Oral Cancer News – Page 269 – The Oral Cancer Foundation News Archive

Chemoradiation confers long-term benefits in head and neck cancer

Source: www.medscape.com Author: Zosia Chustecka In patients with head and neck cancer who do not undergo surgery, chemotherapy with nonplatinum agents given concurrently with radiotherapy offers clear benefits for recurrence and survival, say the authors of one of the largest and longest randomized trials carried out in this patient group. Event-free survival in patients who received concomitant chemoradiation was double that seen in patients who received radiotherapy alone or in those who received chemotherapy after radiation (with or without concurrent chemotherapy). Overall survival was also nearly doubled, although this result was not statistically significant. These benefits persisted for 10 years, the researchers note in their report published online October 27 in the Lancet Oncology. The results come from the UK Head and Neck (UKHAN1) trial, headed by Jeremy Tobias, FRCP, from the Department of Clinical Oncology, University College Hospital, London, United Kingdom. Chemoradiation as a treatment option for head and neck cancer is still rather controversial, Dr. Tobias told Medscape Oncology, and there are some physicians who would consider using radiation alone. "I think this study has gone quite a long way toward showing that chemotherapy given simultaneously with radiation is useful," he said. The benefits were "so striking that they trump any additional toxicity," he added. However, chemotherapy given after radiation did not confer any benefit, and it increased toxicity. Also, there was no benefit from the addition of chemotherapy to radiation in patients with head and neck cancer who had undergone surgery. Details of the Long-Term Results The [...]

Oral Cancer Foundation News Team - A2009-11-05T07:45:25-07:00November, 2009|Oral Cancer News|

Risk factors and survival by HPV-16 E6 and E7 antibody status in human papillomavirus positive head and neck cancer

Source: Int J Cancer, October 28, 2009 Author: Elaine M Smith et al. High-risk human papillomavirus types (HPV-HR) are associated with head and neck cancer (HNC) risk and better survival. Most patients with HPV-HR DNA-positive tumors develop anti-HPV E6/E7 antibodies; however, it is unclear whether those who mount an immune response have similar risk factors or clinical outcomes as those who do not. HPV-16 DNA tumor-positive HNC cases were evaluated for HPV-16 E6 and E7 antibodies using a GST capture ELISA system. Among 57 HPV-16 DNA tumor-positive HNC cases, 67% were detected with HPV-16 E6 and/or E7 antibodies. Male gender (76% versus 42%, p=0.02), younger age (63% versus 16%, p=0.001) but not tobacco or alcohol were associated with E6 and/or E7 seropositivity. Seropositivity was associated more often with late stage (76%), poor grade (65%), positive nodes (82%). and in the oropharynx (82%), Median disease-specific and recurrence-free survival were longer in E6 and/or E7 seropositive compared to E6/E7-negative cases (2.2 years vs. 1.4 years, both outcomes), although results were not statistically significant. When examined jointly with p16 expression, E6 and/or E7-positive/p16-positive cases had better disease-specific (2.1 years vs. 1.1 years, p=0.06) and recurrence-free (2.3 years vs. 1.1 years, p=0.03) survival compared to E6-/E7-/p16- cases. These findings suggest there are two distinct HNC patient groups with HPV DNA-positive tumors, distinguishable by E6 and/or E7 antibody status. Differences in antibody status are associated with distinct risk factors and clinical outcomes. This information can be available as a simple blood test at initial presentation, [...]

Oral Cancer Foundation News Team - A2009-11-05T07:38:00-07:00November, 2009|Oral Cancer News|

Cepharanthin effect on radiation-induced xerostomia and taste disorder in patients with head and neck cancer

Source: Nippon Jibiinkoka Gakkai Kaiho, September 1, 2009; 112(9): 648-55 Author: R Shimazu et al. In evaluating the effect of cepharanthin on and taste disorder in 40 patients undergoing radiotherapy for head and neck cancer, we administered cepharanthin intravenously during chemoradiotherapy to 22 patients, with 18 others as a control group. Cepharanthin did not significantly affect salivary secretion during and after chemoradiotherapy, although taste disorder and oral discomfort were alleviated. Cepharanthin may thus be effective in maintaining the quality of life of patients with head and neck cancer. Authors: R Shimazu, G Tanaka, R Tomiyama, Y Kuratomi, and A Inokuchi Authors' affiliation: Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Saga University, Saga

Oral Cancer Foundation News Team - A2009-11-05T07:32:56-07:00November, 2009|Oral Cancer News|

Comparative prognostic value of HPV16 E6 mRNA compared with in situ hybridization for human oropharyngeal squamous carcinoma

Source: Journal of Clinical Oncology, 10.1200/JCO.2009.23.1670 Author: Wei Shi et al. Purpose: A significant proportion of oropharyngeal squamous cell carcinomas (OSCC) are associated with the human papilloma virus (HPV), particularly HPV16. The optimal method for HPV determination on archival materials however, remains unclear. We compared a quantitative real-time polymerase chain reaction (qRT-PCR) assay for HPV16 mRNA to a DNA in situ hybridization (ISH) method, and evaluated their significance for overall (OS) and disease-free (DFS) survival. Patients and Methods: Matched, archival biopsies from 111 patients with OSCC were evaluated for HPV16 using a qRT-PCR for E6 mRNA and ISH for DNA. Immunohistochemistry for p16, p53, and epidermal growth factor receptor were also performed. Results: HPV16 E6 mRNA was positive in 73 (66%) of 111 samples; ISH was positive in 62 of 106 samples (58%), with 86% concordance. P16 was overexpressed in 72 samples (65%), which was strongly associated with HPV16 status by either method. E6 mRNA presence or p16 overexpression were significantly associated with superior OS; E6 mRNA, HPV16 ISH, or p16 were all significantly associated with DFS. On multivariate analysis adjusted for age, stage, and treatment, positive E6 mRNA was the only independent predictor for superior OS; for DFS, p16 expression or HPV16 status determined by either method was significant. Conclusion: The prevalence of HPV16 in OSCC ranges from 58% to 66%, in a recently treated Canadian cohort. Classification of HPV-positivity by HPV16 E6 mRNA, HPV16 ISH or p16 immunohistochemistry (IHC) is associated with improved DFS. However, the latter two [...]

Oral Cancer Foundation News Team - A2009-11-05T07:30:00-07:00November, 2009|Oral Cancer News|

HPV vaccination: inaccurate assumptions about oropharyngeal cancer

Source: BMJ 2009;339:b4525 Author: Erich M Sturgis et al. Excerpt from article: The article by Kim and Goldie on the cost effectiveness of including boys in a human papillomavirus (HPV) vaccination programme made assumptions about oropharyngeal cancers that are inaccurate.1 The prevalence of HPV in oropharyngeal cancer used in the article (31%) is based on worldwide estimates,2 but its prevalence in the US, where the research was done, is much higher.3 4 Source data for the review article referenced by the authors give the US specific HPV prevalence as 47% (42% for types 16/18),2 5 and other more recent high quality studies from the US have found rates as high as 72%.3 Furthermore, a recent population based study within the Colorado SEER registry found an HPV prevalence rate of 79% for oropharyngeal cancers diagnosed after 1994.4 Authors: Erich M Sturgis, associate professor1, Kristina R Dahlstrom, doctoral student2 Author affiliations: 1 Department of Head and Neck Surgery and Department of Epidemiology, University of Texas, MD Anderson Cancer Center, Houston, Texas 77030, USA, 2 University of Texas School of Public Health, Houston, Texas, USA

Oral Cancer Foundation News Team - A2009-11-04T15:30:17-07:00November, 2009|Oral Cancer News|

Incidental detection of an occult oral malignancy with autofluorescence imaging: a case report

Source: Head Neck Oncol, October 28, 2009; 1(1): 37 Author: Nadarajah Vigneswaran, Sheila Koh, and Ann Gillenwater Background: Autofluorescence imaging is used widely for diagnostic evaluation of malignances of various epithelial malignancies. Cancerous lesions display loss of autofluorescence due to malignant changes in epithelium and subepithelial stroma. Carcinoma of unknown primary site presents with lymph node or distant metastasis, for which the site of primary tumor is not detectable. We describe here the use of autofluorescence imaging for detecting a clinically innocuous appearing occult malignancy of the palate which upon pathological examination was consistent with a metastatic squamous cell carcinoma. Case Description: A submucosal nodule was noted on the right posterior hard palate of a 59-year-old white female during clinical examination. Examination of this lesion using a multispectral oral cancer screening device revealed loss of autofluorescence at 405 nm illumination. An excisional biopsy of this nodule, confirmed the presence of a metastatic squamous cell carcinoma. Four years ago, this patient was diagnosed with metastatic squamous cell carcinoma of the right mid-jugular lymph node of unknown primary. She was treated with external beam irradiation and remained disease free until current presentation. Conclusion: This case illustrates the important role played by autofluorescence tissue imaging in diagnosing a metastatic palatal tumor that appeared clinically innocuous and otherwise would not have been biopsied.

Oral Cancer Foundation News Team - A2009-11-04T15:23:35-07:00November, 2009|Oral Cancer News|

Biovex agrees to Special Protocol Assessment (SPA) with the FDA for a pivotal phase III study with Oncovexin head and neck cancer

Source: www.pressreleasepoint.com Author: press release BioVex Inc, a biotechnology company developing clinical stage treatments for cancer and the prevention of infectious disease, announced today that the U.S. Food and Drug Administration (FDA) has approved the design of a single, pivotal, Phase III clinical trial evaluating its lead product, OncoVEXGM-CSF for the first line treatment of patients with squamous cell cancer of the head and neck. The study is the second the Company has agreed with the FDA under the Special Protocol Assessment (SPA) procedure and highlights the broad potential utility of BioVex’s first-in-class cancer destroying virus technology. The first SPA was in melanoma under which BioVex is currently conducting a pivotal Phase III trial. Patients with head and neck cancer often present with locally advanced, bulky disease that is too large, or too close to vital organs, to remove surgically. These patients typically undergo combination radiation and chemotherapy treatment, with in some cases additional surgery. Patients who present with tumor containing lymph nodes are particularly difficult to treat and approximately half of these patients relapse within two years. Philip Astley-Sparke, President & CEO, for BioVex said: "The announcement of our second SPA governing a Phase III study demonstrates the breadth of the commercial opportunity with OncoVEXGM-CSF. In addition to treating metastatic disease as is the intention in our ongoing Phase 3 study in melanoma, following multiple systemic responses in Phase II, OncoVEXGM-CSFalso has considerable potential utility in treating discrete solid tumor masses across multiple indications including those that are poorly [...]

Oral Cancer Foundation News Team - A2009-11-04T12:54:36-07:00November, 2009|Oral Cancer News|

PMH finding may help some tonsil cancer patients avoid chemotherapy

Source: www.sciencecodex.com Author: staff Clinical researchers at Princess Margaret Hospital (PMH) have confirmed that patients with oropharyngeal squamous cell cancer ("tonsil cancer") harbour a common type of human papilloma virus (HPV16), but also that such cancers are very sensitive to radiation. For some patients, this may mean successful treatment with radiation alone and avoiding the side effects of chemotherapy. "This represents the power of personalized medicine. By using a relatively simple molecular test to evaluate the tumour, we can customize the treatment plan, produce an excellent outcome, and maintain the patient's quality of life," says principal investigator Dr. Fei-Fei Liu, PMH radiation oncologist, Head of the Division of Applied Molecular Oncology, Ontario Cancer Institute, and Dr. Mariano Elia Chair in Head & Neck Cancer Research, University Health Network. Dr. Liu's team discovered that patients whose tumours tested positive for HPV16 had a much better survival, compared to patients whose tumours did not harbour HPV16. This HPV effect was independent of treatment (radiation alone, or radiation plus chemotherapy), suggesting that some HPV16 patients could be treated with radiation only. As a result, PMH now routinely tests tonsil-area tumours for HPV16 -- one of the first cancer programs to do so. The study's finding is important because this particular type of cancer is increasing – up more than 10% in the past 20 years. The jump is likely attributed to the spread of HPV16 through sexual activity, compared with a 20% decline in other similar head-and-neck cancers over the same period because [...]

Oral Cancer Foundation News Team - A2009-11-04T12:27:48-07:00November, 2009|Oral Cancer News|

A dynamic oral cancer field: unraveling the underlying biology and its clinical implication

Source: Am J Surg Pathol, November 1, 2009; 33(11): 1732-8 Authors: IF Tsui, C Garnis, and CF Poh Oral cancer is a complex disease that is characterized by histologic and genetic heterogeneity. The evolution and progression of this disease is thought to result from the accumulation of alterations in molecular pathways. Although the oral cavity is accessible for routine screening of suspicious lesions, gene alterations are known to accrue in histologically normal tissues. Therefore, some cancer forerunners may remain undetected clinically or histologically. Recently emerging optical and molecular technologies have provided a powerful means for redefining the extent of the field of alteration. Often this means expanding upon regions detectable with standard white light approaches. In this report, we used a newly developed optical technique, direct fluorescence visualization, to define a contiguous field that extended beyond the margins of a clinically visible oral squamous cell carcinoma. Multiple biopsies were taken within this contiguous optically altered field. Genome alterations detected for each specimen were compared to define whether each lesion arose independently or as a consequence of a shared progenitor cell. Our results indicate that the field effect of oral cancer is extremely dynamic, with different genetic alterations present in different biopsies within a field. This case study also demonstrated that 2 genetically unrelated squamous cell carcinoma could be developed within 10 mm at the right lateral tongue of this patient. These findings provide evidence for the importance to implement optical technologies in defining surgical margins and support the use of [...]

Oral Cancer Foundation News Team - A2009-11-03T09:07:52-07:00November, 2009|Oral Cancer News|

YM Biosciences reports positive nimotuzumab four-year survival data

Source: www.reuters.com Author: press release YM BioSciences Inc., a life sciences product development company that identifies and advances a diverse portfolio of promising cancer-related products at various stages of development, announced that an oral presentation at the American Society for Therapeutic Radiology and Oncology (ASTRO) 2009 Annual Meeting reported positive 48-month survival data for its EGFR-targeting antibody, nimotuzumab. The "BEST" trial was a randomized four-arm study treating patients with inoperable, locoregionally-advanced, stage III/IVa head and neck cancer with radiation alone, chemoradiation alone, or radiation or chemoradiation in combination with nimotuzumab. These data were a follow-up to 30-month survival data presented at ASCO 2009 and demonstrate that the benefit of adding nimotuzumab to radiation and chemoradiation is durable and persists for several years. "These data are convincing evidence that nimotuzumab is an efficacious and safe drug and highlight its potential in the head and neck cancer indication. In this respect we note that the National Cancer Centre of Singapore has initiated a global Phase III trial with nimotuzumab in the adjuvant setting for head and neck cancer patients," said David Allan, Chairman and CEO of YM BioSciences. "Activity of nimotuzumab in the BEST trial was similar to that demonstrated in separate trials with cetuximab in locally advanced head and neck cancer but there was no evidence that nimotuzumab's activity was accompanied by the advanced toxicities of the class." In the ASTRO presentation, Dr. Lokesh Viswanth, Kidwani Memorial Institute of Oncology, Bangalore, India described that the addition of nimotuzumab to radiotherapy (RT) [...]

Oral Cancer Foundation News Team - A2009-11-03T08:17:42-07:00November, 2009|Oral Cancer News|