9/12/2006 France J. Bourhis et al. Lancet, September 2, 2006; 368(9538): 843-54 Background: Several trials have studied the role of unconventional fractionated radiotherapy in head and neck squamous cell carcinoma, but the effect of such treatment on survival is not clear. The aim of this meta-analysis was to assess whether this type of radiotherapy could improve survival. Methods: Randomised trials comparing conventional radiotherapy with hyperfractionated or accelerated radiotherapy, or both, in patients with non-metastatic HNSCC were identified and updated individual patient data were obtained. Overall survival was the main endpoint. Trials were grouped in three pre-specified categories: hyperfractionated, accelerated, and accelerated with total dose reduction. Findings: 15 trials with 6515 patients were included. The median follow-up was 6 years. Tumours sites were mostly oropharynx and larynx; 5221 (74%) patients had stage III-IV disease (International Union Against Cancer, 1987). There was a significant survival benefit with altered fractionated radiotherapy, corresponding to an absolute benefit of 3.4% at 5 years (hazard ratio 0.92, 95% CI 0.86-0.97; p=0.003). The benefit was significantly higher with hyperfractionated radiotherapy (8% at 5 years) than with accelerated radiotherapy (2% with accelerated fractionation without total dose reduction and 1.7% with total dose reduction at 5 years, p=0.02). There was a benefit on locoregional control in favour of altered fractionation versus conventional radiotherapy (6.4% at 5 years; p<0.0001), which was particularly efficient in reducing local failure, whereas the benefit on nodal control was less pronounced. The benefit was significantly higher in the youngest patients (hazard ratio 0.78 [0.65-0.94] for [...]

9/12/2006 Iowa City, IA starf CancerConsultants.com According to an article recently published in the Journal of Clinical Oncology, single nucleotide polymorphisms (SNPs) can help determine a head and neck cancer patient's response to the chemotherapy agent Platinol® (cisplatin). The American Cancer Society estimates that approximately 11,000 individuals in the United States will die of head and neck cancer in 2006. Head and neck cancer refers to several different types of cancers that begin in any region of the head or neck. Platinol is a common chemotherapy agent for the treatment of head and neck cancers. Although effective, there are a significant portion of patients who do not respond to Platinol. Researchers are evaluating ways to identify which patients will respond to Platinol and which tend to not respond to Platinol. Researchers from Toronto, Canada, recently conducted a clincial study to evaluate SNPs, or genetic variations, within genes that repair DNA among patients with advanced head and neck cancer. This study included 103 patients with advanced head and neck cancer who were treated with Platinol. - Patients with one genetic variant in the DNA repair genes had greater survival than those without these genetic variants. - The presence of seven of these genetic variants confers a 175-fold benefit in survival compared to those with no variants. - Anticancer responses were increased by nearly three-fold among patients with these genetic variants compared to those without. The researchers concluded that SNPs, or genetic variants, help to predict which patients with head and neck [...]

9/11/2006 Philadelphia, PA Susan Boni Philadelphia Inquirer (www.philly.com) Before-and-after portraits show the saving grace of surgery. A native of a small town in northern England, she longed to look normal and would do anything she could to distract people from her face. "I'd dye my hair all different colors," she said. "I'd go over the top with eye makeup to take the view away from my lower face." She has only a few pictures of herself before the age of 29. Today, 11 years later, Morgan-Elphick's face is a case study of what surgery can do. Her new smile has been enshrined in a six-foot oil painting in the "Saving Faces" exhibit that originated at London's National Portrait Gallery. Twenty-six paintings from the original exhibit went on display Friday at the Esther M. Klein Art Gallery, 3600 Market St. The show is in collaboration with the College of Physicians of Philadelphia, which is mounting a smaller version of the exhibit. "Saving Faces" was conceived by Iain Hutchison, an Oral and Maxillofacial surgeon at St. Bartholomew's and the Royal London Hospital. Hutchison, 58, who operated on Morgan-Elphick in 1995, believes that the public needs to know what is possible with modern facial surgery - and what isn't. The exhibit follows some of his patients as they are treated for severe deformities from facial injuries, cancer and congenital impairments. His collaborator, portrait painter Mark Gilbert, 37, has been a regular exhibitor at the National Portrait Gallery since 1993. At Hutchison's urging, Gilbert [...]

9/11/2006 Palm Beach Gardens, FL press release biz.yahoo.com The Cancer Cure Coalition announces its support for the nomination of Dr. Andrew Von Eschenbach as Commissioner of the U.S. Food and Drug Administration and calls for the approval of Advexin, a new gene therapy treatment for cancer. We believe it critical that a permanent director be in charge of this vitally important agency and that he has the special experience and ability required to deal with the complex problems confronting it. For too long this agency has lacked a permanent director and this has led to a slow down in its decision making and fearfulness to approve breakthrough treatments. This is holding back important new treatments for life threatening illnesses, especially those for cancer. One major example of this is the delay in approving Advexin, a P53 gene tumor suppressor now in U.S. Phase III clinical trials. Although the clinical trials are only for head and neck cancer this gene therapy has already shown its ability to successfully treat many other types of cancer including most recently breast cancer. The P53 gene is naturally present in the body and stops cell division when DNA damage occurs. When the P53 gene does not function normally genetic mutations can occur leading to potential cancer growth. What makes this treatment even more promising is the recent development by Genzyme Corp. of a new diagnostic test that detects specific mutations in the P53 gene. This allows the gene therapy treatment to be targeted to those [...]

9/10/2006 Madison, WI Katerina Strati et al. Proc. Natl. Acad. Sci. USA, 10.1073/pnas.0606698103 Head and neck squamous cell carcinoma (HNSCC) is a leading cause of cancer mortality worldwide. Recent reports have associated a subset of HNSCC with high-risk human papillomaviruses (HPVs), particularly HPV16, the same subset of HPVs responsible for the majority of cervical and anogenital cancers. In this study we describe a mouse model for HPV-associated HNSCC that employs mice transgenic for the HPV16 oncogenes E6 and E7. In these mice, E6 and E7 induce aberrant epithelial proliferation and, in the presence of a chemical carcinogen, they increase dramatically the animal's susceptibility to HNSCC. The cancers arising in the HPV16-transgenic mice mirror the molecular and histopathological characteristics of human HPV-positive HNSCC that distinguish the latter from human HPV-negative HNSCC, including overexpression of p16 protein and formation of more basaloid cancers. This validated model of HPV-associated HNSCC provides the means to define the contributions of individual HPV oncogenes to HNSCC and to understand the molecular basis for the differing clinical properties of HPV-positive and HPV-negative human HNSCC. From this study, we identify minichromosome maintenance protein 7 (MCM7) and p16 as potentially useful biomarkers for HPV-positive head and neck cancer. Authors: Katerina Strati, Henry C. Pitot, and Paul F. Lambert Authors' affiliations: McArdle Laboratory for Cancer Research, University of Wisconsin School of Medicine and Public Health, 1400 University Avenue, Madison, WI 53706

9/7/2006 Iowa City, IA staff CancerConsultants.com Researchers in Canada have reported that the administration of 400 IU/day of vitamin E (alfa-tocopherol) is associated with a 38% increased rate of mortality in patients with head and neck cancer treated with radiation therapy. The details of this report appeared in the November 2006 issue of the International Journal of Cancer . There has been concern about patients taking anti-oxidant vitamins while receiving treatment for cancer. These concerns have been justified by the increased death rate in patients with lung cancer taking beta carotene. More recently researchers have reported that high doses of daily vitamin E appear to be associated with higher risks of mortality in persons with chronic diseases. The current trial originally randomly allocated 540 patients with head and neck cancer receiving radiation therapy to receive placebo or alfa tocopherol and beta carotene during treatment and for the following 3 years. Beta carotene was dropped from the study during the trial because of adverse reports in other studies. The median follow-up of this trial was 6.5 years at which time the group receiving alfa tocopheral had a 38% increased risk of dying compared to the control group. Comments: This study should caution individuals about taking high doses of vitamin E and other antioxidant vitamins during cancer treatment in hopes of a health benefit. This should also encourage individuals to get needed vitamins from fruit and vegetable sources rather than from medicinal sources. Reference: Bairati I, Meyer F, Jobin E, et al. [...]

9/7/2006 Los Angeles, CA press release www.tradingmarkets.com Introgen Therapeutics Inc. announced that in a Phase II study, it's investigational cancer therapy Advexin when combined with chemotherapy to treat breast cancer showed better results than what would be expected from chemotherapy treatment alone. In the clinical trial, Advexin was combined with chemotherapy to shrink the tumor before it was surgically removed. In the phase 2 clinical trial, Advexin was locally administered to breast tumors in conjunction with doxorubicin and docetaxel chemotherapy in twelve patients who subsequently underwent surgery to remove residual tumor. Over 50% reduction in tumor size was seen in patients treated with ADVEXIN and chemotherapy. Complete tumor removal by subsequent surgery was achieved in all the patients. At a median follow-up of 37 months, the estimate breast cancer-specific survival rate at 3 years was 84%. Advexin, indicated for treating head and neck cancer was granted Fast Track designation status by the FDA in September 2003. Each year about 40,000 Americans are affected with head and neck cancer. The activation of a local immune response at the site of the tumor was observed in patients treated with Advexin and chemotherapy. The company said that the novel finding suggests that Advexin may also work through additional immune mechanisms of action to eradicate tumor cells.

9/6/2006 Australia, Canada, Finland Rischen et al; Lau et al; Luukkaa et al TherapeuticsDaily.com Reports from Australia, Canada and Finland highlight recent research in head & neck cancer. Study 1: The risk of locoregional failure (LRF) in head and neck cancer patients receiving a nontirapazamine-containing chemoradiotherapy regimen could be related to tumor hypoxia. Researchers in Australia conducted a study "to determine the association between tumor hypoxia, treatment regimen, and LRF in patients with stage III or IV squamous cell carcinoma of the head and neck randomly assigned to radiotherapy (70 Gy in 35 fractions over 7 weeks) plus either tirapazamine and cisplatin in weeks 1, 4, and 7 and tirapazamine alone in weeks 2 and 3 (TPZ/CIS) or cisplatin and infusional fluorouracil during weeks 6 and 7 (chemoboost)." "Forty-five patients were enrolled onto a hypoxic imaging substudy of a larger randomized trial," explained D. Rischin and colleagues, Peter MacCallum Cancer Center. "Pretreatment and midtreatment [F-18]-fluoromisonidazole positron emission tomography scans (FMISO-PET) were performed 2 hours after tracer administration, with qualitative scoring of uptake in both primary tumors and nodes. Thirty-two patients (71%) had detectable hypoxia in either or both primary and nodal disease." "In patients who received chemoboost, 1 of 10 patients without hypoxia had LBF compared with 8 of 13 patients with hypoxia; the risk of LRF was significantly higher in hypoxic patients (exact log-rank, p=.038; hazard ratio [HR]=7.1). By contrast, in patients who received the TPZ/CIS regimen, only 1 of 19 patients with hypoxic tumors had LRF; risk of [...]

9/6/2006 Iowa City, IA staff CancerConsultants.com According to an article recently published in the journal Cancer, patients with nasopharyngeal cancer have an increased risk of second cancers in the upper aerodigestive tract. The nasopharynx is the area above the soft palate (roof of the mouth) and behind the nose. Nasopharyngeal cancer is considered a type of head and neck cancer. Approximately 40,000 people in the U.S. are diagnosed with head and neck cancer every year. Radiation therapy is a common form of treatment for cancers of the head and neck. However, researchers have been concerned that radiation to affected tissues may cause long-term side effects, including the development of another cancer. Researchers from China recently conducted a clinical study to evaluate the effects of treatment among patients with nasopharyngeal cancers. This study included 326 patients with nasopharyngeal cancer that had not spread to distant sites in the body. These patients were treated between 1994 and 1995. All patients received radiation therapy as part of their treatment regimen. At nearly six years follow-up, the following results were reported: -5.2% of patients developed subsequent tumors (SPTs) that were not associated with cancer spread from their initial cancer. -64.7% of these patients developed the SPTs in the upper aerodigestive tract (areas such as the lip, tongue, major salivary glands, gums and nearby oral cavity tissues, floor of the mouth, tonsils, all parts of the throat and other oral regions, nasal cavity, accessory sinuses, middle ear, and larynx (voice box). -Only 21.4% of the [...]

9/5/2006 Houston, TX Eric Berger Chron.com Medical scientists have great power in their laboratories, and perhaps nowhere more so than with a technique known as RNA interference. By harnessing the potential of short bits of RNA inside cells, researchers have gained the power to shut off a gene's capability to make proteins. Emerging in the last decade, this ability to "silence" genes holds great promise for treating human diseases by stopping the production of harmful proteins. The tiny bits of RNA work well in cells, but getting them into human cells within the body has proved more problematic. That's because the body's defense mechanisms perceive the RNA bits as invaders and kill them before they can reach their intended target. Now, a team led by Dr. Anil Sood, an associate professor at the University of Texas M.D. Anderson Cancer Center, may have solved the problem for ovarian cancer, opening the door to promising treatments for other forms of cancer. "The purpose of our research was to figure out how to get these short pieces of RNA into tumor cells," Sood said. Sood's first step was to identify bits of RNA with considerable cancer-killing promise. In lab dishes, the selected RNA shut down production of a protein that helps ovarian cancer cells survive and spread. Difficult to penetrate Most cancer drugs target proteins on the exterior walls of cells because cells are so difficult to penetrate. For Sood's RNA drug to work, it had to find a doorway into the cells [...]