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Beaumont Researchers: biomarkers predict effectiveness of radiation treatments for head and neck cancer

Source: www.healthcanal.com Author: staff An international team of researchers, led by Beaumont Health System’s Jan Akervall, M.D., Ph.D., looked at biomarkers to determine the effectiveness of radiation treatments for patients with squamous cell cancer of the head and neck. They identified two markers that were good at predicting a patient’s resistance to radiation therapy. Their findings were published in the February issue of the European Journal of Cancer. Explains Dr. Akervall, co-director, Head and Neck Cancer Multidisciplinary Clinic, Beaumont Hospital, Royal Oak, and clinical director of Beaumont’s BioBank, “Radiation therapy is a common treatment for people with squamous cell cancer of the head and neck. However, it’s not always well-tolerated. It can take two months, resulting in lots of side effects. Some of these complications are permanent. Before my patient goes down that path, I really want to know if their tumors are going to respond to radiation. That’s where the patient’s biomarkers can shed some light. If not, we can look at other treatment options - saving time, possible risk for complications and expense.” A biomarker is a gene or a set of genes or its products, RNA and proteins, that researchers use to predict a key clinical issue such as diagnosis, prognosis, and response to treatment, choice of treatment or recurrence. Biomarker studies can provide a bridge between emerging molecular information and clinical treatment. Biomarkers may also lead to personalized treatment, in contrast to protocol-based medicine of today. “Personalized treatment decisions based on biomarkers go beyond traditional cancer [...]

2014-03-30T10:18:00-07:00March, 2014|Oral Cancer News|
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Anti-seizure medications prevent cancer

Source: guardianlv.com Author: Lindsey Alexander A recent report came out from the journal Cancer indicating a new finding that anti-seizure medications might prevent some forms of cancer. Drugs like valporic acid (Depakote), are one form of prescription in this classification. Though also used as a mood-stabilizer, Depakote can prevent seizures from occurring, and has been investigated for cancer prevention. These particular anti-seizure medications have been found to inhibit genetic changes that lead to cancer of the head and neck. The study included nearly 440,000 veterans, including 27,000 who were taking valporic acid for various disorders including post-traumatic stress disorder, bipolar disorder, seizures, and migraines. The overall findings suggested that veterans who were on the prescription were 34 percent less likely to develop cancers of the head and neck, than those who were not taking the drug. The risk decreased in those subjects who took higher doses or for longer periods of time. Dr. Johann Brandes with Atlanta Veterans Affairs Medical Center was the team leader of this study. He claims that this 34 percent statistic means 16,000 new cases, and between 3,000 and 4,000 cancer deaths can be prevented every year. Though there is a strong association, the study did not form a direct cause-and-effect relationship between cancer prevention and anti-seizure medications. The National Cancer Institute describes cancers of the neck and head as usually squamous cell cancers that line mucosal surfaces inside the head and neck. This can affect the mouth, the throat, and the nose. This is a [...]

2014-03-30T10:04:44-07:00March, 2014|Oral Cancer News|
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Unilateral radiation benefited patients with advanced tonsil cancer

Source: www.healio.com Author: staff Unilateral radiotherapy was associated with effective regional control in patients with advanced tonsil cancer, according to study results presented at the 2014 Multidisciplinary Head and Neck Cancer Symposium. Additionally, the results supported previous findings that suggest the primary tumor location, not the extent of ipsilateral neck lymph node involvement on the tumor side of the neck, governs the disease risk in the contralateral side of the neck. Researchers evaluated 153 consecutive patients diagnosed with squamous cell carcinoma of the tonsil who were treated with surgical removal and postoperative intensity-modulated radiation therapy. Forty-six of the patients underwent unilateral radiotherapy. Of these patients, 72% were male. The average patient age was 59 years. Current or former smokers comprised 61% of the study population. Lateralized primary tumors were confirmed in 40 (87%) of the patients. Two (4%) patients had non-lateralized tumors. Lateralization could not be retrospectively ascertained in four patients (9%). The cancer stages for these patients were distributed as follows: TX, 2%; T1, 44%; T2, 41%; and T3, 13%. Lymph node involvement stages were as follows: N0, 11%; N1, 13%; and N2, 76%. The patients underwent radiation doses of 60 Gy to 66 Gy to the postoperative bed and involved neck, and 52 Gy to 54 Gy to the elective region in 30 to 33 fractions using a simultaneous integrated boost technique. Concurrent chemotherapy was administered to 30 of the 46 patients. The median follow-up period was 2.8 years (range, 0.4-8.7 years). Researchers reported no local or regional [...]

2014-03-26T16:02:26-07:00March, 2014|Oral Cancer News|
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Humidifying mouth, throat during radiotherapy cuts mucositis

Source: www.drbicuspid.com Author: staff Head and neck cancer (HNC) patients who received daily humidification of the mouth and throat during radiation therapy treatment spent nearly 50% fewer days hospitalized to manage their side effects, such as mucositis, according to research presented at the recent Multidisciplinary Head and Neck Cancer Symposium in Scottsdale, AZ. Mucositis, inflammation and ulceration of the mouth and throat, is a painful side effect of radiation therapy that can negatively affect patients' quality of life. Using humidification is based on the fact that moisturizing wounds generally helps them heal faster, according to the researchers. The study by the Trans Tasman Radiation Oncology Group (TROG) evaluated 210 HNC patients in New Zealand and Australia from June 2007 to June 2011. Patients in the phase III trial were randomized to institutional standard of care (control group) or humidification. The humidified air was delivered through the nose via a plastic interface (mask-type apparatus) that can be worn by patients while sleeping or sitting. Patients began humidification on the first day of radiation therapy and continued until the ulceration in their mouth and throat had resolved. On average, humidification patients spent 57% as many days in the hospital to manage side effects, compared with the controls (control = 4.1 days, humidification = 2.3 days). The humidifier group also resumed close-to-normal eating patterns at significantly higher rates three months after radiotherapy. Only 43 patients (42%) of the patients in the humidification group met the defined benchmark of humidification compliance and were able [...]

2014-03-23T13:26:37-07:00March, 2014|Oral Cancer News|
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App for cancer patients puts rehabilitation at their fingertips

Source: globalnews.ca Author: staff A new app will make therapy more accessible for survivors of head and neck cancers. Developed at the Misericordia hospital and the University of Alberta, the portable swallowing therapy unit will help patients with swallowing impairments complete their rehab in the comfort of their own home. Video available here. The technology will help patients understand what their muscles are doing while they swallow. The app will take two years to develop and test, and the Alberta Cancer Foundation has agreed to fund it – $1.9 million over the next five years. Dr. Jana Rieger, the lead researcher on the project, said it will give patients more independence in their rehabilitation, in contrast to traditional therapy. Traditional swallowing therapy requires patients come to the hospital three to four times a week to use the large rehabilitation equipment. “What ends up happening is probably only about 10 per cent of patients who could benefit from this type of therapy actually come in and get it,” said Rieger. “There’s lots of people out there living with swallowing disorders that we aren’t getting to as clinicians.” The app is combined with an adhesive sensor under the jaw and a pendant that rests on the patient’s chest. The pendant speaks wirelessly to the app and it can send the patient’s data to health-care professionals anywhere in the province. The technology has a few settings that the patient can set to motivate them to complete the therapy. “Things like progress bars, goal-setting, [...]

2014-03-19T07:37:45-07:00March, 2014|Oral Cancer News|
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Experimental EGFR inhibitor added nothing but rash

Source: www.oncologypractice.com Author: Neil Osterweil, Oncology Report Digital Network The addition of the experimental targeted agent zalutumumab to primary curative chemoradiation for head and neck cancers did not improve locoregional control, disease-specific survival, or overall survival at 3 years of follow-up. The only thing that zalutumumab added to therapy was a skin rash in the large majority of patients who received it, reported Dr. Jens Overgaard, of the department of experimental clinical oncology at Aarhus University, Denmark. Response to zalutumumab, a monoclonal antibody targeted to the epidermal growth factor receptor (EGFR), was not related to tumor human papillomavirus 16 (HPV/p16) status or to chemoradiotherapy, Dr. Overgaard reported at the Multidisciplinary Head and Neck Cancer Symposium. The results of the DAHANCA 19 trial echo those of the RTOG (Radiation Oncology Therapy Group) trial 0522, which found no benefit from the addition of the EGFR inhibitor cetuximab (Erbitux) to accelerated cisplatin-based chemoradiotherapy, said Dr. Paul Harari, an invited discussant from the University of Wisconsin, Madison. "Where I think we have a lot of unanswered questions is acknowledging how little we actually understand about EGFR biology, despite now 40 years of progressive knowledge," Dr. Harari said. "We’re now seeing very clearly in molecular and clinical correlate studies that the more we suppress the EGFR, the more we see collateral overexpression of additional RTKs [receptor tyrosine kinases], including members of the HER family, such as HER-3, that enable an escape mechanism for tumors that become resistant to EGFR inhibition," he said. Dr. Overgaard and [...]

2014-03-19T07:20:46-07:00March, 2014|Oral Cancer News|
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Chemoradiation offered better survival than accelerated radiation in head and neck squamous cell carcinomas

Source: www.oncologypractice.com Author: Neil Osterweil, Oncology Report Digital Network Concurrent chemoradiation offered better overall survival and disease-free survival than accelerated radiotherapy in patients with moderately advanced squamous cell carcinomas of the head and neck, investigators reported at the Multidisciplinary Head and Neck Symposium. Actuarial rates of 2-year overall survival and disease-free survival in patients treated with concurrent chemoradiation (CCR) were significantly better than for patients treated with accelerated radiotherapy alone, reported Dr. Krzysztof Skladowski of the Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology in Gliwice, Poland. "CCR with conventional 7 weeks of fractionation and at least two courses of high-dose cisplatin is more effective than 6 weeks of accelerated radiotherapy alone," he said. Even if patients can tolerate only a single course of cisplatin, CCR is still superior to accelerated radiation, he added. The findings suggest that accelerated radiation protocols should be reserved for patients with more favorable prognosis, such as those with stage T2 disease with limited nodal involvement, and those who are positive for the human papillomavirus (HPV) p16 protein, Dr. Skladowski said at the symposium cosponsored by the American Society for Radiation Oncology and the American Society of Clinical Oncology. The findings are "concordant with data that has been emerging now over approximately 10-14 years of the value of concurrent chemoradiation in head and neck cancer for a substantial cohort of patients over radiation alone," said Dr. Paul Harari of the University of Wisconsin, Madison, and the invited discussant. Although a previous meta-analysis (Lancet 2006; [...]

2014-03-19T07:16:22-07:00March, 2014|Oral Cancer News|
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Recurrent mouth and throat cancers less deadly when caused by HPV

Source: www.oncologynurseadvisor.com Author: Kathy Boltz, PhD People with late-stage cancer at the back of the mouth or throat that recurs after chemotherapy and radiation treatment are twice as likely to be alive 2 years later if their cancer is caused by the human papillomavirus (HPV), suggests new research. This study was presented at the 2014 Multidisciplinary Head and Neck Cancer Symposium, held in Scottsdale, Arizona. Previous studies have found that people with so-called HPV-positive oropharyngeal cancers are more likely to survive than those whose cancers are related to smoking or whose origins are unknown. The new study shows that the longer survival pattern holds even if the cancer returns. Oropharyngeal cancers, which once were linked primarily to heavy smoking, are now more likely to be caused by HPV, a virus that is transmitted by oral and other kinds of sex. The rise in HPV-associated oropharyngeal cancers has been attributed to changes in sexual behaviors, most notably an increase in oral sex partners. For the study, the researchers used data provided by the Radiation Therapy Oncology Group on 181 patients with late-stage oropharyngeal cancer whose HPV status was known and whose cancer had spread after primary treatment. There were 105 HPV-positive participants and 76 HPV-negative ones. Although the median time to recurrence was roughly the same (8.2 months vs 7.3 months, respectively), some 54.6% of those with HPV-positive cancer were alive 2 years after recurrence, whereas only 27.6% of those with HPV-negative cancers were still alive at that point in time. [...]

2014-03-19T07:11:24-07:00March, 2014|Oral Cancer News|
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Global trends suggest HPV positive oral cancer greatly increased in young males

Source: www.zawya.com Author: staff While the incidence of smoking-related oral squamous cell carcinoma has decreased in many parts of the world, cases of human papilloma virus (HPV) positive oropharyngeal cancer (OPSCC) have greatly increased. Otolaryngologists are finding that the majority of their patients are male and a lot younger in age than their counterparts. This "new" head and neck cancer patient differs in several ways from the "traditional" head and neck cancer patients who were older, had significant tobacco and alcohol exposure, and potential tumours throughout the upper aerodigestive tract. The significance of this global trend suggests that more attention needs to be paid to the phenomena here in the Middle East. Dr Marilene Wang, Professor, Chief of Otolaryngology, UCLA Department of Head and Neck Surgery, will be discussing the increasing incidence of young cancer patients who are non-smokers, but happen to be HPV positive and how these cases should be managed in the Middle East at the 11th Middle East Update in Otolaryngology Conference & Exhibition - Head and Neck Surgery (ME-OTO) from the 20-22 April 2014 at the Madinat Jumeirah Arena, Dubai, UAE. According to Dr Wang, "Currently, the most common head and neck cancer patients are younger, primarily male, and have no or relatively minimal exposures to tobacco and alcohol. Yet, they often have histories of notable increased sexual encounters. Although HPV positive OPSCC demonstrates an alarming increasing incidence, this is balanced by a significant response to treatment regardless of advanced stage. "Cases of OPSCC associated with [...]

2014-03-16T08:45:03-07:00March, 2014|Oral Cancer News|
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Identification and characterization of cancer stem cells in human head and neck squamous cell carcinoma

Source: 7thspace.com Author: staff Current evidence suggests that initiation, growth, and invasion of cancer are driven by a small population of cancer stem cells (CSC). Previous studies have identified CD44+ cells as cancer stem cells in head and neck squamous cell carcinoma (HNSCC). However, CD44 is widely expressed in most cells in HNSCC tumor samples and several cell lines tested. We previously identified a small population of CD24+/CD44+ cells in HNSCC. In this study, we examined whether this population of cells may represent CSC in HNSCC. Methods: CD24+/CD44+ cells from HNSCC cell lines were sorted by flow cytometry, and their phenotype was confirmed by qRT-PCR. Their self-renewal and differentiation properties, clonogenicity in collagen gels, and response to anticancer drugs were tested in vitro. The tumorigenicity potential of CD24+/CD44+ cells was tested in athymic nude mice in vivo. Results: Our results show that CD24+/CD44+ cells possessed stemness characteristics of self-renewal and differentiation. CD24+/CD44+ cells showed higher cell invasion in vitro and made higher number of colonies in collagen gels compared to CD24-/CD44+ HNSCC cells. In addition, the CD24+/CD44+ cells were more chemo-resistant to gemcitabine and cisplatin compared to CD24-/CD44+ cells. In vivo, CD24+/CD44+ cells showed a tendency to generate larger tumors in nude mice compared to CD24-/CD44+ cell population. Conclusion: Our study clearly demonstrates that a distinct small population of CD24+/CD44+ cells is present in HNSCC that shows stem cell-like properties. This distinct small population of cells should be further characterized and may provide an opportunity to target HNSCC CSC for [...]

2014-03-16T08:39:30-07:00March, 2014|Oral Cancer News|
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