Charlotte Parker, Author at Oral Cancer News

Tackling side effects in head and neck cancer treatment – the end of the road for hyperbaric oxygen?

Source: Cancer Research UK Date: May 2, 2019 Author: Katie Roberts Some side effects appear years after cancer treatment. That’s the case for one side effect of radiotherapy for head and neck cancer, called osteoradionecrosis. This painful condition results from damage to the jaw bone, which often doesn’t heal properly and can cause bone fractures or even bone death. It can develop without an obvious trigger, but it’s often linked to dental work like tooth extractions or implants. And it can happen even if the dental work is carried out 20 years after radiotherapy. Professor Richard Shaw, a Cancer Research UK-funded head and neck surgeon at the University of Liverpool, treats the difficult condition quite frequently through reconstructive surgery. Shaw says that these procedures are often bigger and harder than patients’ original cancer surgery, because they’ve already had so much treatment in that area. For that reason, researchers have looked for ways to prevent osteoradionecrosis from developing. And that’s where hyperbaric oxygen comes in. It started with a small trial in the 80s, which has influenced the way doctors prepare patients for dental surgery ever since. But new Stand Up To Cancer trial data, led by Shaw and published in the International Journal of Radiation Oncology, shows the hyperbaric oxygen hype may have been a bit premature. The trial of hyperbaric oxygen Back in the 1980s, a small trial in the US showed that giving hyperbaric oxygen before dental surgery could reduce the risk of osteoradionecrosis developing. What is hyperbaric oxygen therapy? Hyperbaric oxygen treatment involves [...]

Charlotte Parker2019-05-06T10:21:09-07:00May, 2019|Oral Cancer News|

Oral HPV DNA Persistence After Head and Neck Cancer Treatment Linked to Disease Progression

Source: genomeweb Date: May 2, 2019 Author: Staff Reporter NEW YORK (GenomeWeb) – Persistent traces of human papilloma virus DNA after treatment for HPV-positive head and neck cancer is linked to an increased recurrence risk, a new study has found. Head and neck cancers affect some 53,000 people in the US each year, according to the National Cancer Institute, and HPV has been implicated in many of those cases. In general, patients with HPV-positive tumors have higher survival rates than those with HPV-negative tumors. A team of MD Anderson Cancer Center-led researchers collected oral rinse samples from nearly 400 patients with head and neck squamous cell carcinomas at diagnosis and as their treatments progressed. As they reported today in JAMA Oncology, the researchers found that viral load in patients' oral samples broadly decreased as they underwent therapy. But some patients' viral loads persisted despite treatment, which was linked to an increased risk of cancer recurrence and death, the researchers reported. "Our data suggest that a subset of patients with HPV-positive HNSCC at high risk for locoregional recurrence can be identified by detection of persistent, oral HPV after treatment," MD Anderson's Maura Gillison and her colleagues write in their paper. The researchers enrolled 396 patients with oral cavity, oropharyngeal, or unknown primary HNSCC in their study. They tested the patients' tumors for the presence of 13 high-risk HPV types using an mRNA expression test and found 202 patients had HPV-positive tumors. At the same time, the researchers collected oral rinse samples from patients [...]

Charlotte Parker2019-05-06T10:20:43-07:00May, 2019|Oral Cancer News|

E-cig users develop some of the same cancer-related molecular changes as cigarette smokers

Source: EurekAlert! Date: February 14, 2019 If you think vaping is benign, think again. A small USC study shows that e-cig users develop some of the same cancer-related molecular changes in oral tissue as cigarette smokers, adding to the growing concern that e-cigs aren't a harmless alternative to smoking. The research, published this week in the International Journal of Molecular Sciences, comes amid a mushrooming e-cig market and mounting public health worries. On a positive note, recent research found vaping is almost twice as effective as other nicotine replacement therapies in helping smokers quit. But among adolescents, vaping now surpasses smoking, and there's evidence that e-cig use leads to nicotine addiction and future smoking in teens. "The existing data show that e-cig vapor is not merely 'water vapor' as some people believe," said Ahmad Besaratinia, an associate professor at Keck School of Medicine of USC and the study's senior author. "Although the concentrations of most carcinogenic compounds in e-cig products are much lower than those in cigarette smoke, there is no safe level of exposure to carcinogens." Besaratinia emphasized that the molecular changes seen in the study aren't cancer, or even pre-cancer, but rather an early warning of a process that could potentially lead to cancer if unchecked. The researchers looked at gene expression in oral cells collected from 42 e-cig users, 24 cigarette smokers and 27 people who didn't smoke or vape. Gene expression is the process by which instructions in our DNA are converted into a functional product, [...]

Charlotte Parker2019-02-18T10:40:06-07:00February, 2019|Oral Cancer News|

Merck’s Keytruda looks to zoom past Opdivo with fast head and neck cancer review

Source: Fierce Pharma Date: February 11, 2019 Author: Carly Helfand Merck & Co.’s Keytruda is duking it out with Bristol-Myers Squibb’s Opdivo in the head and neck cancer marketplace, but Keytruda just took one step toward a green light that would give it a big edge. The FDA has tagged Merck’s approval application for the immuno-oncology superstar—alone or in tandem with chemo—with its priority review designation in previously untreated patients with head and neck cancer. The move, which Merck announced Monday, sets Keytruda up for a quick trip down the regulatory pathway; the agency expects to have a decision by June 10, Merck said. FDA staffers based their decision on data Merck trotted out at last year’s European Society for Medical Oncology (ESMO) meeting in October. Results showed that solo Keytruda, when pitted against a standard-of-care regimen dubbed by doctors as “Extreme,” could cut the risk of death by 22% in patients testing positive for the biomarker PD-L1. In patients with high levels of PD-L1 in their tumors, that figure shot up to 39%. And when paired with chemo, Keytruda pared down the risk of death by 23% regardless of patients’ PD-L1 status. Based on “the limited interaction we’ve had with key opinion leaders, I think this is seen as practice-changing,” Roy Baynes, Merck SVP and head of global clinical development, said when the data were released. And in addition to shaping opinions on clinical practice, the results also confirmed Keytruda’s place in the second-line setting, where it had previously suffered a narrow trial miss. [...]

Charlotte Parker2019-02-11T11:48:00-07:00February, 2019|Oral Cancer News|

Tumor Mutational Burden Predicts Who Will Respond to Immunotherapy

The advent of immunotherapy has significantly shifted the treatment paradigm and prognosis for multiple advanced-stage cancers. In cancers like metastatic melanoma and non–small cell lung cancer (NSCLC), the treatment class has greatly improved survival rates. However, not all patients respond to the treatments, highlighting the need for predictive biomarkers to determine which patients will benefit. Early reports and small cohorts have suggested high tumor mutational burden being associated with improved clinical response, and now a large study has confirmed the hypothesis. “Given the potential toxicities of immunotherapy and the highly variable response to immune checkpoint inhibitors, as well as the significant economic cost of these agents, there is an urgent need for biomarkers that can predict immunotherapy response,” explained the researchers of the study. Looking at data from more than 1000 patients with stage IV or metastatic disease for which immune checkpoint inhibitors are approved, including NSCLC, melanoma, renal cell carcinoma, bladder cancer, and head and neck cancer, researchers found that higher somatic tumor mutational burden is associated with improved overall survival. Patients were treated with atezolizumab, avelumab, durvalumab, ipilimumab, nivolumab, pembrolizumab, or tremelimumab. Tumor mutational burden was calculated by normalizing the number of somatic nonsynonymous mutations to the total number of megabases sequenced, and noting that mutational load varies across tumor types, the researchers defined tumor mutational burden within each cancer type. The authors found that, across all cancers, more mutations translated into improved overall survival. The authors noted that the association remained even when removing NSCLC and melanoma [...]

Charlotte Parker2019-01-22T11:03:57-07:00January, 2019|Oral Cancer News|

Researchers Uncover Major Clue In Predicting Response To Immunotherapy

Researchers at Memorial Sloan Kettering Cancer Center in New York have discovered that cancer cells with high numbers of faults in their DNA are more likely to respond to immune checkpoint inhibitors (ICI), a major class of immunotherapy drugs, which includes Keytruda. The study, published today in Nature Genetics adds important pieces to the puzzle as to why some cancer patients respond to immunotherapy whereas others do not. The researchers measured 'tumor mutation burden (TMB)', essentially counting how many DNA faults a tumor contains by looking for errors in the DNA sequence. "People assume that TMB is important in predicting response to immunotherapy in all cancers, but up until now, all we've had is data from small studies and clinical trials on mostly lung cancers and melanoma," said Luc Morris, MD, surgical oncologist at Memorial Sloan Kettering Cancer Center and one of the lead authors of the paper. The researchers studied the DNA of 1,662 patients with advanced cancer (classified as stage IV or metastatic disease) treated with one or more of several FDA-approved ICI drugs and DNA from 5,371 patients with advanced cancer who had not had ICI. They used a tool called MSK-IMPACT, which looks at just 3% of the coding-regions in DNA, but is correlated to the number of mutations in the genome. "Is TMB associated with likelihood that immunotherapy has benefit? Is this true in all cancers? We wanted to find out whether TMB had broad applicability," said Morris. The researchers found that if they took [...]

Charlotte Parker2019-01-16T11:03:13-07:00January, 2019|Oral Cancer News|

CDC: Top HPV-Associated Cancer Is Now Oropharyngeal

Date: 08/23/18 Source: medscape.com Author: Nick Mulcahy Oropharyngeal squamous cell carcinoma (SCC) is now the most common HPV-associated cancer in the United States, according to a new report from the Centers for Disease Control and Prevention (CDC) that covers the years 1999 to 2015. During that period, cervical cancer dropped from being the top HPV-associated cancer and oropharyngeal SCC took its place. The transition happened because cervical carcinoma incidence rates decreased 1.6% per year, and oropharyngeal SCC incidence rates increased 2.7% per year among men and 0.8% per year among women. In 2015, there were a total of 11,788 cervical cancers compared with 18,917 oropharyngeal SCCs. The decline in cervical cancer is a "continued trend since the 1950s as a result of cancer screening," write the report authors, led by Elizabeth Van Dyne, MD, MPH, an epidemic intelligence service officer at the CDC. The uptick in oropharyngeal SCC could be due in part to "changing sexual behaviors," including unprotected oral sex, especially among white men, who report having the highest number of sexual partners and performing oral sex at a younger age compared with other racial/ethnic groups, the authors say. Oropharyngeal SCCs include those at the base of tongue, pharyngeal tonsils, anterior and posterior tonsillar pillars, glossotonsillar sulci, anterior surface of soft palate and uvula, and lateral and posterior pharyngeal walls. The new report was published August 24 in the Morbidity and Mortality Weekly Report. The study authors defined HPV-associated cancer as "an invasive malignancy in which HPV DNA was frequently [...]

Charlotte Parker2019-01-02T13:54:33-07:00January, 2019|Oral Cancer News|

Five Things To Look Out For In Cancer Research In 2019

Date: 12/28/18 Source: Forbes.com Author: Victoria Forster 2018 was a remarkable year for cancer research, with great strides made in diagnosing and treating various types of cancer as well as important breakthroughs looking at the health of cancer survivors. What can we expect to see from cancer research in 2019? As a cancer research scientist, here are the top five topics that I'll be looking out for. 1. Immunotherapy. Who will respond, who won't respond and why? Immunotherapy is now seemingly everywhere, with several therapies approved for various cancer types, including CAR T-cells and immune checkpoint inhibitors and several more in development such as tumor infiltrating lymphocyte (TIL) therapy. TILs successfully cleared all tumors from a woman with metastatic breast cancer, in a research breakthrough which was one of the most reported in 2018. Over 2,500 trials are now registered worldwide, but as the use of immunotherapy grows, there are still major questions to be answered. One particularly important to the use of immune-checkpoint blocking drugs such as those which target PD-1 or CTLA-4 is 'why do some patients respond whereas others do not?' Several research teams worldwide are currently grappling with this question, which is unlikely to have a single, clear answer, but I expect to see much more research published on this in 2019, which will hopefully start to benefit patients by identifying who will and won't respond to these expensive drugs. 2. Liquid biopsy tests. More clarity on precisely what they do and more evidence that they [...]

Charlotte Parker2019-01-02T13:07:21-07:00January, 2019|Oral Cancer News|

Hospitals required to post all prices online beginning January 1

Date: 12/26/18 Source: KATV Author: Associated Press WASHINGTON (AP) — Medicare will require hospitals to post their standard prices online and make electronic medical records more readily available to patients, officials said Tuesday. The program is also starting a comprehensive review of how it will pay for costly new forms of immunotherapy to battle cancer. Seema Verma, head of the Centers for Medicare and Medicaid Services, said the new requirement for online prices reflects the Trump administration’s ongoing efforts to encourage patients to become better-educated decision makers in their own care. “We are just beginning on price transparency,” said Verma. “We know that hospitals have this information and we’re asking them to post what they have online.” Hospitals are required to disclose prices publicly, but the latest change would put that information online in machine-readable format that can be easily processed by computers. It may still prove to be confusing to consumers, since standard rates are like list prices and don’t reflect what insurers and government programs pay. Patients concerned about their potential out-of-pocket costs from a hospitalization would still be advised to consult with their insurer. Most insurance plans nowadays have an annual limit on how much patients must pay in copays and deductibles — although traditional Medicare does not. Likewise, many health care providers already make computerized records available to patients, but starting in 2021 Medicare would base part of a hospital’s payments on how good a job they do. Using electronic medical records remains a cumbersome task, and [...]

Charlotte Parker2019-01-02T12:52:16-07:00January, 2019|Oral Cancer News|

Immunotherapy extends the life of head and neck cancer patients

Source: Pharmatimes.com Date: 12/3/18 Author: Anna Smith A new immunotherapy can greatly extend the lives of a proportion of people with advanced head and neck cancer, with some living for three years or more, reports a major new clinical trial. The study, by The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, found that the drug – MSD’s Keytruda (pembrolizumab) - has been shown to have significant benefits for patients, with 37% of those who received it surviving for a year or more, compared with only 26.5% of those on standard care. The drug was evaluated in a trial of nearly 500 patients with very advanced head and neck cancer that had spread around the body and already become resistant to platinum chemotherapy, the first-line treatment for the disease. Some 247 patients were randomised to receive Keytruda and 248 to standard of care – chemotherapy or the targeted agent Erbitux (cetuximab). When chemotherapy or targeted therapies stop working, treatment options for people with advanced head and neck cancer are limited, and they are normally expected to survive for less than six months. Patients in the Keytruda arm survived for a median of 8.4 months, compared to 6.9 months with standard treatment. However, a minority of patients responded extremely well to Keytruda – 36 patients saw their cancer partially or completely disappear, and some are still cancer free three years after first receiving the drug. “Our findings show that the immunotherapy pembrolizumab extends the life of people with [...]

Charlotte Parker2018-12-05T17:20:46-07:00December, 2018|Oral Cancer News|

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