HPV-associated head and neck cancer blood test shows promise as a test to replace tissue biopsy

Date: December 2nd, 2021 Author: Massachusetts Eye and Ear Infirmary Source: MedicalXpress Featured Image Courtesy of Mass Eye and Ear Infirmary: Daniel L. Faden, MD, a head and neck surgical oncologist and investigator in the Mike Toth Head and Neck Cancer Research Center at Mass Eye and Ear, and assistant professor of otolaryngology–head and neck surgery at Harvard Medical School. Credit: Mass Eye and Ear   Researchers at Mass Eye and Ear and Mass General Hospital have developed a blood test, or liquid biopsy, for head and neck cancer associated with the human papilloma virus (HPV) that was shown in a new study to be more accurate, faster and cheaper than conventional testing methods. In the study, published December 2 in Clinical Cancer Research, a journal of the American Association for Cancer Research, liquid biopsy was more than 98 percent accurate and obtained a diagnosis 26 days quicker on average than conventional tissue biopsy. The cost of the novel test was 38 percent lower than standard methods. When the researchers combined the liquid biopsy with findings from routine imaging and physical exam to create a fully non-invasive diagnostic approach, diagnostic accuracy remained greater than 95 percent. With HPV-associated head and neck cancer rates on the rise, there is a great need for more accurate, less-invasive, faster and less expensive diagnostic tests, according to authors of the study. "Current diagnostic approaches for HPV-associated head and neck cancers are imperfect and invasive, which means patients often need repeat biopsies to get to [...]

2021-12-06T11:31:49-07:00December, 2021|Oral Cancer News|

Treatment Paradigms Are Shifting for Locally Advanced HPV-Positive Head and Neck Cancers

Date: November 18th, 2021 Authors: Kaveh Zakeri, MD, MAS, Nancy Y. Lee, MD Source: OncLive The standard of care for patients with locally advanced head and neck squamous cell carcinomas does not substantially differ according to human papillomavirus (HPV) status in the National Comprehensive Cancer Network guidelines.1 Resectable tumors can be treated with surgery followed by adjuvant therapy. Alternatively, definitive chemoradiation therapy with cisplatin is the other dominant treatment paradigm. Incidence of HPV-associated oropharyngeal squamous cell carcinoma has increased rapidly and is associated with higher overall survival (OS) compared with cancers caused by smoking and alcohol.2,3 Given the unique biology of HPV-associated oropharyngeal disease, a separate staging system was developed for these tumors.4 HPV-associated oropharyngeal cancers are more radiosensitive and chemosensitive than cancers caused by smoking and alcohol, yet the traditional treatment paradigms—including high doses of radiation and chemotherapy—were developed prior to the epidemic of HPV-associated disease. De-escalation of therapy has been proposed for HPV-associated oropharyngeal cancer based on data demonstrating high OS and progression-free survival (PFS).5 De-escalation of therapy has been investigated for both definitive surgical and chemoradiation therapy paradigms. Most de-escalated approaches focus on selecting patients according to clinical features, such as disease stage and smoking status, whereas personalized de-escalation reduces treatment intensity for patients according to treatment response. Transoral Robotic Surgery Followed by Adjuvant Radiotherapy Transoral robotic surgery (TORS) is a minimally invasive approach that reduces morbidity compared with traditional, open surgery for patients with oropharyngeal cancers. TORS is a standard of care option for patients with [...]

2021-12-06T11:00:39-07:00December, 2021|Oral Cancer News|

Liquid biopsy provides accurate, fast Dx of HPV-associated head and neck cancer

Source: www.medpagetoday.com Author: Mike Bassett, Staff Writer, MedPage Today The use of liquid biopsy for the diagnosis of human papillomavirus (HPV)-associated head and neck squamous cell carcinoma (HNSCC) was more accurate, faster, and less expensive than standard tissue-based biopsies, according to a prospective observational study. The sensitivity and specificity of this circulating tumor HPV DNA-based approach were 98.4% and 98.6%, respectively, with positive and negative predictive values of 98.4% and 98.6%, reported Daniel L. Faden, MD, of Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues. The diagnostic accuracy of this non-invasive approach was significantly higher than standard of care (Youden index 0.968 vs 0.707, P<0.0001), they noted in Clinical Cancer Research. In addition, liquid biopsy reduced the time to diagnosis from a median of 41 days to 15 days, and estimated costs associated with this method were about 36% to 38% less than the traditional biopsy approach. "Currently the way we diagnose HPV-associated cancer is either with a needle biopsy of a neck lymph node or a tissue biopsy from the oropharynx -- and these approaches have a couple of different limitations," Faden told MedPage Today. Not only are they invasive and painful for patients, but needle biopsy of a neck lymph node has high failure rates due to a lack of adequate cellular material. "So, patients might have to undergo a repeat biopsy to get the diagnosis we are waiting for," he noted. "That adds time to diagnosis, and we know that time from presentation to [...]

2021-12-03T05:54:26-07:00December, 2021|Oral Cancer News|

Etiglimab/Nivolumab combination shows promise in solid tumors

Source: www.targetedonc.com Author: Sara Karlovitch The combination of etigilimab, an anti-TIGIT antibody, in combination with nivolumab (Opdivio) has demonstrated anti-tumor efficacy and acceptable safety data in patients with solid tumors, according to a press release on the interim results of the phase 1b/2 ACTIVATE trial by Mereo BioPharma Group plc. The phase 1b/2 study (NCT04761198) has a target enrollment of 125 participants and an estimated study completion date of June 2023. The primary end point is objective response rate. During the study, patients will receive an infusion of etigilimab every 2 weeks and an infusion of nivolumab every 2 weeks. Cohorts include squamous cell carcinoma of the head and neck, cervical cancer on or after chemotherapy, gastric or gastroesophageal junction adenocarcinoma, endometrial carcinoma, tumor burden high and microsatellite stable solid tumors, rare disease with high TIGIT expression, ovarian cancer, and endometrial carcinoma post standard of care therapy. At the time of data cutoff, 22 patients were included in the safety analysis. Twenty patients were evaluable with a minimum of at least one scan and 15 were included in the efficacy analysis. The analysis found that 1 patient in the cervical cancer cohort had a complete response. In the ovarian cancer cohort, 1 patient had a partial response. Four patients with stable disease was seen in ovarian cancer, cervical cancer, and uveal melanoma. Additionally, the ovarian cancer cohort has crossed futility for expansion into the second stage of the study. The combination was found to be well tolerated, and no new [...]

2021-12-02T08:25:04-07:00December, 2021|Oral Cancer News|

Geographic disparities in head and neck cancer survival in Upstate New York 2011-2019

Source: www.docwirenews.com Author: DocWire News Featured Reading This article was originally published here Head Neck. 2021 Nov 29. doi: 10.1002/hed.26945. Online ahead of print. ABSTRACT PURPOSE: To examine the association between distance to care-center and urban-rural residence on 5-year overall survival (OS) from head and neck cancer (HNC). MATERIALS AND METHODS: Five-year OS was retrospectively measured from date of initial diagnosis for patients with HNC treated at a single tertiary care center. Distances were calculated based on ZIP code of patient’s residence and care center. Multilevel Weibull regression was used to adjust for confounders and identify disparities in 5-year all-cause mortality. RESULTS: A total of 670 patients included in study. Multivariable analysis revealed older age or late-stage cancer at diagnosis, and HPV negative status were associated with poorer OS. Patients residing in isolated small rural town (HR = 2.20, p = 0.015) or small rural town (HR = 2.07, p = 0.015) had lower OS. Distance to care center was not associated with OS (HR = 0.996, p = 0.11). CONCLUSIONS: Greater rurality was associated with poorer OS among HNC patients in Upstate New York.

2021-12-01T15:19:36-07:00December, 2021|Oral Cancer News|
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