8/26/2006 Chicago, IL John Otrompke www.docguide.com Researchers who are evaluating the safety of pioglitazone in nondiabetic patients with precancerous leukoplakia say the drug can be delivered safely for 90 days to non-diabetic people with oral leukoplakia. Nelson Rhodus, MD, professor of oral medicine, department of diagnostic and biological sciences, University of Minnesota, Minneapolis, Minnesota, and colleagues conducted a phase 2a trial to evaluate the safety of pioglitazone in nondiabetic patients with high-risk oropharyngeal leukoplagia. Their findings were presented in a poster session here at the 2006 annual meeting of the American Head and Neck Society (AHNS). Leukoplakia is a precancerous oral condition which affects 1% of the U.S. adult population. Individuals with the condition are at relatively high-risk for conversion to malignancy, with 5% of those with leukoplakia going on to develop oral cancer. By comparison, 1% of those with colonic polyps go on to develop intestinal cancer, the poster said. The researchers undertook this study because the thiazolidinedione class of drugs, commonly used for treatment of type 2 diabetes, bind to peroxisome proliferating-activated receptor (PPAR) gamma nuclear receptors and are therefore theorized to drive dysplastic cells to decrease proliferation and increase maturation. The trial enrolled patients with precancerous leukoplakia but no oral cancer, diabetes, prior radiation to the oral cavity, or serious oral infections between January of 2004 and March of 2006. All patients received 45 mg daily of pioglitazone for 12 weeks. Researchers evaluated laboratory abnormalities using paired Student's t-test and clinical side effects using National Cancer Institute [...]

8/26/2006 Chicago, Il John Otrompke www.docguide.com Treatment with an intranodal vaccine prepared by feeding apoptotic autologous tumor cells to dendritic cells may benefit some patients with squamous cell head and neck cancer, but lymph node sterility may limit the viability of the treatment for certain patients. Thirty patients with stage III/IV resectable squamous cell carcinoma of the head and neck were assessed for the experimental treatment as part of a trial reported here at the annual meeting of the American Head and Neck Society (AHNS). Lymph nodes from the patients were processed, and sterile tumor cells were recovered from 10 of the 30 patients. Lymph nodes from five of the patients in the trial underwent leukapheresis to generate immature dendritic cells, which were then coincubated with apoptotic cells, according to the abstract by Theresa L. Whiteside, PhD, professor of pathology and otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, and colleagues. The researchers evaluated the dendritic cell vaccines for cell recovery, viability, purity, and potency and delivered them to four of the patients. Of the four patients who received the vaccine, none showed toxic effects, and all are alive with no evidence of cancer. The patients all generated immune responses to the vaccines. However, the researchers noted in their abstract, autologous tumor sterility and small cell numbers limited this vaccination strategy to few enrolled subjects. Source: Presentation title: Dendritic Cell (DC)-Based Vaccine for Patients With SCCHN Using Autologous Tumor Cells as Immunogens. Abstract s012_AHNS

8/26/2006 Bethesda, MD press release EurekAlert.com High-tech laboratory tools, like computers, are often updated publicly as their analytical capabilities expand. In the September issue of the Journal of Molecular Diagnostics, NIH grantees report they have developed a second generation "lab on a silicon chip" called the MitoChip v2.0 that for the first time rapidly and reliably sequences all mitochondrial DNA. Mitochondria, the energy-producing organelles that power our cells, are unique because they are equipped with their own genetic instructions distinct from the DNA stored in the cell nucleus. The authors say their full-sequence chip will be a key tool in accelerating research on mitochondrial DNA, a growing area of scientific interest. This interest stems from data that suggests natural sequence variations and/or mutations in each person's mitochondrial DNA could be biologically informative in fields as diverse as cancer diagnostics, gerontology, and criminal forensics. According to Dr. Joseph Califano, a scientist at Johns Hopkins University School of Medicine in Baltimore and senior author on the paper, the MitoChip v2.0 showed in his group's hands better sensitivity that its predecessor to sequence variations in head and neck cancer samples. The v2.0 also detected nearly three dozen variations in the non-coding D-loop, long considered to be a sequencing no-man's land and which the original MitoChip did not include. "At this point, we don't foresee a MitoChip v3.0," said Califano, whose research was supported by the NIH's National Institute of Dental and Craniofacial Research. "The v2.0 is a very good tool in that we've [...]

8/25/2006 Scotland Ian Johnston news.scotsman.com PROBIOTIC bacteria might be able to prevent a deadly form of throat cancer which kills 500 people a year in Scotland, according to new research by Dundee University scientists. They discovered that the kind of bacteria living in the throats of people with a disease called Barrett's Oesophagus, which increases the risk of cancer by up to 125 times, was significantly different from the "flora" found in healthy people. Those with the disease were found to have one particular kind of bacteria, an unusual form of campylobacter, which has been linked with cancer of the oesophagus in animals. The researchers now plan to investigate whether the use of probiotics, prebiotics or a combination of the two called synbiotics can change the make-up of the bacteria and prevent the genetic damage that results in cancer. Cancer deaths resulting from Barrett's Oesophagus have been increasing in Europe over the last three decades and in the UK it has risen from the 20th most common type of cancer death to the seventh most common. Dr Sandra MacFarlane, an expert in the bacteria which lives inside the human digestive tract, carried out a study which tested the microflora found in the throats of seven Barrett's patients and seven healthy people. "We found in the Barrett's patients there was a greater species diversity of bacteria, but the most important thing we found was a significant difference in numbers of campylobacter," she said. "Fifty-seven per cent of Barrett's patients had them [...]

8/25/2006 Iowa City, IA staff CancerConsultants.com Researchers from Harvard University have reported that a regimen of induction chemotherapy followed by concomitant Taxotere (docetaxel) results in disease eradication in 70% of patients with locally advanced head and neck cancer. The details of this phase II study appeared in the July 15, 2006, issue of the International Journal of Radiation Oncology Biology Physics . There have been several randomized and non-randomized clinical trials which suggest that the concomitant administration of platinum-based chemotherapy and radiotherapy is superior to radiotherapy alone for the treatment of patients with advanced head and neck cancer for local and regional control. Most, but not all, have also shown a survival advantage for combined treatment. More recently, Taxotere has emerged as a very effective agent for the treatment of head and neck cancer. The current study was carried out by researchers at the Beth Israel Deaconess Medical Center, the Dana-Farber Cancer Institute, and the Brigham and Women's Hospital in Boston. They treated 31 patients with locally advanced head and neck cancer with induction chemotherapy, concomitant Taxotere and radiation therapy and surgery for neck dissections when indicated. The induction regimens in this trial were Platinol® (cisplatin) and 5-fluorouracil (5-FU), Paraplatin® (carboplatin) and 5-FU or Taxotere, Platinol and 5-FU. All patients received Taxotere 4 times per week while receiving radiation therapy. The complete response rate to induction chemotherapy was 20%, the complete response rate after Taxotere and radiation therapy was 70%. Nineteen patients had a neck dissection and 7 were positive [...]

8/24/2006 Chicago, IL John Otrompke www.docguide.com An investigational chemotherapeutic agent under research in the treatment of gastrointestinal carcinoma may also have utility as part of a combination regimen for head and neck cancer, according to a poster presented here at the 2006 annual meeting of the American Head and Neck Society (AHNS). "These patients are heavily pretreated, and they're ill. Often it is not possible to give them cisplatin, because it is nephrotoxic and cardiotoxic. But we can give them oxaliplatin even if they have heart failure," said study presenter Jan Raguse, MD, oral and maxillofacial surgeon, Charite Campus, Berlin, Germany. Between 2002 and 2004, Dr. Raguse and colleagues enrolled 36 patients with recurrent and/or metastatic disease and treated them with the combined regimen. The overall response was 60.6% (21.2% complete responders and 39.4% partial responders), and the 1-year survival rate was 43.2%. Twenty-four percent of patients were alive after 2 years. Of those enrolled, 14 had previously been treated with surgery and radiation, and 22 had been treated with radiation and chemotherapy, Dr. Raguse said. The median age of patients was 59 years, and overall survival was nearly 1 year in 60% of the study's patients, he said. Median survival for those receiving conventional palliative chemotherapy is usually in the 4-to6-month range, the poster said. Another advantage of the oxaliplatin regimen was that the treatment was administered over a 24-hour period, compared with the corresponding cisplatin regimen, which often occurs over the course of a week. However, drawbacks of [...]

8/23/2006 Bergen, Norway DE Costea et al. Oral Dis, September 1, 2006; 12(5): 443-54 There is increasing evidence that the growth and spread of cancers is driven by a small subpopulation of cancer stem cells (CSCs) - the only cells that are capable of long-term self-renewal and generation of the phenotypically diverse tumour cell population. Current failure of cancer therapies may be due to their lesser effect on potentially quiescent CSCs which remain vital and retain their full capacity to repopulate the tumour. Treatment strategies for the elimination of cancer therefore need to consider the consequences of the presence of CSCs. However, the development of new CSC-targeted strategies is currently hindered by the lack of reliable markers for the identification of CSCs and the poor understanding of their behaviour and fate determinants. Recent studies of cell lines derived from oral squamous cell carcinoma (OSCC) indicate the presence of subpopulations of cells with phenotypic and behavioural characteristics corresponding to both normal epithelial stem cells and to cells capable of initiating tumours in vivo. The present review discusses the relevance to OSCC of current CSC concepts, the state of various methods for CSC identification, characterization and isolation (clonal functional assay, cell sorting based on surface markers or uptake of Hoechst dye), and possible new approaches to therapy. Authors: DE Costea, O Tsinkalovsky, OK Vintermyr, AC Johannessen, and IC Mackenzie Authors' affiliation: Bergen Oral Cancer Group, Department of Oral Sciences, Oral Pathology and Forensic Odontology, University of Bergen, Bergen, Norway

8/23/2006 Baltimore, MD RA Ord J Oral Maxillofac Surg, September 1, 2006; 64(9): 1409-14 Purpose: To evaluate local and regional recurrence and the outcomes for salvage surgery in patients for oral cancer. Patients and Methods: This study analyzed 354 consecutive patients with oral cancer treated primarily by surgery or surgery combined with adjuvant therapy by 1 surgeon (R.A.O.) between February 1991 and September 2001. Results: Overall recurrence rate was 15.5%; with 5.4% local, 8.5% regional, and 1.4% locoregional. Overall salvage for local recurrence was 52.6% 3-year survival, and statistically significant favorable prognostic factors were salvaged by surgery alone and initial cancer staging of I/II. Overall salvage for regional recurrence was 50%, with recurrence in a previously untreated neck and salvage with radical neck dissection plus radiotherapy giving the best prognosis. No patients with locoregional recurrence were salvaged. Conclusions: Patients who were stage I/II and were treated initially by surgery alone were the best candidates for salvage if they recurred. Salvage was best achieved with surgery or surgery + adjuvant therapy, and patients recurring within 6 months had a worse survival. Patients with locoregional recurrence or treated with RT +/- chemotherapy alone have negligible survival. Authors: RA Ord, A Kolokythas, and MA Reynolds Authors' affiliation: Department of Oral and Maxillofacial Surgery, University of Maryland, Greenbaum Cancer Center, Baltimore, MD

8/23/2006 Iowa City, IA staff CancerConsultants.com According to an article published in The Lancet, fractionated radiation therapy improves survival over conventional radiation therapy for patients with squamous cell head and neck cancer. Head and neck cancer originates in sites within the head or neck. The American Cancer Society estimated that 11,000 individuals died from head and neck cancer in the United States in 2005. The most common type of head and neck cancer is squamous cell head and neck cancer, which refers to the type of cell from which the cancer originated. Radiation therapy remains an important component in the treatment of head and neck cancer. Researchers continue to evaluate optimal types of radiation delivery and schedules for the treatment of this disease. Hyperfractionated radiation therapy refers to radiation therapy that is given two to three times per day, versus the conventional once-per-day dosing. Hyperfractionated radiation therapy utilizes smaller doses with each administration than doses used with the once-daily administration. Accelerated radiation therapy refers to radiation that is administered over a shorter duration of time than conventional radiation. The doses with hyperfractionated or accelerated radiation therapy may be increased overall, may stay equal, or may be reduced compared to conventional radiation therapy. Researchers on behalf of the Meta-Analysis of Radiotherapy in Carcinomas of Head and Neck (MARCH) Collaborative Group recently compiled and analyzed data from 15 clinical trials evaluating different radiation schedules and doses for the treatment of squamous cell head and neck cancer. The majority of patients had advanced [...]

8/23/2006 Chicago, IL John Otrompke www.docguide.com The selective serotonin reuptake inhibitor Celexa (citalopram) shows efficacy in treating depression in patients with recently-diagnosed head and neck cancer, according to research presented here at the 2006 annual meeting of the American Head and Neck Society (AHNS). "Depression is a significant problem: it decreases immune function, adherence to therapy, and the ability of patients to seek medical attention, and it may even decrease survival," said Bill Lydiatt, MD, associate professor, head and neck surgery, University of Nebraska Medical Center, Omaha, Nebraska. Previous studies have shown that 19% of all hospital suicides in cancer patients occur in those with head and neck cancer, who make up 2% to 3% of all cancer patients, said Dr. Lydiatt, who presented scientific the findings at the conference on August 18th. The high suicide rate among head and neck cancer patients occurs because the disease "impairs the most basic aspects of your humanity, including speech, swallowing, and facial appearance," he explained. In the study, 36 subjects with head and neck cancer were randomized to Celexa or placebo, and 23 completed the 12-weeks of treatment. Depression was assessed using the Hamilton Depression Rating Scale, the Geriatric Depression Scale, and the Collateral Source Geriatric Depression Scale. At 12 weeks, 50% of patients in the placebo group experienced clinically significant depression compared with 15% in the Celexa group. Two patients in the placebo arm experienced suicidal ideation compared with none in the Celexa arm. At 12 weeks, 50% of those in [...]