Checkpoint inhibitors whiff in head and neck cancer trials

Source: Author: Charles Bankhead Three different checkpoint inhibitors missed the primary endpoints in separate randomized trials of head and neck cancer. In one trial, adding avelumab (Bavencio) to standard treatment did not significantly improve progression-free survival (PFS) in cisplatin-eligible or ineligible patients with locally advanced head and neck squamous cell carcinoma (HNSCC). In another trial, the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) did not improve overall survival (OS) as first-line treatment for recurrent/metastatic HNSCC. Both trials were reported during the European Society for Medical Oncology (ESMO) virtual meeting. Although subgroup analyses suggested benefits for certain patients, neither study should influence clinical practice at this point, said ESMO invited discussant Amanda Psyrri, MD, of the University of Athens in Greece. In the avelumab study, known as GORTEC-REACH, results in cisplatin-eligible patients were consistent with those of the previously reported JAVELIN trial with avelumab, said Psyrri. A signal of benefit was evident in cisplatin-ineligible patients but did not achieve statistical significance. With regard to the CheckMate 651 trial of nivolumab and ipilimumab, Psyrri said, "Combined PD-1 and CTLA-4 inhibition does not appear to be an effective strategy in recurrent/metastatic HNSCC. Future research efforts may identify predictive biomarkers for response to anti-PD-1 and anti-CTLA-4 combinations in HNSCC." Additionally, a smaller trial of pembrolizumab (Keytruda) showed no significant improvement in OS versus chemotherapy for platinum-treated relapsed/metastatic nasopharyngeal carcinoma. GORTEC-REACH This trial evolved from evidence of potential synergy with PD-1/L1 inhibition, cetuximab (Erbitux), and radiotherapy, said Jean Bourhis, MD, of University Hospital Center [...]

2021-09-24T06:54:20-07:00September, 2021|Oral Cancer News|

Saliva testing may allow early detection of human papillomavirus–driven head and neck cancers

Source: Author: Elsevier Cancer causing high-risk human papillomaviruses (HR-HPV) are responsible for the rising incidence of HR-HPV–driven head and neck cancers (HNC), particularly oropharyngeal cancers (OPC, or throat cancers). Investigators have determined that HR-HPV DNA can be detected in saliva in most patients with HPV-driven OPC at the time of diagnosis. This work highlights a potentially life-saving screening program based on salivary HR-HPV DNA testing for early cancer detection and patient monitoring. Their findings appear in The Journal of Molecular Diagnostics. "Despite the upsurge in HPV-driven HNC, there are no early detection methods or screening strategies for this cancer type, unlike cervical cancer, which is caused by the same virus. Biomarkers enabling early detection, monitoring and disease prognostication are warranted to combat the rising incidence of HPV-driven OPC," observed lead investigator Chamindie Punyadeera, Ph.D., head, Saliva & Liquid Biopsy Translational Laboratory, School of Biomedical Science, Faculty of Health, Queensland University of Technology (QUT), and Translational Research Institute, Brisbane, QLD, Australia. Dr. Punyadeera and her colleagues investigated the efficacy of salivary HPV detection as a biomarker of HPV-HNC and survival patterns in patients with OPC to evaluate the utility of salivary HR-HPV as a prognostic biomarker for OPC. Saliva testing was performed on 491 patients at the time of first diagnosis of HNC and 10 patients with recurring HNC. Forty-three percent were positive for salivary HR-HPV DNA. HPV16, a high-risk strain of the virus, was detected in 92% of the HPV-positive saliva samples. The vast majority of HPV-HNC had arisen [...]

2021-09-22T09:38:25-07:00September, 2021|Oral Cancer News|

Bifunctional protein shows promise in HPV-related cancers

Source: Author: Charles Bankhead, Senior Editor, MedPage Today September A bifunctional fusion protein with immunotherapeutic activity proved active in advanced, difficult-to-treat cancers associated with human papillomavirus (HPV), according to pooled data from two prospective studies. Overall, 21 of 75 patients had confirmed responses with bintrafusp alfa, which inhibits tumor growth factor-beta (TGF-β) and PD-L1 interaction with its receptor. Responses were durable in many cases and occurred in patients with a variety of HPV-associated cancers. With a median follow-up of 33 months, the two cohorts had a median overall survival (OS) of 21.3 months, reported James Gulley, MD, PhD, of the National Cancer Institute in Bethesda, Maryland, during the virtual European Society for Medical Oncology (ESMO) meeting. "Overall survival appears to have a plateau of around 40-45% out to beyond 3 years," said Gulley. "The median survival compares favorably to the reported overall survival with PD-1 inhibitors of 8 to 12 months." "The need for effective treatment options in patients with HPV-associated malignancies is high," he added. "Therefore, these results showing efficacy of bintrafusp alfa across different HPV-related tumor types are of interest. Clinical trials of bintrafusp alfa in HPV-associated malignancies are ongoing." The frequency and durability of responses are "really remarkable in a quite difficult-to-treat patient population," said ESMO invited discussant Sebastian Kobold, MD, of Ludwig Maximilian University in Munich. "It's especially stunning because we all know that cervical cancers in previous trials have shown rather disappointing results with PD-1-targeting single agents, indicating that's [the anti-PD-1 component of the [...]

2021-09-21T07:23:47-07:00September, 2021|Oral Cancer News|

Stanley Tucci’s tongue cancer

Source: Author: Michele R. Berman, MD Actor Stanley Tucci is known for his roles in films such as "The Devil Wears Prada," "The Hunger Games," "The Lovely Bones," "Spotlight," and "Julie and Julia." But now he is becoming known for another role -- cancer survivor. In an interview in the September 2021 issue of Virgin Atlantic's inflight magazine Vera, 60-year-old Tucci revealed that he was diagnosed with cancer at the base of his tongue 3 years ago. "It was too big to operate, so they had to do high-dose radiation and chemo," he explained. Tucci was very reluctant to undergo this treatment, since he had seen the effects of this regimen on his first wife, Kate, who died from breast cancer in 2009. "I'd vowed I'd never do anything like that, because my first wife died of cancer, and to watch her go through those treatments for years was horrible," he said. He was equally concerned about how his illness would affect his five children. "The kids were great, but it was hard for them," he noted. "I had a feeding tube for 6 months. I could barely make it to the twins' high school graduation." Now, Tucci said that he is confident that the cancer is unlikely to return: "[Cancer] makes you more afraid and less afraid at the same time. I feel much older than I did before I was sick. But you still want to get ahead and get things done." And that's exactly what he [...]

2021-09-15T06:17:25-07:00September, 2021|Oral Cancer News|

World’s largest trial Of “Game-Changer” early cancer test begins in UK

Source: Author: Maddy Chapman Yesterday, England's National Health Service (NHS) launched the world’s largest trial of a blood test that can detect more than 50 types of cancer before symptoms appear. The trial aims to recruit 140,000 volunteers from different ethnic backgrounds, aged between 50 and 77, and living in eight areas across England. The test itself, the Galleri test, is a simple blood test that checks for the earliest signs of cancer. Ideally, it can be used to identify cancers at their earliest stages – stage one or two. When it comes to detecting cancer, the earlier the better. A diagnosis at stage one can increase chances of survival by five to 10 times, compared to a diagnosis at stage four. The new test, developed by healthcare company GRAIL, is particularly effective at identifying cancers that are difficult to diagnose early – head and neck, bowel, lung, pancreatic, and throat cancers, for example. “This quick and simple blood test could mark the beginning of a revolution in cancer detection and treatment here and around the world,” NHS chief executive Amanda Pritchard said in a statement. “By finding cancer before signs and symptoms even appear, we have the best chance of treating it and we can give people the best possible chance of survival.” The Galleri test works by identifying fragments of DNA that have been shed by tumors into the bloodstream. Participants in the trial, who must not have received a cancer diagnosis in the last three years, [...]

2021-09-15T06:09:46-07:00September, 2021|Oral Cancer News|

FDA gives ISA101b fast track designation for HPV 16+ oropharyngeal cancer

Source: Author: Hayley Virgil The first patients with human papillomavirus 16–positive oropharyngeal cancer have been dosed with ISA101b, which was given a fast track designation by the FDA, as part of a phase 2 study. ISA101b has received a fast track designation from the FDA for the treatment of patients with recurrent and metastatic human papillomavirus (HPV) 16–positive oropharyngeal cancer, according to a press release from drug developer ISA Pharmaceuticals.1 The fast track designation is intended to facilitate the development of investigational therapies that may help to address unmet medical needs for serious or life threatening diseases. An ongoing randomized, double-blind phase 2 trial is examining cemiplimab (Libtayo) with or without ISA101b and has an estimated enrollment of 194 patients (NCT03669718). “Recurrent and metastatic HPV16-positive OPC is a form of head and neck cancer with a high unmet medical need. The Fast Track designation for ISA101b underlines the potential benefit of this immunotherapy for patients suffering from this disease,” Leon Hooftman, chief medical officer at ISA Pharmaceuticals, said in a press release. ISA101b elicits strong and specific immune responses to HPV16 virus proteins and creates a robust T-cell immune response against cancerous cells or tissues. In the ongoing trial, patients in the experimental arm will receive ISA101b 3 times over 3 weeks plus cemiplimab every 3 weeks for up to 24 months, and the control arm will receive a matched placebo plus cemiplimab at the same dose. The primary outcome measures are overall response rate and safety, with a [...]

2021-09-15T06:04:52-07:00September, 2021|Oral Cancer News|

Chemotherapy and radiation therapy issues: What audiologists need to know

Source: Author: A. Croutch, Carl AuD With hearing loss, tinnitus, and imbalance as among the numerous side-effects of cancer treatment,1 audiologists play a critical role in monitoring patients receiving chemotherapy and radiation therapy. Sensorineural hearing loss (SNHL) attributed to chemotherapy and radiation therapy is usually permanent, making audiometric monitoring essential to detect its early occurrence.2 Cisplatin, carboplatin & radiation therapy Chemotherapy is used to treat cancer, control the growth and spread of cancer cells, and ease cancer symptoms. Cisplatin and carboplatin are two common antineoplastic agents used to treat testicular, ovarian, breast, esophageal, lung, and head and neck cancers among others. Besides hearing loss, these can cause other side effects including kidney, gastrointestinal disorders, allergic reactions, decreased immunity to infections, and hemorrhaging. Cisplatin was first found to have cytotoxic properties in the 1960s, and in 1978 was the first platinum compound approved by the FDA for cancer treatment.3 On the other hand, carboplatin is less potent than cisplatin and does have fewer side effects, especially on kidney problems.3 Both drugs work by interfering with DNA repair mechanisms causing DNA damage and inducing apoptosis in cancer cells. Cancerous cells cannot limit cell division as do normal cells. Normal cells cease dividing when they encounter similar cells whereas cancerous cells do not. The effectiveness of chemotherapy is determined by its ability to damage the RNA or DNA that gives the cell instructions to copy itself. The cells will die if they are unable to divide. The more quickly they are dividing, [...]

2021-09-09T06:48:49-07:00September, 2021|Oral Cancer News|

New cancer treatments may be on the horizon – thanks to success in mRNA vaccine trial

Source: Author: Andy Corbley A personalized, mRNA vaccine, given to patients with particular kinds of aggressive cancers could leverage the immune system of the patient to kill the cancer on its own, and in doing so usher in a new epoch of cancer treatment. Messenger RNA (ribonucleic acid) vaccines were what sparked the COVID-19 vaccine drives, as Pfizer and Moderna adapted the technology to create an emergency treatment to train the body to fight off the viral spike protein. What most of us won’t know however, is that the mRNA vaccines were originally in development for aggressive cancer types. Molly Cassidy, a mother studying for the Arizona Bar exam, is living proof that while the approach isn’t a panacea, it can clear away some of the most dreadful and fast cancers we know of. After being diagnosed with head and neck cancer, she underwent surgery and chemotherapy. However it was only ten days after finishing chemo that she found a marble-like bump on her collarbone from the cancer’s swift return. Later examinations found it had spread from her ear all the way to her lungs, and she was told to get her affairs in order. Cassidy was told she was eligible to join a clinical trial at the University of Arizona, testing an mRNA vaccine personalized to the cancer mutations of the host. By 27 weeks, Cassidy had received nine vaccine doses paired with an immunotherapy drug, and her CT scans were clear: the cancer had left her body. [...]

2021-09-07T05:46:03-07:00September, 2021|Oral Cancer News|

Recognizing and treating oral leukoplakia in primary care

Source: Authors: Christina Alvarez, PA-C, Corinne I. Alois, MS, PA-C, Louise Lee, EdD, MHA, PA-C Oral leukoplakia is a common premalignant condition most commonly identified in the smoking patient population. Once oral leukoplakia is diagnosed, the fundamental goal is to minimize progression towards invasive carcinoma through the use of various treatment methods such as traditional scalpel excision, cryotherapy, and carbon dioxide (CO2) laser therapy. Epidemiology and Pathogenesis of Oral Leukoplakia Leukoplakia is defined as a white, painless, plaque most commonly occurring on the buccal mucosa, lateral tongue, or floor of the mouth.1 Leukoplakia is considered one of the most common oral potentially malignant disorders (OPMDs) with an estimated worldwide prevalence of 1.5% to 2.6%.1 This premalignant condition, which can lead to oral cancer, particularly squamous cell carcinoma, presents with various transformation rates ranging from 0.1% to 17.5%.2 Due to variability in transformation to malignancy, identification, treatment, and monitoring is imperative. The etiology of oral leukoplakia is multifactorial and many cases are considered idiopathic; however, several strong risk factors are associated with this condition, the most common being chronic exposure to all forms of tobacco products, which cause mucosal irritation over time.1,2 Prolonged use of tobacco products is attributed to the conversion of normal cells to hyperplasia, dysplasia, and eventually carcinoma in situ or invasive carcinoma. It is reported that leukoplakia is 6 times more common in smokers than nonsmokers.1 Oral leukoplakia is most commonly seen in men aged 40 years and older, particularly after years of chronic tobacco use.1,2 [...]

2021-09-05T08:19:58-07:00September, 2021|Oral Cancer News|

Study: HPV vaccination will reduce throat and mouth cancers, but overall impact will take 25-plus years to see

Source: Author: Johns Hopkins Bloomberg School of Public Health Vaccinations against human papillomavirus (HPV), a major cause of throat and back of mouth cancers, are expected to yield significant reductions in the rates of these cancers in the U.S., but will not do so until after 2045, according to a new modeling study from researchers at the Johns Hopkins Bloomberg School of Public Health. HPV is the most common sexually transmitted infectious virus worldwide. HPV infections are often silent, and while most infections clear, some are chronic and can trigger cancers including mouth and throat (oropharyngeal), and cervical cancer because they disrupt DNA and inhibit tumor-suppressor proteins in the cells they infect. Although there is no cure for existing HPV infections, new infections are preventable with vaccines, the first of which entered use in the U.S. in 2006. In the new study, the Bloomberg School researchers analyzed national databases on oropharyngeal cancer cases and HPV vaccinations, and projected the impact of HPV vaccination on the rates of these cancers in different age groups. They estimated that the oropharyngeal cancer rate would nearly halve between 2018 and 2045 among people ages 36–45. However, they also projected that the rate in the overall population would stay about the same from 2018-2045, due to still-rising rates of these cancers in older people, where most of these cancers occur. The study appears online September 2 in JAMA Oncology. “We estimate that most of the oropharyngeal cancers from 2018 to 2045 will occur among [...]

2021-09-03T12:26:37-07:00September, 2021|Oral Cancer News|
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