an important role in recognizing potential threats and triggering the immune response to foreign substances.

According to Eloiza Helena Tajara, a professor at the São José do Rio Preto Medical School (FAMERP) in São Paulo State, Brazil, and co-author of the article, a specific group of variants in this region, located on chromosome 6, is associated with enhanced protection against oropharyngeal cancer caused by human papilloma virus (HPV).

“Previous research showed that these same variants confer protection against cancer of the uterine cervix, which is known to be associated with HPV,” Tajara said. “Our findings suggest that the genes that control the immune system play a key role in predisposition to HPV-related tumors. This discovery points to the possibility of clarifying the mechanisms whereby such tumors develop and of designing methods for monitoring risk groups.”

The study was coordinated by the International Agency for Research on Cancer (IARC) and involved 40 research groups in Europe, the United States, and South America. The Brazilian participants are members of the Head & Neck Genome Project (GENCAPO), a consortium of scientists affiliated with several institutions.

In a recent study, GENCAPO evaluated more than 7 million genetic variants in samples from 6,034 patients with head and neck cancer. The cases comprised 2,990 oral cavity tumors, 2,641 oropharyngeal tumors, 305 tumors in the hypopharynx (the bottom part of the pharynx near the esophagus), and 168 tumors in other regions or more than one region concurrently. The study population also included samples from 6,585 people without cancer as controls.

The researchers detected eight loci (genomic sites) associated with susceptibility to these types of tumor. Seven had not previously been linked to mouth or throat cancer.

According to Tajara, the IARC set out to focus on analyzing oral cavity and oropharynx tumors because there are no genome-wide association studies of these two tumor types. Although these cancers are predominantly caused by tobacco and alcohol use, the importance of HPV, particularly HPV16, as a cause of oropharyngeal cancer has become more evident in recent years.

“The throat is the most affected area among head and neck cancer subsites, likely because its tissue is more receptive to the virus,” Tajara said.

In the article, the researchers note that the proportion of HPV-related oropharyngeal cancer cases is estimated to be approximately 60% in the US and 30% in Europe but lower in South America.

“One finding that was expected to some extent was the absence of HLA associations with oropharyngeal cancer, which may be due to the fact that the frequency of HPV-positive oropharyngeal cancer is less than 10% in South America,” Tajara said. “The same factor appears to account for the weak association between the variants identified and HPV-positive oral cavity cancer, which is also far less frequent than HPV-negative oral cavity cancer.”

In her view, the strong rise in cases linked to HPV in the US could be partly due to a change in sexual habits, especially regarding the practice of oral sex. “It’s possible that Brazil is still in a transition stage and that the habits that favor infection are only starting to become more common. If so, the effects will appear in a few years’ time,” she said.

Previous studies have already shown that HPV-associated head and neck cancers affect younger people and develop rapidly. By contrast, cases associated with tobacco and alcohol use as well as poor oral hygiene are more prevalent in those over fifty years old and progress more slowly but are harder to treat.

In addition to DNA in tissue samples taken from participants of the study, data were also collected on environmental and clinical factors possibly associated with the development of this type of cancer, such as smoking, alcohol consumption, and age.

According to Tajara, thanks to the joint efforts of 40 research groups it was possible to obtain data on a significant number of patients, thus enhancing the impact and reliability of the results. The GENCAPO team contributed some 1,000 samples from tumors for analysis.

“Based on these results, we can try to understand from the molecular standpoint how the observed polymorphisms interfere with the response to HPV infection,” Tajara said. “This may give us clues as to how to protect people and how to reduce the incidence of this type of tumor.”

December, 2016|Oral Cancer News|