FDA approves Gardasil 9, the HPV vaccine, to prevent head-and-neck cancer

Source: www.statnews.com Author: Matthew Herper For the past decade, evidence has suggested that Gardasil, the HPV vaccine, could stem an epidemic of throat cancer. But it has also never received approval from the Food and Drug Administration for that use — and it was unclear if it ever would. Charles Rex Arbogast/AP On Friday, the agency granted that approval, clearing the latest version of the vaccine, Gardasil 9, to prevent a cancer that affects 13,500 Americans annually. The decision was announced by Gardasil’s maker, Merck. The decision doesn’t change recommendations about who should get the vaccine, which is already recommended for females and males ages 9 through 45 to prevent cervical, vulvar, vaginal, and anal cancer as well as genital warts. But cancers of the head and neck — mainly those of the tonsils and throat — have been left off the list. It’s a striking omission, because head and neck cancer, mostly cancer of the throat, is the most common malignancy caused by HPV, the human papilloma virus, in the U.S. According to the Centers for Disease Control and Prevention, there are 35,000 cases of HPV-related cancer in the U.S. annually. On top of the 13,500 cases in the throat, 10,900 are cases of cervical cancer. “That’s excellent news,” said Stewart Lyman, a pharmaceutical consultant whose doctors discovered a tumor in his throat in 2016. It was removed surgically, and was caused by HPV. “To have this extended to head and neck cancer is really very helpful [...]

Fighting throat cancer with T cells

Source: www.miragenews.com Author: press release, Centenary Institute Research led by the Centenary Institute has discovered that immune cells accumulating within the tumor environment, called tumor-resident T cells, are a critical determinant in survival rates of patients suffering from throat cancer. Reported in the prestigious ‘Journal for ImmunoTherapy of Cancer’, the research suggests that strategies aiming to boost these T-cells at tumor sites could be beneficial to patients. “Oropharyngeal squamous cell carcinoma (OPSCC) is a form of throat cancer. It can be caused by environmental factors such as smoking or by human papillomavirus infection (HPV), the same virus that causes cervical cancer in women,” said Ms Rehana Hewavisenti, lead author of the study and researcher at the Centenary Institute and the University of Sydney. “We knew that patients with HPV-related OPSCC had far better clinical outcomes compared to other OPSCC patients but we didn’t know why,” she said. In examining over sixty patient samples, Ms Hewavisenti and her colleagues discovered that increased levels of tumor-resident T cells, whether in HPV or non-HPV OPSCC cases, was clearly associated with improved patient survival outcomes. “It was the accumulation of these immune T-cells, in and around the tumour site that appeared to be key,” said Ms Hewavisenti. The researchers also found in their study that HPV OPSCC patients generally had far higher levels of tumour-resident T cells compared to their non-HPV OPSCC patient counterparts. “We think these HPV positive patients tended to have better clinical outcomes as HPV infection is likely to favor the [...]

These 4 diet and lifestyle changes can lower your cancer risk by almost 20%

Source: www.marketwatch.com Author: Nicole Lyn Pesce Bad news, booze and beef lovers. The American Cancer Society has updated its diet and physical activity recommendations to help prevent cancer — and the new guidelines released on Tuesday discourage consuming red meat, processed food, sugar-sweetened drinks — and all alcohol. The combination of these risk factors (as well as being physically inactive) accounted for at least 18.2% of cancer cases and 15.8% of cancer deaths in the U.S. in 2014, the American Cancer Society reported — making this unhealthy combo the biggest cancer risk factor after cigarette smoking in both men and women. While the American Cancer Society has advised limiting the consumption of alcoholic drinks to no more to than one per day for women, and two for men since 2012, the new recommendations draw a harder line. “It is best not to drink alcohol,” it says. Period. For people who still choose to imbibe, the revised guidance reiterates sticking to just one drink a day for women and two for men. And it should be noted that a standard single “drink” is defined as 12 ounces of regular beer, five ounces of wine, and a 1.5-ounce shot of distilled spirits or liquor, which may be smaller than what you actually pour yourself. For example, the University of Cambridge has noted that the average wine glass today holds 15 ounces — or three servings’ worth. “That recommendation is the synthesis of the evidence and science that finds any amount of alcohol [...]

Dental record data analytics to improve oral health outcomes

Source: healthitanalytics.com Author: Jessica Kent A team from Regenstrief Institute and the Indiana University School of Medicine is applying data analytics techniques to previously inaccessible dental record information with the goal of improving oral health outcomes. Researchers assessed de-identified data from electronic dental records (EDRs) of 217,887 patients of 99 solo or small dental practices across the US. These EDRs included more than 11 million observations, with observation periods as long as 37 years. Information on demographics, reason for visit, medical and dental history, social history, tooth characteristics and treatment, and practice and practitioner characteristics was collected for each patient visit. Dentists could share their data for research in an anonymized process with the help of their EDR vendor. Data from two EDR systems with different formats and operating systems were combined, where interoperability has previously proved difficult with medical data. Additionally, the study looked at the oral health and treatment options of both insured and uninsured patients, in contrast to previous studies which have relied on insurance records and haven’t provided any information on uninsured patients. The group found that it was possible to mine and utilize massive amounts of dental record data to determine which dental therapies work and which don’t, which could lead to quality improvement from individual dentists. The study showed that EDR data is reliable for purposes beyond clinical patient care. Dental practitioners can learn from aggregated data across practices and compare their practice with their peers, researchers said. Information collected at each patient’s visit [...]

Experts release new guidelines for studies into most effective treatments for HPV-positive throat cancer

Source: en.brinkwire.com Author: provided by University of Birmingham, United Kingdom Heightened caution is needed when considering de-escalation trials for patients with Human papillomavirus (HPV)-positive oropharyngeal cancer (OPC), to ensure minimal harm to patients, new guidelines from a group of international head and neck cancer experts have suggested. HPV-positive oropharyngeal cancer is a cancer of the throat caused by the human papillomavirus—a common, but symptomless group of sexually transmitted viruses. Instances of many throat and neck cancers have declined as smoking rates have fallen, whereas HPV-positive OPC has increased, largely affecting younger patients. The standard course of treatment for this disease is a combination of cisplatin (a common chemotherapy drug) and radiotherapy. The younger age of the patient population, significantly improved prognosis, and relatively minimal morbidities caused by the standard treatment pathway have led to the popularisation of the concept of treatment de-escalation as a way to improve the quality of life of patients by reducing dosage or frequency of treatment. These new recommendations, published today in the Journal of Clinical Oncology have been created by the Head and Neck Cancer International Group, a group of experts from nineteen countries, led by the University of Birmingham, UK. The guidelines have been prompted by the recent results of the first three randomised de-escalation trials which suggested a clear detriment in survival when cisplatin is omitted or substituted to minimise side effects. After a review of available HPV-positive OPC literature, the guidelines recommend an overall need for caution when considering de-escalation options, even [...]

Gambling today: time to ban smoking in casinos

Source: www.si.com Author: Frankie Taddeo Casinos are working feverishly towards making guests feel they are not at risk when they travel back to properties with newly implemented safety measures. Among all these new features, there is one important change blatantly missing: prohibiting smoking. Smoking could easily spread the COVID-19 virus, not only because of the need to remove your mask but because of an individual's pattern of fingers to mouth while in constant contact with each game they decide to participate in. Many doctors and experts have gone on record expressing that smoking or exposure to secondhand smoke can lead to coughing which in turn can aid in the spread of the infection. Unfortunately, casino operators don’t appear to have all the health interests of both their guests and employees at the heart of their newly implemented changes. Should that change, now is the time to play the hand being dealt and push all the collective chips into the middle. Patrons either turning on the news or coming across signs in local establishments are told to avoid touching surfaces others have touched, and then touching your face, mouth, or eyes. In casinos, gamblers continuously touch cards, chips, dice, slot machine buttons, and above all, money. Even those of us who are not medical experts can rationalize that the act of smoking could likely lead to a higher risk of transmission during uncertain times Also, what about the risks to non-smokers resulting from secondhand smoke? Part of the outline in the [...]

ASCO 2020: New optimized precision radiotherapy can reduce swallowing difficulties for head and neck cancer patients

Source: www.icr.ac.uk Author: staff A new optimized intensity-modulated radiation therapy (IMRT) pioneered at The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London, has been shown to spare head and neck cancer patients’ adverse life-long side effects post treatment. The initial results from the Dysphagia-Aspiration Related Structures (DARS) trial, funded by Cancer Research UK and the National Institute for Health Research, were presented at the American Society for Clinical Oncology (ASCO) virtual conference this week. The randomized study found patients with head and neck cancer experienced less adverse side effects with the new precision radiotherapy technique optimized to reduce the risk of swallowing difficulties, known as dysphagia. Half of newly diagnosed patients with oropharyngeal and hypopharyngeal cancers (tumors of the throat) recruited to the trial received standard IMRT radiotherapy and the other half received IMRT optimized to reduce the radiation dose to the structures related to swallowing and breathing. The trial recruited 112 patients across 23 UK cancer centres. Difficulties eating and drinking Patients with head and neck cancer have a 90 percent survival rate but can be left with life changing side effects including swallowing problems, making it difficult to eat and drink. The self-reported measure of swallowing ability as perceived by patients themselves was better in the optimised IMRT group. Twelve months after treatment, 40 percent of patients given the optimized form of precision radiotherapy reported their swallowing was as good as ever in comparison to just 15 percent on the standard treatment. The DARS [...]

Sentinel node biopsy proves mettle in H&N cancer

Source: www.medpagetoday.com Author: Ed Susman, Contributing Writer, MedPage Today Sentinel node biopsy achieved "oncological equivalence" with neck dissection in patients with operable T1-T2N0 oral and oropharyngeal cancer, researchers reported. In a head-to-head trial, the 2-year neck-relapse free survival (RFS) was 90.7% in the sentinel node (SN) biopsy group versus 89.4% in the neck dissection group, according to Renaud Garrel, MD, PhD, of Montpellier University Hospital Center in France. That 1.1% difference fell well within the pre-specified 10% difference to determine if there was non-inferiority of SN biopsy to neck dissection, which is considered the standard of care for treatment of early stage head and neck cancers (P=0.008 for equivalence), he reported at the American Society of Clinical Oncology virtual meeting. At 5 years, 89.4% of the SN biopsy group achieved neck-RFS versus 89.6% in the neck dissection group, he said in a pre-recorded oral presentation on the Senti-MER study. Overall, there were 14 neck recurrences in 139 patients in the neck dissection group and 13 neck recurrences in 120 patients in the SN biopsy group. Also, overall survival was 82.2% in the SN biopsy group and 81.8% in the neck dissection group. Hisham Mehanna, MBChB, PhD, of the University of Birmingham and the Warwickshire Head and Neck Clinic in England, commented that "Elective neck dissection is the standard, especially for oral cancer. Sentinel node biopsy is an accepted technique as there have been large series that show benefit, but there has never been a head-to-head study with the standard of [...]

Less intense treatment safe for HPV+ throat cancer

Source: www.miragenews.com Author: public release, University of Pittsburgh School of Medicine A less intense treatment for human papillomavirus positive (HPV+) throat cancer—using robotic surgery followed by low-dose radiation—could provide as much benefit as standard higher-dose radiation and chemotherapy while preserving a patient’s throat function, and with potentially less toxicities, according to researchers at UPMC Hillman Cancer Center and Yale Cancer Center. The results of their randomized phase two clinical trial will be presented virtually this week at the American Society of Clinical Oncology (ASCO) annual meeting during the Head and Neck Oral Abstract Session (Abstract 6500). “These results present a promising deintensification approach that has proven to be safe in patients with intermediate risk, locally advanced oropharynx cancer,” said Robert Ferris, M.D., Ph.D., director, UPMC Hillman Cancer Center and a surgical oncologist specializing in head and neck cancer, who was lead investigator of the trial. The results are not yet published in a peer-reviewed journal. About 60% of oropharynx cancer, in which cancer cells form in the back of the throat, base of the tongue and tonsils, is associated with HPV infection. The incidence has been increasing in recent years, especially in individuals under the age of 45. Following robotic surgery, patients with HPV-associated throat cancer would typically undergo high dose radiation and chemotherapy. While robotic surgery allows for more precise and optimal preservation of the organs and surrounding tissue, there is still concern with the toxicities from the chemotherapy and consequences of tissue damage from radiation therapy, particularly in [...]

Vaping e-cigarettes could increase the risk of oral disease, study finds

Source: technology.inquirer.net Author: staff New American research has found that individuals who use e-cigarettes could be at risk of developing oral diseases in the future, which could range from gum disease to cancer. Carried out by researchers at The Ohio State University, the new study looked at a group of 123 people with no signs of oral disease. The group included 25 smokers, 25 non-smokers, 20 e-cigarette users, 25 former tobacco smokers who used e-cigarettes and 28 people who smoked both tobacco cigarettes and e-cigarettes. The team collected plaque samples taken from under the gums of the participants to analyze the bacteria in this part of the mouth; bacteria here is the last line of defense against disease as it is the least likely to be disrupted by environmental changes in the mouth, such as food, toothpaste and tobacco. The researchers then carried out DNA deep sequencing of the bacteria’s genomes to identify what types of microbes were living in participants’ mouths and what their functions were. The findings, published in the journal Science Advances, showed that although the e-cigarette users didn’t have signs of active disease, their oral bacteria composition was similar to that of people with severe periodontitis, a severe gum infection that can lead to health problems such as tooth loss, and, if left untreated, is a risk factor for serious conditions such as heart and lung disease. The effect of e-cigarette smoking was also seen with or without nicotine, which the researchers say suggests that it [...]

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