HPV testing, p16 IHC may be needed for oropharyngeal cancer trials

Source: www.cancernetwork.com Author: Russ Conroy Human papillomavirus and p16 discordance may correlate with a worse prognosis for oropharyngeal cancer, according to data from an individual patient data analysis. Patients with discordant p16-negative, human papillomavirus (HPV)–positive or p16-positive, HPV-negative oropharyngeal cancer had a significantly worse prognosis compared with patients who had p16-positive and HPV-positive disease and a better prognosis compared with those who have p16-negative and HPV-negative disease. The data suggest the need for routine p16 immunohistochemistry and mandated HPV testing in clinical trials for oropharyngeal cancer, according to findings from the HNCIG-EPIC-OPC individual patient data analysis. The 5-year overall survival (OS) rate was 81.1% (95% CI, 79.5%-82.7%) for patients with p16-positive, HPV-positive disease; 40.4% (95% CI, 38.6%-42.4%) for those with p16-negative, HPV-negative disease; 53.2% (95% CI, 46.6%-60.8%) for those with p16-negative, HPV-positive disease; and 54.7% (95% CI, 49.2%-60.9%) for those with p16-positive, HPV-negative disease. Additionally, 5-year disease-free survival (DFS) was 84.3% (95% CI, 82.9%-85.7%), 60.8% (95% CI, 58.8%-62.9%), 71.1% (95% CI, 64.7%-78.2%), and 67.9% (95% CI, 62.5%-73.7%) for each respective patient group. Investigators of this multi-center, international individual patient data analysis included retrospective and prospective cohorts with a minimum size of at least 100 patients with primary squamous cell carcinoma of the oropharynx. Patients underwent cross-sectional imaging; histological confirmation by biopsy; and treatment with surgery, radiotherapy, chemotherapy, or combination therapy for oropharyngeal cancer. The primary end points of the analysis included OS, DFS, and the proportion of patients in the overall cohort who showed different p16 and HPV result combinations. [...]

New immunotherapy strategies in targeting complexity in the tumor microenvironment

Source: medicalxpress.com Author: International Association for Dental Research A symposium aiming to provide a better understanding of the tumor microenvironment, immune tolerogenic niches at cancer initiation, and novel immunotherapeutic strategies in head and neck cancer patients was featured at the 52nd Annual Meeting & Exhibition of the AADOCR, held in conjunction with the 47th Annual Meeting of the CADR. The AADOCR/CADR Annual Meeting & Exhibition took place at the Oregon Convention Center in Portland on March 15-18, 2023. Cancer immunotherapy has arisen as a promising new treatment modality for head and neck cancer (HNC), built on an increased understanding of tumor immunology over the last two decades. However, it has become clear that not all tumors are created equal when it comes to their immune profiles, and many are resistant to immunotherapy. Thus, there is a need to better understand the complex tumor microenvironment to more accurately determine prognosis and design therapeutic strategies capable of rendering tumors susceptible to immunotherapy and the immunologic effects of conventional therapies. Organized by Simon Young of the University of Texas Health Science Center at Houston, this symposium provided a high-level overview of exciting developments in understanding the tumor microenvironment, both in terms of the complex immunosuppressive mechanics of the extracellular matrix, the creation of an immune tolerogenic niche at cancer initiation, and how novel immunotherapeutic strategies can target the adverse the tumor immune microenvironment in head and neck cancer. A broad spectrum of expertise was represented by featured clinician-scientist speakers: topics included current challenges [...]

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, [...]

Novel PET radiotracer successfully detects multiple cancers, offers potential for new targeted radionuclide therapy

Source: www.eurekalert.org Author: news release, Society of Nuclear Medicine and Molecular Imaging A new radiotracer, 68Ga-FAP-2286, has been found to be more effective than the most commonly used nuclear medicine cancer imaging radiotracer, 18F-FDG. In a study published in the March issue of The Journal of Nuclear Medicine, 68Ga-FAP-2286 detected 100 percent of primary tumors across multiple cancer types as compared to 18F-FDG, which identified only 80 percent. 68Ga-FAP-2286 was also more effective in detecting lymph node metastases and distant metastases. Currently, 18F-FDG, which measures glucose metabolism, is used extensively in nuclear medicine cancer imaging. Recent advances have shown that fibroblast activation protein (FAP), which is overexpressed in cancer cells, may be a better target for the imaging of solid tumors. “In this study we aimed to investigate the diagnostic accuracy of 68Ga-FAP-2286—a radionuclide developed to target FAP—for detecting the primary and metastatic lesions in patients with various types of cancer,” said Haojun Chen, MD, PhD, nuclear medicine physician at the First Affiliated Hospital of Xiamen University in Xiamen, China. Sixty-four patients with 14 types of cancer were included in the study. Sixty-three of the patients underwent paired 68Ga-FAP-2286 and 18F-FDG PET/CT, and 19 patients underwent paired 68Ga-FAP-2286 and 68Ga-FAP-46 (another 68Ga-radiolabeled variant). Results were evaluated and compared. 68Ga-FAP-2286 PET yielded a higher radiotracer uptake, tumor-to-background ratio and tumor detectability than 18F-FDG. In addition, 68Ga-FAP-2286 and 68Ga-FAPI-46 yielded comparable clinical results. “The novel radionuclide 68Ga-FAP-2286 is shown to be a promising FAP-inhibitor derivative for safe cancer diagnosis, staging and restaging,” [...]

Saliva: The next frontier in cancer detection

Source: knowablemagazine.org Author: Matías A. Loewy In the late 1950s, dentist and US Navy Capt. Kirk C. Hoerman, then a young man in his 30s, attempted to answer a bold question: Might the saliva of prostate cancer patients have different characteristics from that of healthy people? Could it contain traces of a disease that’s so far away from the mouth? Without wasting more of their own saliva on elaborate discussion, Hoerman and his colleagues from the department of dental research at the Naval Training Center in Great Lakes, Illinois, got down to work. They analyzed samples from more than 200 patients and healthy controls, and found that the saliva of patients with untreated prostate cancer showed a significant increase in the levels of enzymes called acid phosphatases. Writing in 1959 in the journal Cancer, the researchers then made a prescient reflection: that it may be valuable to observe discrete biochemical changes in tissues distant from the site of tumor origin. More than 60 years later, the idea that saliva analysis can be used to detect different types of cancer is gaining traction in the scientific community. In the specialized literature, papers containing the keywords “diagnosis,” “cancer” and “saliva” grew more than tenfold over the past two decades, from 26 in 2001 to 117 in 2011, 183 in 2016 and 319 in 2021, according to the PubMed database, a search engine for biomedical research articles. The appeal of this approach is obvious. Although cancer can be diagnosed through tissue biopsy, that [...]

The invisible side effect of visible cancer survivorship

Source: www.curetoday.com Author: Miranda Lankas How do survivors of head and neck cancer cope with drastic changes to one of the most visibly identifiable body parts — the head? Many cancer survivors display outward signs of their disease history; people lose hair, gain scars and ostomy bags, or even experience the full or partial loss of a body part. Some survivors embrace the physical changes in their lives wholeheartedly, with tattoos or photo shoots commemorating their new normal. However, coping with external changes can be a unique challenge for head and neck cancer survivors, whose facial changes include not only disfigurement but challenges with eating, talking and socializing in general. Head and neck cancer refers to a group of diagnoses where cancer forms in the face, mouth (including the lips, tongue and jawbone), throat, voice box and salivary glands: highly sensitive and critical areas. Survivors often face challenges speaking, chewing, swallowing and smiling, as well as changes to the skin and control over facial muscles, making this a diagnosis nearly impossible to disguise. Changes to a person’s face and their ability to eat and speak will significantly affect their ability to socialize, which poses a clear risk to mental health as well as the ability to return to previous activities. Stacey Maurer, an assistant professor and clinical psychologist in behavioral medicine in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina in Charleston, has been working with head and neck cancer survivors on the psychological [...]

Tech innovation offers hope for head/neck cancer treatment

Source: www.miragenews.com Author: University of Colorado Anschutz Medical Campus Over the past decade, human papillomavirus (HPV) has increasingly been identified as a significant cause of certain head and neck cancers – for example, evidence suggests it causes 70% of oropharyngeal cancers in the United States. Further, over the past three decades, incidence of HPV-driven cancers has increased substantially worldwide and in the U.S. While there are well-established screening tools, as well as vaccines, for HPV-driven cancers such as cervical cancer, there are fewer resources for HPV-driven head and neck cancers. As a result, researchers are working with a sense of urgency to develop innovative therapeutics to treat them. One groundbreaking therapeutic has shown significant promise in a phase 1 clinical trial led by Antonio Jimeno, MD, PhD, co-leader of the University of Colorado Cancer Center Developmental Therapeutics Program and the CU Cancer Center head and neck cancer SPORE grant. Research results published today show that a microfluidic squeezing technology used on peripheral blood mononuclear cells (PBMCs), a type of immune cell, helps stimulate anti-tumor activity in a subtype of HPV16-positive cancers, including head and neck, cervical, and anal cancers. “This technology is quite novel,” Jimeno explains. “As opposed to other cell therapies that require a patient’s cells to be genetically modified, this involves a different way of manipulating cells that does not lead to genetic modifications. It makes the process faster and perhaps more agile as to what you can direct the cells against.” “Sending them to boot camp” This [...]

Health and geology experts work together in 250k project to improve early detection of oral cancer

Source: www.abdn.ac.uk Author: issued by The Communications Team, Directorate of External Relations, University of Aberdeen University of Aberdeen experts across the institutes of Dentistry, Medical Sciences and The School of Geosciences will work together to improve the ability to detect malignant changes in precancerous lesions which can develop into oral cancer in a £250k project. Oral cancer is a growing health problem that has seen little improvement in survival rates, mainly because of late diagnosis when the disease has progressed beyond a cure. One of the main challenges clinicians face is the lack of ways to reliably predict malignant changes in oral potentially malignant disorders (OPMDs) which carry a higher risk of developing into cancer. The researchers will use techniques typically used in geological and material science to develop methods that can detect disease progression to help identify patients at early stages when the potential of a cure is more likely. Funded by Cancer Research UK, the multidisciplinary team from the University of Aberdeen, including Dr Rasha Abu-Eid of the Institute of Dentistry, Professor Valerie Speirs from the Institute of Medical Sciences, and Dr Dave Muirhead, Head of the School of Geosciences, will work with specialists around the world including Professor WM Tilakaratne and Dr TG Kallarakkal from the University of Malaya in Malaysia, Professor BSMS Siriwardena from the University of Peradeniya in Sri Lanka and Professor J James from Queen’s University Belfast, Northern Ireland. Dr Rasha Abu-Eid explains: “In recent years we have seen a rise in oral cancer [...]

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