2009 – Page 9 – Oral Cancer News

Comparative prognostic value of HPV16 E6 mRNA compared with in situ hybridization for human oropharyngeal squamous carcinoma

Source: Journal of Clinical Oncology, 10.1200/JCO.2009.23.1670 Author: Wei Shi et al. Purpose: A significant proportion of oropharyngeal squamous cell carcinomas (OSCC) are associated with the human papilloma virus (HPV), particularly HPV16. The optimal method for HPV determination on archival materials however, remains unclear. We compared a quantitative real-time polymerase chain reaction (qRT-PCR) assay for HPV16 mRNA to a DNA in situ hybridization (ISH) method, and evaluated their significance for overall (OS) and disease-free (DFS) survival. Patients and Methods: Matched, archival biopsies from 111 patients with OSCC were evaluated for HPV16 using a qRT-PCR for E6 mRNA and ISH for DNA. Immunohistochemistry for p16, p53, and epidermal growth factor receptor were also performed. Results: HPV16 E6 mRNA was positive in 73 (66%) of 111 samples; ISH was positive in 62 of 106 samples (58%), with 86% concordance. P16 was overexpressed in 72 samples (65%), which was strongly associated with HPV16 status by either method. E6 mRNA presence or p16 overexpression were significantly associated with superior OS; E6 mRNA, HPV16 ISH, or p16 were all significantly associated with DFS. On multivariate analysis adjusted for age, stage, and treatment, positive E6 mRNA was the only independent predictor for superior OS; for DFS, p16 expression or HPV16 status determined by either method was significant. Conclusion: The prevalence of HPV16 in OSCC ranges from 58% to 66%, in a recently treated Canadian cohort. Classification of HPV-positivity by HPV16 E6 mRNA, HPV16 ISH or p16 immunohistochemistry (IHC) is associated with improved DFS. However, the latter two [...]

Oral Cancer Foundation News Team - A2009-11-05T07:30:00-07:00November, 2009|Oral Cancer News|

HPV vaccination: inaccurate assumptions about oropharyngeal cancer

Source: BMJ 2009;339:b4525 Author: Erich M Sturgis et al. Excerpt from article: The article by Kim and Goldie on the cost effectiveness of including boys in a human papillomavirus (HPV) vaccination programme made assumptions about oropharyngeal cancers that are inaccurate.1 The prevalence of HPV in oropharyngeal cancer used in the article (31%) is based on worldwide estimates,2 but its prevalence in the US, where the research was done, is much higher.3 4 Source data for the review article referenced by the authors give the US specific HPV prevalence as 47% (42% for types 16/18),2 5 and other more recent high quality studies from the US have found rates as high as 72%.3 Furthermore, a recent population based study within the Colorado SEER registry found an HPV prevalence rate of 79% for oropharyngeal cancers diagnosed after 1994.4 Authors: Erich M Sturgis, associate professor1, Kristina R Dahlstrom, doctoral student2 Author affiliations: 1 Department of Head and Neck Surgery and Department of Epidemiology, University of Texas, MD Anderson Cancer Center, Houston, Texas 77030, USA, 2 University of Texas School of Public Health, Houston, Texas, USA

Oral Cancer Foundation News Team - A2009-11-04T15:30:17-07:00November, 2009|Oral Cancer News|

Incidental detection of an occult oral malignancy with autofluorescence imaging: a case report

Source: Head Neck Oncol, October 28, 2009; 1(1): 37 Author: Nadarajah Vigneswaran, Sheila Koh, and Ann Gillenwater Background: Autofluorescence imaging is used widely for diagnostic evaluation of malignances of various epithelial malignancies. Cancerous lesions display loss of autofluorescence due to malignant changes in epithelium and subepithelial stroma. Carcinoma of unknown primary site presents with lymph node or distant metastasis, for which the site of primary tumor is not detectable. We describe here the use of autofluorescence imaging for detecting a clinically innocuous appearing occult malignancy of the palate which upon pathological examination was consistent with a metastatic squamous cell carcinoma. Case Description: A submucosal nodule was noted on the right posterior hard palate of a 59-year-old white female during clinical examination. Examination of this lesion using a multispectral oral cancer screening device revealed loss of autofluorescence at 405 nm illumination. An excisional biopsy of this nodule, confirmed the presence of a metastatic squamous cell carcinoma. Four years ago, this patient was diagnosed with metastatic squamous cell carcinoma of the right mid-jugular lymph node of unknown primary. She was treated with external beam irradiation and remained disease free until current presentation. Conclusion: This case illustrates the important role played by autofluorescence tissue imaging in diagnosing a metastatic palatal tumor that appeared clinically innocuous and otherwise would not have been biopsied.

Oral Cancer Foundation News Team - A2009-11-04T15:23:35-07:00November, 2009|Oral Cancer News|

Biovex agrees to Special Protocol Assessment (SPA) with the FDA for a pivotal phase III study with Oncovexin head and neck cancer

Source: www.pressreleasepoint.com Author: press release BioVex Inc, a biotechnology company developing clinical stage treatments for cancer and the prevention of infectious disease, announced today that the U.S. Food and Drug Administration (FDA) has approved the design of a single, pivotal, Phase III clinical trial evaluating its lead product, OncoVEXGM-CSF for the first line treatment of patients with squamous cell cancer of the head and neck. The study is the second the Company has agreed with the FDA under the Special Protocol Assessment (SPA) procedure and highlights the broad potential utility of BioVex’s first-in-class cancer destroying virus technology. The first SPA was in melanoma under which BioVex is currently conducting a pivotal Phase III trial. Patients with head and neck cancer often present with locally advanced, bulky disease that is too large, or too close to vital organs, to remove surgically. These patients typically undergo combination radiation and chemotherapy treatment, with in some cases additional surgery. Patients who present with tumor containing lymph nodes are particularly difficult to treat and approximately half of these patients relapse within two years. Philip Astley-Sparke, President & CEO, for BioVex said: "The announcement of our second SPA governing a Phase III study demonstrates the breadth of the commercial opportunity with OncoVEXGM-CSF. In addition to treating metastatic disease as is the intention in our ongoing Phase 3 study in melanoma, following multiple systemic responses in Phase II, OncoVEXGM-CSFalso has considerable potential utility in treating discrete solid tumor masses across multiple indications including those that are poorly [...]

Oral Cancer Foundation News Team - A2009-11-04T12:54:36-07:00November, 2009|Oral Cancer News|

PMH finding may help some tonsil cancer patients avoid chemotherapy

Source: www.sciencecodex.com Author: staff Clinical researchers at Princess Margaret Hospital (PMH) have confirmed that patients with oropharyngeal squamous cell cancer ("tonsil cancer") harbour a common type of human papilloma virus (HPV16), but also that such cancers are very sensitive to radiation. For some patients, this may mean successful treatment with radiation alone and avoiding the side effects of chemotherapy. "This represents the power of personalized medicine. By using a relatively simple molecular test to evaluate the tumour, we can customize the treatment plan, produce an excellent outcome, and maintain the patient's quality of life," says principal investigator Dr. Fei-Fei Liu, PMH radiation oncologist, Head of the Division of Applied Molecular Oncology, Ontario Cancer Institute, and Dr. Mariano Elia Chair in Head & Neck Cancer Research, University Health Network. Dr. Liu's team discovered that patients whose tumours tested positive for HPV16 had a much better survival, compared to patients whose tumours did not harbour HPV16. This HPV effect was independent of treatment (radiation alone, or radiation plus chemotherapy), suggesting that some HPV16 patients could be treated with radiation only. As a result, PMH now routinely tests tonsil-area tumours for HPV16 -- one of the first cancer programs to do so. The study's finding is important because this particular type of cancer is increasing – up more than 10% in the past 20 years. The jump is likely attributed to the spread of HPV16 through sexual activity, compared with a 20% decline in other similar head-and-neck cancers over the same period because [...]

Oral Cancer Foundation News Team - A2009-11-04T12:27:48-07:00November, 2009|Oral Cancer News|

A dynamic oral cancer field: unraveling the underlying biology and its clinical implication

Source: Am J Surg Pathol, November 1, 2009; 33(11): 1732-8 Authors: IF Tsui, C Garnis, and CF Poh Oral cancer is a complex disease that is characterized by histologic and genetic heterogeneity. The evolution and progression of this disease is thought to result from the accumulation of alterations in molecular pathways. Although the oral cavity is accessible for routine screening of suspicious lesions, gene alterations are known to accrue in histologically normal tissues. Therefore, some cancer forerunners may remain undetected clinically or histologically. Recently emerging optical and molecular technologies have provided a powerful means for redefining the extent of the field of alteration. Often this means expanding upon regions detectable with standard white light approaches. In this report, we used a newly developed optical technique, direct fluorescence visualization, to define a contiguous field that extended beyond the margins of a clinically visible oral squamous cell carcinoma. Multiple biopsies were taken within this contiguous optically altered field. Genome alterations detected for each specimen were compared to define whether each lesion arose independently or as a consequence of a shared progenitor cell. Our results indicate that the field effect of oral cancer is extremely dynamic, with different genetic alterations present in different biopsies within a field. This case study also demonstrated that 2 genetically unrelated squamous cell carcinoma could be developed within 10 mm at the right lateral tongue of this patient. These findings provide evidence for the importance to implement optical technologies in defining surgical margins and support the use of [...]

Oral Cancer Foundation News Team - A2009-11-03T09:07:52-07:00November, 2009|Oral Cancer News|

YM Biosciences reports positive nimotuzumab four-year survival data

Source: www.reuters.com Author: press release YM BioSciences Inc., a life sciences product development company that identifies and advances a diverse portfolio of promising cancer-related products at various stages of development, announced that an oral presentation at the American Society for Therapeutic Radiology and Oncology (ASTRO) 2009 Annual Meeting reported positive 48-month survival data for its EGFR-targeting antibody, nimotuzumab. The "BEST" trial was a randomized four-arm study treating patients with inoperable, locoregionally-advanced, stage III/IVa head and neck cancer with radiation alone, chemoradiation alone, or radiation or chemoradiation in combination with nimotuzumab. These data were a follow-up to 30-month survival data presented at ASCO 2009 and demonstrate that the benefit of adding nimotuzumab to radiation and chemoradiation is durable and persists for several years. "These data are convincing evidence that nimotuzumab is an efficacious and safe drug and highlight its potential in the head and neck cancer indication. In this respect we note that the National Cancer Centre of Singapore has initiated a global Phase III trial with nimotuzumab in the adjuvant setting for head and neck cancer patients," said David Allan, Chairman and CEO of YM BioSciences. "Activity of nimotuzumab in the BEST trial was similar to that demonstrated in separate trials with cetuximab in locally advanced head and neck cancer but there was no evidence that nimotuzumab's activity was accompanied by the advanced toxicities of the class." In the ASTRO presentation, Dr. Lokesh Viswanth, Kidwani Memorial Institute of Oncology, Bangalore, India described that the addition of nimotuzumab to radiotherapy (RT) [...]

Oral Cancer Foundation News Team - A2009-11-03T08:17:42-07:00November, 2009|Oral Cancer News|

Saliva tests may help with disease diagnosis

Source: www.readingeagle.com Author: John Reitz, DDS The Dentist's Chair Jim: With the newly discovered connection between oral health and overall health, is there anything a dentist can tell about my overall health from looking in my mouth? Dr. Reitz: Dear Jim, a dentist can tell if you have gum disease and tooth decay by looking in your mouth, but to determine your overall health he may need a sample of your saliva. Instead of having just a blood test by your physician, your dentist will soon have the ability to diagnosis systemic disease by doing a saliva test. In dental school I was taught that saliva's function was to neutralize acids and help swallow food. We are now finding that saliva is more complex than originally thought, containing over 1,000 different proteins. The question now is why are the proteins there. Recent advances in technology have found saliva contains indicators, either genes or salivary proteins called biomarkers, of systemic disease. Of the 1,000 salivary proteins already identified, only specific proteins are found in patients with systemic disease. Research at the University of California, Los Angeles is expected to get Food and Drug Administration approval within two years for a saliva test that can detect pancreatic cancer. Other studies have found biomarkers for breast cancer, oral cancer, diabetes, arthritis, heart disease and autoimmune disorders. In addition to finding systemic diseases, saliva tests will determine a person's chances of getting tooth decay. Some promising studies have identified biomarkers for a predisposition to [...]

Oral Cancer Foundation News Team - A2009-11-02T11:20:17-07:00November, 2009|Oral Cancer News|

CyberKnife to be focus of numerous presentations at the American Society for Radiation Oncology (ASTRO) annual meeting

Source: www.reuters.com Author: press release Accuray Incorporated, a global leader in the field of radiosurgery, announced today that 28 CyberKnife-focused abstracts have been accepted as part of the 51st Annual Meeting of the American Society for Radiation Oncology (ASTRO), taking place November 1 - 5 in Chicago, Illinois. This represents a 27 percent increase in CyberKnife abstracts over last year's Annual Meeting. The accepted abstracts, which will be presented as posters or oral presentations, focus on the use of the CyberKnife® Robotic Radiosurgery System to treat tumors located throughout the body including the prostate, lung, brain, spine, liver, pancreas, head and neck. "The depth and breadth of research presented at this year's ASTRO meeting is a testament to the growing clinical acceptance of the CyberKnife System and the important role it is playing in the treatment of cancer," said Euan Thomson, Ph.D., president and CEO of Accuray. Highlights of the research that will be showcased include seven presentations focusing on the use of CyberKnife radiosurgery to treat prostate cancer. CyberKnife prostate procedures from July-September 2009 increased 21 percent over the same period the previous year, confirming the increasing demand for this treatment option. To date, CyberKnife radiosurgery has been used to treat more than 4,000 men with prostate cancer. Additionally, Accuray will host a number of presentations in the company's booth reporting on experience with CyberKnife radiosurgery. Presenters include Eric Lartigau, M.D., Ph.D., from Centre Oscar Lambret; Xiaodong Wu, Ph.D., from University of Miami; Donald B. Fuller, M.D., from CyberKnife [...]

Oral Cancer Foundation News Team - A2009-10-31T10:06:44-07:00October, 2009|Oral Cancer News|

Males can get HPV vaccine Gardasil thanks, in part, to Gulfport cancer survivor

Source: St. Petersburg Times Author: John Barry David Hastings' crusade to inoculate boys against a cancer-causing virus that afflicts women — but threatened him, too — has scored a victory. But it's not quite the one he has been fighting for in the past three years. A panel of the Centers for Disease Control and Prevention last week allowed a vaccine to be given to boys and young men that is already used to protect girls and young women from human papillomavirus, HPV, which causes cervical cancer. The panel's vote followed the Food and Drug Administration's recent okay of the vaccine for boys as a protection against genital warts. The vaccine, Gardasil, was approved only for females, ages 9 to 26, in 2006. But research has since linked HPV to many oral cancers in men. Hastings, who owns the Habana Cafe in Gulfport with his wife, Josefa, testified before the CDC's Advisory Committee on Immunization Practices. He told them how HPV was found in a deadly carcinoma in his throat in 2006. It took seven weeks of simultaneous chemotherapy and radiation at the H. Lee Moffitt Cancer Center in Tampa to arrest the cancer. Ever since, he has spread the message that HPV is a threat to men. He urged the CDC panel to recommend routine vaccinations for boys, as it already does for girls. Hastings and other proponents argued that only 17 percent of girls are completing the series of three doses needed for protection. "We rely on females [...]

Charlotte Parker2009-10-30T10:58:18-07:00October, 2009|Oral Cancer News|