3/2/2007 Rancho Mirage, CA Jennifer R. Grandis, MD Medscape Today (www.medscape.com) Introduction: The Multidisciplinary Head and Neck Cancer Symposium, cosponsored by the American Society for Therapeutic Radiology and Oncology and the American Society of Clinical Oncology, was held in Rancho Mirage, California, from January 18-20, 2007. Several presentations focused on advances in the medical management of patients with head and neck cancer (HNC). Despite increasing awareness of the cancer-inducing effects of tobacco, the incidence of HNC has not decreased worldwide. Efforts to prevent these tumors through pharmacologic intervention have largely failed, and early detection strategies have not been successful. Thus, most patients with HNC present with advanced (stages III and IV) disease. Oral cavity tumors are treated primarily with surgical resection due to the toxicity of radiation in this region (eg, osteoradionecrosis). Advanced tumors of the pharynx and larynx are generally treated with combined modality therapy (chemoradiation [CRT]), with surgery reserved for neck dissection when the patient presents with advanced neck disease (N2 or N3) and/or has an incomplete response in the neck to CRT. The major advance in the management of HNC continues to be the integration of targeted therapeutics into treatment regimens. Inhibiting the Epidermal Growth Factor Receptor: The landmark Radiation Therapy Oncology Group trial[1] comparing the epidermal growth factor receptor (EGFR) monoclonal antibody cetuximab plus radiation vs radiation alone led to approval of this agent by the US Food and Drug Administration (FDA) in 2006 for the treatment of HNC. Cetuximab was the first drug approved for [...]

3/1/2007 web-based article Miranda Hitti WebMD (www.mebmd.com) Human papillomavirus is common among U.S. women, especially those in their early 20s, says the CDC. Human papillomavirus (HPV) is America's most common sexually transmitted infection. HPV infection typically clears within two years, and most infected people don't realize they have the virus. However, some strains of HPV can cause cervical, anal, and other genital cancers, note the CDC's Eileen Dunne, MD, MPH, and colleagues. Dunne's team calculated the total number of U.S. women aged 14-59 with HPV infection from 2003 to 2004. More than one in four U.S. women in that age range -- nearly 27% -- had HPV infection. That equals nearly 25 million U.S. women, according to the CDC. About 3 million had any of the four HPV strains targeted by Gardasil, a vaccine designed to prevent cervical cancer and genital warts, the CDC estimates. HPV Infection in Young Women HPV infection was most common among women aged 20-24. Nearly half of the women in that age group (49%) had HPV infection. A third of women aged 14-24 had HPV infection. That's nearly 7.5 million -- far more than previous estimates that 4.6 million women in that age range had HPV. Older women were less likely to have HPV infection, the study shows. Data came from 1,921 women who submitted self-collected vaginal swabs for a national health study conducted from 2003 to 2004. The findings appear in The Journal of the American Medical Association. Vaccine's Impact The data was gathered [...]

2/28/2007 Barcelona, Spain Bruce Sylvester Doctor's Guide (www.docguide.com) Re-irradiation combined with chemotherapy after salvage surgery improves progression-free survival rates in patients with head and neck cancer but does not affect their overall survival rate, researchers report. "In this first randomised trial on the subject, we found that this combination treatment can indeed improve disease-free survival after salvage surgery, but we note that there was no effect on overall survival," said investigator and presenter Dominique de Raucourt, MD, radiologist, Centre Francois Baclesse, Caen, France. Dr. de Raucourt presented the results in an oral session here on February 24th at the International Meeting on Innovative Approaches in Head and Neck Oncology. The meeting was co-sponsored by the European Head and Neck Society (EHNS) and the European Society for Therapeutic Radiology and Oncology (ESTRO). The investigators enrolled 130 head and neck cancer patients who had been treated with salvage surgery. Patients were randomised to receive either full dose re-irradiation combined with chemotherapy (arm A) or no postoperative treatment after the salvage surgery (arm B). Eligibility for enrolment included the following criteria: recurrence of disease or appearance of second primary cancer site in a previously irradiated area (up to at least 45 Gy); absence of distant metastasis; salvage surgery with macroscopic complete resection; possibility of starting adjuvant treatment within 6 weeks after salvage surgery. Subjects in arm A received 60 Gy radiation within 12 weeks combined with concomitant 5-fluorouracil (5FU) and hydroxyurea. After the end of the trial the 29 surviving subjects who did [...]

2/28/2007 New Rochelle, NY press release Genetic Engineering News (www.genengnews.com) Auriga Laboratories, Inc., a specialty pharmaceutical company with products for the treatment of acute respiratory diseases and dermatological conditions, announces the launch of Aquoral(TM) for the treatment of xerostomia, also known as "dry mouth." This new, patent-pending, prescription-only product introduction marks Auriga's entrance into the $1 billion xerostomia marketplace. Beginning in March, Aquoral will be rolled out to high-prescribing physicians nationwide via Auriga's expanding 200-member national sales force. Auriga will also launch www.aquoral.com as part of a direct-to-patient campaign. "Millions of people suffer from dry mouth caused by prescription medications or medical conditions," said Alan Roberts, Auriga's senior vice president of scientific affairs. "Left untreated, dry mouth can have significant consequences including increased tooth decay, mouth ulcerations and infections, painful and difficult speech and swallowing. Aquoral offers a novel, non-systemic approach to treating this widespread condition. It is a lipid-based solution that moistens and lubricates the oral cavity, but unlike water-based, saliva substitutes, forms a lipidic film that helps reduce additional moisture loss and protects against further inflammation." A recent poll conducted by the Academy of General Dentistry (AGD) revealed that more than 80 percent of dental patients complain about dry mouth and dry mouth symptoms(1). Dry mouth is listed as a side effect for over 400 prescription drugs, including popular antidepressants, anti-anxiety medications, and treatments for overactive bladder. There are an estimated 300 million prescriptions written annually for these dry mouth causing medications. In some instances the dry mouth [...]

2/28/2007 Barcelona, Spain Bruce Sylvester Doctor's Guide (www.docguide.com) Sentinel node biopsy (SNB) is an accurate method of assessing the neck status of patients with squamous cell cancer grade T1T2 NO (early stage tumours) of the oral cavity, researchers report. The findings were presented in an oral session here on February 24th at the International Meeting on Innovative Approaches in Head and Neck Oncology, sponsored by the European Head and Neck Society (EHNS) and the European Society for Therapeutic Radiology and Oncology (ESTRO). "We saw a remarkable lack of false negatives in our use of sentinel node biopsy for assessing the patients. It is a viable procedure," said lead investigator and presenter Gerard Mamelle, MD, clinical oncologist, Institut Gustave Roussy, Villejuif, France. In the first part of their study, the investigators included 55 subjects; 53 of the subjects underwent SNB and an elective neck dissection (END) during the same surgery. The investigators compared results of pathological examinations with stepped serial sectioning and immunohistochemistry of sentinel nodes to results of routine pathologal examinations of remaining END nodes. They found positive sentinel nodes in 12 subjects, and no false positives among them. For up to 3 years after the tests, there was no node recurrence for any patient with negative sentinel node findings. In a second part of their study, 48 new subjects underwent SNB without END. Sentinel node was not found in 4 subjects. Eleven of the remaining 44 subjects (25%) had a positive sentinel node. And follow-up showed node recurrence in [...]

2/26/2007 Salt Lake City, UT press release PRNewswire (www.prnewswire.com) BSD Medical Corp. today reviewed the presentations made at the annual conference of the American College of Radiation Oncology (ACRO) held February 22-24 in San Diego. The emphasis was on the clinical science behind hyperthermia therapy for treating cancer and BSD Medical's advanced systems used to deliver the therapy. In addition to a 45-minute lecture by Dr. Mark Hurwitz of Harvard Medical School on the results of clinical studies on hyperthermia and the technological capabilities now emerging to deliver the cancer therapy, a commercial exhibit by BSD Medical also showcased the science supporting the therapy and the advanced features of the BSD's cancer therapy systems. The Science The lecture included a review of Phase III clinical studies that have been conducted adding hyperthermia to radiation treatments as compared to radiation treatments alone. * In a clinical study conducted in Italy involving 41 patients (44 nodes) with inoperable Stage IV head and neck cancer, patients receiving hyperthermia and radiation therapy had an 83% complete response rate compared to 41% for patients who received radiation therapy alone, and the 3-year local relapse-free survival rate was 24% for patients receiving only radiation and 68% for those who received both radiation and hyperthermia therapy. (See International Journal of Radiation Oncology, Biology, Physics Vol. 28, pp. 163-169.) * In an international clinical study conducted in Denmark, the Netherlands and Norway involving 128 patients with recurrent or metastatic malignant melanoma, patients who received hyperthermia therapy along with [...]

2/26/2007 Staten Island, NY Diane O'Donnell Staten Island Advance (www.silive.com) TomoTherapy combines daily CT scans to check for any changes in size or location of a tumor with the ability to target it with high doses of radiation while decreasing damage to the surrounding healthy tissues and organs Paul Lewek takes off his Mets baseball cap and settles his lanky 6-foot-5 frame onto a movable table connected to a large donut-shaped machine. For the 57-year-old retired cop, this is day 11 of his 6 1/2 week Monday to Friday regimen of TomoTherapy, a relatively new approach to treating cancerous tumors. After having his right tonsil and a golf ball-size mass removed from his neck in December to battle advanced tonsillar cancer, Lewek shruggingly accepts the routine. Lewek is the first head-and-neck cancer patient to be treated with the more than $3 million, state-of-the-art machine at TomoTherapy of Staten Island, housed in West Brighton-based Regional Radiology. The TomoTherapy Hi-Art System machine, which debuted on the Island last month, is one of only two in the New York City area and 71 nationwide. According to Patty Kitowski, marketing communications manager of Madison, Wis.-based TomoTherapy Incorporated, which created the machine, there are 102 units worldwide. TomoTherapy combines daily CT scans to check for any changes in size or location of a tumor with the ability to accurately target it with high doses of radiation while sparing healthy surrounding tissue to a greater degree than was previously possible. The process is achieved through Image [...]

2/26/2007 Monza, Italy Werner Garavello et al. Oral Oncol, February 15, 2007 Previous studies on squamous cell carcinoma of the tongue have reported conflicting results with respect to age and prognosis. The aim of this study is to elucidate if any differences in outcome exist between patients younger and older than 40 years. A case-control study was performed. Patients recorded in the head and neck cancer registry of Milano-Bicocca School of Medicine between January 1981 and December 1998 were reviewed. Cases were patients with squamous cell carcinoma of the tongue aged 40 years or less. Controls were patients older than 40 who were matched to cases for diagnosis, sex and TNM classification. Two controls were matched for each case, thus forty-six cases and 92 controls were selected. The frequency of recurrences was found to be significantly higher in younger patients. The survival analysis further supports this conclusion (log-rank test, p=0.002). The number of cancer-related deaths in patients younger and older than 40 years were 23 (50%) and 31 (34%), respectively (p=0.10). A statistical significant difference emerged when the number of deaths was compared using survival curves (log-rank test, p=0.05). In conclusion, in patients with squamous cell carcinoma of the tongue, young age is an independent predictor of worse survival. Authors: Werner Garavello, Roberto Spreafico, and Renato Maria Gaini Authors' affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Milano-Bicocca, DNTB, Ospedale San Gerardo, 20052 Monza (MI), Italy.

2/26/2007 Boston, MA staff Medical Matrix (www.hemonctoday.com) An analysis of nicotine yield from major brand-name cigarettes sold in Massachusetts between 1997 and 2005 has confirmed that manufacturers have steadily increased the levels of this agent in cigarettes. The analysis, based on data submitted to the Massachusetts Department of Public Health by the manufacturers, found that increases in smoke nicotine yield per cigarette average 1.6% each year, or about 11% through a seven-year period. A research team from the Tobacco Control Research Program at the Harvard School of Public Health performed the data analysis. “Cigarettes are finely-tuned drug delivery devices, designed to perpetuate a tobacco pandemic,” Howard Koh, MD, associate dean for public health practice at the Harvard School of Public Health said in a press release. “Yet precise information about these products remains shrouded in secrecy, hidden from the public. Policy actions today requiring the tobacco industry to disclose critical information about nicotine and product design could protect the next generation from the tragedy of addiction.” In addition to the increase in yield, the researchers concluded that manufacturers accomplished the increase not only by intensifying the concentration of nicotine in the tobacco but also by modifying several design features of cigarettes to increase the number of puffs per cigarette. The end result is a product that is potentially more addictive. The researchers also examined all market categories and found that smoke nicotine yields were increased in the cigarettes of each of the four major manufacturers and across all the major [...]

2/26/2007 Chapel Hill, NC ES Oh and DM Laskin J Oral Maxillofac Surg, March 1, 2007; 65(3): 424-6 Purpose: Early detection of oral cancer is crucial in improving survival rate. To improve early detection, the use of a dilute acetic acid rinse and observation under a chemiluminescent light (ViziLite; Zila Pharmaceuticals, Phoenix, AZ) has been recommended. However, to date, the contributions of the individual components of the system have not been studied. The present study was done to investigate the efficacy of the individual components of the ViziLite system in providing improved visualization of early oral mucosal lesions. Patients and Methods: A total of 100 patients, 39 males and 61 females, age 18 to 93 years (mean age, 44 years), who presented to the Virginia Commonwealth University School of Dentistry for dental screening were examined. There were 58 Caucasians, 29 African-Americans, 5 Hispanics, 6 Asians, and 2 of mixed ethnicity. Thirty-five patients smoked, 53 used alcohol, and 25 both smoked and drank. After written consent, the oral cavity was examined under incandescent light for soft tissue abnormalities. After 1-minute rinse with 1% acetic acid, the mouth was re-examined for additional mucosal abnormalities. Then, the mouth was examined once again using the ViziLite system's chemiluminescent light. Any lesions detected by these 3 examinations that were clinically undiagnosable were brush biopsied (Oral CDx) for determination of cellular representation. Results: In the original examination of the 100 patients, 57 clinically diagnosable benign lesions (eg, linea alba, leukoedema) and 29 clinically undiagnosable lesions were [...]