Cisplatin aids survival of high-risk head and neck cancer

Source: www.oncologyreport.com Author: Miriam E. Tucker Adding chemotherapy to radiotherapy improved 10-year survival of resectable head and neck carcinomas among high-risk patients who had microscopically involved resection margins and/or extracapsular spread of disease – but not in high-risk patients who only had tumor in multiple lymph nodes. The findings come from a long-term update and unplanned subset analysis of 410 evaluable patients from the RTOG (Radiation Therapy Oncology Group) 9501 phase III study, which previously showed no overall survival advantage from the addition of cisplatin chemotherapy to radiation. The new data are "good news," according to lead author Dr. Jay Cooper, director of Maimonides Cancer Center in Brooklyn, N.Y. "We now can eradicate some advanced head and neck tumors that we couldn’t before by adding chemotherapy to radiation therapy. At the same time, we can spare other patients who would not do better with the addition of chemotherapy from its side effects," he said at a head and neck cancer symposium sponsored by the American Society for Radiation Therapy. The RTOG 9501 study randomized 459 patients with high-risk, resected head and neck cancers to receive either radiation therapy of 60 Gy in 6 weeks (RT), or identical radiotherapy plus cisplatin at 100 mg/m2 IV on days 1, 22, and 43 (RT+CT). When reported at a median follow-up of 45.9 months, the locoregional control rate was significantly higher in the combined-therapy group than in the group given radiotherapy alone (hazard ratio for locoregional recurrence, 0.61); disease-free survival was significantly longer with [...]

2012-02-03T19:44:50-07:00February, 2012|Oral Cancer News|

Cancer Patients’ Health Benefits From Physical Activity

Source: MedicalNewsToday.com According to an investigation published on bmj.com, cancer patients who have completed their primary cancer-related treatment, who engage in physical activity, can enhance their health. Earlier studies discovered that individuals with cancer anticipate to return to normal daily activities after completing their primary cancer-related treatment. However, these patients often find they experience lower physical activity, increased fatigue and a decrease in quality of life (QOL). Although, several health factors including QOL can be enhanced through engaging in exercise, according to studies. Investigators from the University of Hong Kong examined the results of 34 human trials that evaluated how exercise effects adult individuals with cancer. Each trial consisted of an average of 93 participants who had either suffered from prostate, breast, lung, colorectal, gynecologic or gastric cancer. The average age of the participants was 55 years. The trials included resistance, strength and aerobic training for a median duration of 13 weeks. Health improvements, such as BMI and body weight, blood sugar control, lower limb strength, fatigue, depression and QOL, were observed among participant's who received breast cancer treatment who engaged in a period of physical activity. Improvements, such as oxygen consumption, depression, BMI, body weight, handgrip strength and QOL, were also observed among patients who completed treatments for other types of cancer. Furthermore, variations in intensity and type of physical activity influenced the physical health of cancer patients and played a vital role in the effects of the exercise. Individuals with breast cancer found that resistance and aerobic exercise [...]

2012-02-03T10:35:20-07:00February, 2012|Oral Cancer News|

HPV Vaccine Not Linked To Autoimmune Disorders, Study

Source: MedicalNewsToday.com A two-year study of nearly 190,000 girls and women, finds that Gardasil, the human papillomavirus (HPV) vaccine made by Merck & Co, does not trigger autoimmune disorders such as lupus, rheumatoid arthritis, type 1 diabetes and multiple sclerosis. The results are published in the Journal of Internal Medicine. Study lead author Dr Chun Chao, a research scientist at the Kaiser Permanente Department of Research & Evaluation in Pasadena, California, said in a statement released on Friday, that: "This kind of safety information may help parents with vaccination decisions." ""These findings offer some assurance that among a large and generalizable female population, no safety signal for autoimmune conditions was found following HPV4 vaccination in routine clinical use," said Chao. Gardasil is a "quadrivalent" vaccine because it helps protect against 4 types of HPV. In girls and young women age 9 to 26, it targets 2 types that cause about 75% of cervical cancers, and 2 other types that cause 90% of cases of genital warts. The vaccine, which is given as three injections over six months, also helps protect boys and men age 9 to 26 against 90% of cases of genital warts. Genital warts is the most common sexually transmitted infection in the US, where it infects about 6.2 million people every year. It can also lead to cervical cancer in women. Gardasil received US Food and Drug Administration (FDA) approval in 2006. But a longstanding concern about links with autoimmune disorders has surrounded the vaccine, and many [...]

2012-02-03T10:40:12-07:00February, 2012|Oral Cancer News|

Connected nodes in throat cancer signal poor prognosis

Source: OncologyNurseAdvisor.com The presence of “matted” lymph nodes in persons with oropharyngeal squamous cell carcinoma (SCC)—that is, nodes that are connected together—was associated with a 3-year survival rate of 69%, compared with 94% among patients without matted nodes. Such a marker could help clinicians identify patients who are at heightened risk for metastasis and who might benefit from additional systemic therapy. Conversely, a person without matted nodes could be a candidate for less therapy, which would in turn reduce uncomfortable side effects. The study, led by Matthew E. Spector, MD, a resident in the department of otolaryngology – head and neck surgery at the University of Michigan Health System in Ann Arbor, focused on 78 previously untreated persons with stage III or IV oropharyngeal SCC. All patients were undergoing chemotherapy in combination with intensity-modulated radiation therapy (IMRT) as part of a clinical trial. The 3-year disease-specific survival rate for the 16 patients presenting with matted nodes was 69%, compared with 94% among the 61 other patients. Matted nodes were found to be a poor prognostic factor independent of tumor classification, human papillomavirus (HPV) status, epidermal growth factor receptor (EGFR), and smoking status. Matted nodes did appear to be an especially strong indicator of increased risk among HPV-positive persons, despite the fact that these patients had better overall outcomes than did those who were HPV-negative. The best outcomes were seen among HPV-positive nonsmokers. The investigators, who reported their findings in Head & Neck, say the reasons for the survival differences between [...]

2012-02-01T17:10:52-07:00February, 2012|Oral Cancer News|

Queensland researchers make cancer treatment breakthrough

Source: HealthCanal.com The culmination of 10 years of collaborative research between scientists from the Queensland Institute of Medical Research (QIMR) and The University of Hong Kong (HKU) Li Ka Shing Faculty of Medicine has led to a significant breakthrough in the treatment of nasopharyngeal carcinoma (NPC), an aggressive throat cancer with a high prevalence in South-East Asia. NPC is associated with Epstein-Barr virus infection in a manner similar to the association of hepatitis B virus and liver cancer. By using immunotherapy, the human body’s own immune system was used to successfully fight the disease. Professor Rajiv Khanna who heads the Australian Centre for Vaccine Development at QIMR said by enhancing the immune cells of NPC patients they have doubled the survival time of terminally ill patients. “The presence of EBV in the cancer cells gives the body’s immune system a definite target to help battle the NPC, resulting in few side-effects,” Professor Khanna said. “Patients who participated in the trial were in the late stages of the cancer and quite unwell, so it was important to ensure the treatment was non-invasive, non toxic and did not damage healthy cells. “By offering such targeted treatment, we were able to increase the expected time of patient survival from 200 to over 500 days, which is an extremely positive result. “We believe that if we offer this treatment in the earlier stages of NPC, accompanied with chemotherapy and radiation, we can further enhance survival rates.” Twenty four NPC patients were recruited at the [...]

2012-02-01T17:06:54-07:00February, 2012|Oral Cancer News|

The search for biomarkers of disease in spit

Source: University of Minnesota It's a researcher's dream: a simple, noninvasive test to detect life-threatening cancer, heart disease, or other maladies while they're still treatable. A team of University of Minnesota researchers is in hot pursuit of that goal, using one of the simplest means imaginable: testing spit. They've discovered that conditions such as breast and oral cancer leak certain proteins into saliva, and if detected, such proteins can be "biomarkers" for the disease. "This would be an easy way to monitor oral cancer," says Timothy Griffin, an associate professor of biochemistry, molecular biology and biophysics. "Every year in the United States there are about 40,000 cases, more than cervical or ovarian cancer, melanoma, or lymphoma, and it has a higher mortality." Saliva contains at least 2,000 proteins, but the most abundant ones tend to be the least informative, he notes. But he and his colleagues have become the world experts on snagging rare proteins from spit and detecting both their presence and their abundance. Promising discoveries In a study of 10 women with metastatic breast cancer, the researchers sifted through their salivary proteins and found a handful that were already known to seep into the blood of women with this cancer. The proteins appeared only at very low levels in saliva of healthy controls. "The next idea is, can you take this back through the earlier stages to detect nonmetastatic cancer?" says Griffin. Biomarker proteins also appear in saliva of patients with oral cancer. Team members Frank Ondrey, an [...]

2012-02-01T16:42:25-07:00February, 2012|Oral Cancer News|

Jaw Necrosis Common after Radiation for Oral Cancer

Source: MedpageToday.com Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco.     Action Points Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal. Explain that osteoradionecrosis of the jaw (ORNJ) occurred more than twice as often as reported in the literature among patients with oral cancer treated with radiation. Point out that factors associated with the risk of ORNJ included female sex, no chemotherapy, and lower Charlson comorbidity index.     PHOENIX -- Osteoradionecrosis of the jaw (ORNJ) occurred more than twice as often as reported in the literature, according to a population-based study of patients treated with radiation for oral cancer. A review of national medical records showed that 16.1% of patients had jaw complications or interventions consistent with ORNJ compared with published rates of 5% to 7%. However, when investigators applied the definition of ORNJ to patients who had interventions associated with jaw complications, the rate approximated the published rates, as reported here at the Multidisciplinary Head and Neck Cancer Symposium. "The rates of all jaw complications in the SEER-Medicare database are higher than reported rates from prospective and retrospective institutional reports," said Beth M. Beadle, MD, PhD, of the University of Texas MD Anderson Cancer Center in Houston. "If we limited the definition to interventions, the rates are similar to those of published reports." Radiation therapy has documented efficacy for locoregional [...]

2012-02-01T16:34:06-07:00February, 2012|Oral Cancer News|

Squamous cell subgroups respond differently to treatment

Source: www.medscape.com Author: Nancy A. Melville A long-term follow-up of patients with head and neck squamous cell carcinoma suggests that only certain high-risk subgroups benefit from radiation plus chemotherapy. This information will spare patients who will not benefit from undergoing the additional treatment. According to the study, presented here at the 2012 Multidisciplinary Head and Neck Cancer Symposium, patients with microscopically involved resection margins and/or extracapsular spread of disease had a lower risk for cancer recurrence with radiation plus chemotherapy 10 years later, whereas those with tumors in multiple lymph nodes did not benefit from combination treatment; they fared better with radiation alone. "The clinical implication of these findings is that the high-risk group of patients is not as homogenous a group as we believed it was before the study started," lead author Jay S. Cooper, MD, director of the Maimonides Cancer Center, in Brooklyn, New York, told Medscape Medical News. Dr. Cooper and his colleagues analyzed 10 years of follow-up data from the Radiation Therapy Oncology Group (RTOG) 9501/Intergroup phase 3 trial, which examined 410 patients with high-risk resected head and neck cancers. The patients were considered high risk for cancer recurrence because they had microscopically involved resection margins, extracapsular spread of disease, or multiple lymph node involvement. "The allocation was equally divided [according to treatment regimen] at the beginning of the study; the groups were not intended to be balanced for the different [risk] factors," Dr. Cooper said. "We thought they were all equally important." The treatment regimen [...]

Erlotinib dose doubled for smokers with head/neck cancer

Source: www.oncologyreport.com Author: Miriam E. Tucker Giving smokers a higher, short-course dose of erlotinib before definitive surgery for squamous cell carcinoma of the head and neck resulted in favorable responses for the first patients evaluated in a small pilot study. Investigators gave 300 mg of erlotinib (Tarceva) to smokers daily and 150 mg daily to nonsmokers who had a waiting period of more than 14 days before scheduled surgery for head and neck cancer. Seven of the 10 patients evaluated so far had partial responses and 3 had stable disease, according to a poster presented at a head and neck cancer symposium sponsored by the American Society for Radiation Oncology. The study was based on recent data in non–small cell lung cancer (NSCLC) patients showing that smokers metabolize erlotinib, an epidermal growth factor receptor (EGFR) inhibitor, twice as quickly as do nonsmokers (J. Clin. Oncol. 2009;27:1220-6), said lead author Dr. Mercedes Porosnicu of Wake Forest Baptist Medical Center in Winston Salem, N.C. That study established the maximum tolerated dose of erlotinib at 300 mg daily in NSCLC patients who smoke. Dr. Poroniscu’s presentation included the case study of a smoker with a very large oral cavity tumor protruding through his lips. He was described as being in significant pain and unable to eat or chew. The first CT scan showed a tumor of at least 8 cm and there was "significant metabolic activity" on PET scan. "At 6 days of erlotinib treatment, his tumor was obviously smaller and he could [...]

Head and neck cancer in transplant patients: For better or worse?

Source: medicalxpress.com Author: Henry Ford Health System staff Transplant patients who develop head and neck cancer are more likely to be non-smokers and non-drinkers, and less likely than their non-transplant counterparts to survive past one year of diagnosis, according to a new study from Henry Ford Hospital in Detroit. As part of a 20-year review, Henry Ford researchers found cancers of the throat, tonsils and mouth may be more aggressive in transplant recipients as the result of long-term immunosuppressive therapy required to prevent solid organ rejection. Transplant patients in the study who developed skin cancer in the head and neck region were more likely to have multiple lesions, compared to the general public. In all, 2.6% of transplant patients in the study developed some form of head and neck cancer. While the risk for developing head and neck cancer is small, the study serves as an important reminder to all transplant recipients to be vigilant about any changes to their skin, as well as persistent sore throat, ear pain or swallowing issues – all signs of head and neck cancer. "The benefits of organ transplantation and immunosuppressive therapy still outweigh the risk of transplant patients developing head and neck cancer," says study author Robert Deeb, M.D., with the Department of Otolaryngology-Head & Neck Surgery at Henry Ford. "Still, our study highlights that head and neck cancer arising in transplant patients warrants the need for regular screenings and aggressive treatment." The study will be presented Jan. 28 in Miami Beach at [...]

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