2/27/2006 East Lansing, MI Barbara A. Conley Journal of Clinical Oncology, Vol 24, No 7 (March 1), 2006: pp. 1023-1025 Treatment of advanced squamous cell cancers of the head and neck (HNSCC) can be a frustrating endeavor. Early diagnosis may be missed by delay on the part of patients or their physicians and dentists. Patients are often elderly and have multiple medical or social comorbidities. HNSCC is an interdisciplinary disease, with optimum management requiring the input of the medical, radiation, and surgical oncologist, as well as pathologist, dentist, speech pathologist, social worker, and a dedicated home caregiver. The necessary specialists for optimum management may not be present near the patient's home, necessitating ad hoc clinical teams or further delay and dislocation of the patient and caregiver for an extended treatment period. Numerous phase II and phase III studies have been performed with the hope of improving survival and preserving organ function in locally advanced disease. We now know that survival is improved by radiation administered concurrent with chemotherapy, but there are added toxicities.1 We also know that radiation with chemotherapy can result in survival that approximates the survival obtained by radical surgery followed by radiation therapy, especially if surgical salvage is performed at early signs of residual or recurrent disease.2,3 We know less about what the optimal radiation regimen or chemotherapy regimen should be for an individual patient. Currently, standard therapy for locally advanced HNSCC could be radiation administered daily, twice daily, or in a concomitant boost regimen, with or [...]

2/27/2007 Norfolk, VA Nancy Young HamptonRoads.com Freddie Cano had cancer. He doesn't anymore. In 1998, he noticed a lump on his neck. It turned out to be a tumor at the base of his tongue that wrapped all the way around his left carotid artery. Surgery, chemotherapy, radiation and success followed. The cancer was killed. But the treatment that vanquished the cancer also destroyed Cano's salivary glands, so he constantly drinks water to keep his mouth from getting dry. It takes longer to eat, because of scar tissue in his throat that must periodically be thinned. For a time after the treatment, one foot "dropped" when he walked. "The chemo was short-circuiting the brain waves to my feet." The dream, Cano said, is "the treatments end and everything is fine again. It doesn't happen." Like many cancer survivors, he's not complaining about the side effects. The Norfolk resident is just happy about the main effect: He's alive and making the most of it. He recently celebrated his 60th birthday by getting his first tattoo, a Navy anchor, on his left biceps. But whether they complain or not, there's growing concern that cancer survivors are not getting the care they need to live the fullest lives possible. In the past few years, national organizations including the Institute of Medicine and the Lance Armstrong Foundation have called for more systematic long-term follow-up for adult cancer survivors. In the United States, men have a nearly 50-50 chance of developing cancer in their lifetimes, [...]

2/25/2006 Taiwan P.N. Chen et al. This Article Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity. Here, we provide molecular evidence associated with the anti-metastatic effect of silibinin by showing a marked inhibition of the invasion and motility of SCC-4 tongue cancer cells, with 89% and 66.4% of inhibition, respectively, by 100 µM of silibinin. This effect was associated with a reduced expression of MMP-2 and u-PA, together with an enhanced expression of TIMP-2 and PAI-1. Silibinin also exerted an inhibitory effect on the phosphorylation of ERK1/2. Additionally, pre-treatment of SCC-4 cancer cells with 10 and 20 µM of U0126, a specific MEK inhibitor, resulted in a reduced expression of MMP-2 (18.7 and 51.4%) and u-PA (19.2 and 48.9%) concomitantly with a marked inhibition of cell invasion (13.7 and 45.7%). Finally, silibinin was evidenced by its inhibition of the metastasis of Lewis lung carcinoma (LLC) cells in vivo. These results suggested that silibinin can reduce the invasion and metastasis of tumor cells, and such a characteristic may be of great value in the development of a potential cancer therapy. Authors: P.-N. Chen1,2, Y.-S. Hsieh1,a, C.-L. Chiang2, H.-L. Chiou3, S.-F. Yang1, and S.-C. Chu2,a Authors' affiliations: 1 Institute of Biochemistry, 2 Department of Food Science, Central Taiwan University of Science and Technology, No. 11 Pu-tzu Lane, Pu-tzu Road, Taichung 406, Taiwan 3 School of Medical Technology, Chung Shan Medical University, No. 110, Section 1, Chien Kuo N. Road, Taichung 402, Taiwan; and

2/23/2006 Larchmont, NY press release Genetic Engineering News (www.genengnews.com) ImClone Systems Incorporated today issued the following statement regarding the announcement that Merck KGaA, Darmstadt, Germany, has received a positive opinion from the Committee for Medicinal Products for Human Use (CHMP), the scientific committee of the EMEA (European Medicines Agency), for its application to extend the use of ERBITUX(Cetuximab), an IgG1 monoclonal antibody, to the treatment of squamous cell carcinoma of the head and neck (SCCHN): "We are pleased that our partners, Merck KGaA, may soon be able to offer ERBITUX to head and neck cancer patients in the European Union. This is the first new modality of treatment for this disease state since chemoradiation began use over thirty years ago," stated Eric K. Rowinsky, M.D., Chief Medical Officer of ImClone Systems. The CHMP opinion recommends marketing authorization by the European Commission for the use ERBITUX in combination with radiation in patients with locoregionally advanced SCCHN. The license application is based on the results from a randomized, international phase III trial (IMCL-9815), conducted by ImClone Systems and Merck KGaA, which examined the impact of combining ERBITUX with radiation on locoregional control and overall survival in 424 patients with locally or regionally advanced SCCHN. About Head and Neck Cancer In Europe alone, around 100,800 people are diagnosed with head and neck cancer and almost 40,000 die from the disease every year.(1) Head and neck cancer is the sixth most frequently occurring cancer worldwide.(2) Head and neck cancer includes cancers of the tongue, [...]

2/23/2006 Tampa Bay, FL Christine R. Vaughn Largo Leader (www.thnweekly.com) For the estimated 15 million people in the U.S. diagnosed with dysphagia, the act of swallowing is a tremendous challenge. Taking a bite of a juicy steak or savoring the taste of a warm chocolate chip cookie is an unattainable pleasure of the past for such patients. It was a tedious recovery for Phyllis Hamel, a former patient at East Bay Nursing Center. After respiratory failure, Hamel required a tracheotomy, which affected her ability to swallow. She could not eat or drink without choking. Most of her nutrition was given through a feeding tube inserted in her stomach. At the nursing center, Hamel was treated with VitalStim Therapy, which is used in the treatment of swallowing disorders. Her muscles were re-educated to help her swallow properly. “I noticed a difference after just a few sessions,” she said. At the end of 15 sessions, Hamel was able to return home, where she is eating all her favorite foods again and has a nearly complete return of her muscle function. The treatment was developed by Marcy Freed, a speech-language pathologist. The procedure utilizes electrodes placed on the neck, similar to those used during an EKG. The device sends a low-current electrical impulse that stimulates the nerve supply to the oropharyngeal muscles. Patients receive up to one hour of therapy each day until their swallowing function is restored to an acceptable level. It is the only such method cleared by the FDA to [...]

2/22/2006 Vienna, VA press release PRNewswire (prnewswire.com) CEL-SCI Corporation announces positive results from a long-term follow-up study of head & neck cancer patients treated with its drug Multikine(R) in a Phase II clinical trial. The follow-up study indicated that Multikine treatment resulted in a substantial increase in the survival of patients. In addition, Multikine treatment also improved local regional control of the patients' tumors. Improved local regional control of the tumor is considered by many surgeons and oncologists to be an important measurement of the success of a head & neck cancer drug. Both survival and local regional control of the tumor are stated endpoints in CEL-SCI's planned Phase III clinical trial. The Phase II study, which used the same Multikine treatment protocol as proposed for the Phase III trial, included advanced primary head & neck cancer patients who were scheduled for their first cancer treatment. The Multikine treatment was administered for 3 weeks prior to the standard treatment for head & neck cancer, surgery or surgery plus radiation/chemotherapy. Results from this study were published in a leading cancer publication, the Journal of Clinical Oncology (Timar et al, JCO, 23(15): May 2005) The median follow-up period for the patients was 3.2 years. The results of the Phase II trial follow-up study showed that the Multikine-treated patients had substantially increased survival rates and achieved a higher rate of 2-year local regional control as compared to the survival and the 2-year local regional control rates published in the scientific literature (39 clinical [...]

2/21/2006 Poland D Mielcarek-Kuchta et al. Otolaryngol Pol, January 1, 2005; 59(5): 683-8 Aim of the Study: The evaluation of the importance of the prognostic of sentinel node biopsy in head and neck cancer with N0 neck. Material and Methods: Prospective study included 19 patients with squamous cell carcinoma of the oral cavity, pharynx and larynx without enlarged lymph nodes in ultrasound examination (N0). The study was carried out in ENT Department of Medical University in Pozna between 2001-2004. Each patient underwent lymphoscintigraphy after administration of radionuclide Technetium 99m (Nanocol). In case of detection of sentinel node, blue dye was injected into the tumour bed and dyed lymph nodes were removed. The specimens were evaluated histologically and immunohistochemically. The patients are still followed up. Results: So far 19 patients were included in our study. The tumours were classified from T1 to T4. In each case sentinel nodes were located. Metastases in removed lymphnodes were found in 5 patients. In one of them regional recidive was observed after 5 month. In the other patients no changes were found in follow up examination. In 14 cases in histological examination no metastases were found in sentinel nodes. In this group in one case local recurrence was observed and in another two lymph nodes metastases were confirmed. In patients with positive sentinel node elective neck dissection was performed. So far immunohistochemical examination has not provided us with any vital information. In no case with negative sentinel node we found micrometastases with the use of [...]

2/19/2006 St. Louis, MO Dan Ferber ScienceNow Daily News (sciencenow.sciencemag.org) Human saliva contains telltale markers of breast cancer, diabetes, and an autoimmune disease, according to new results presented here today at annual meeting of the American Association for the Advancement of Science (which publishes ScienceNOW). If the findings are validated in clinical trials, spit tests could make up a new non-invasive way to quickly diagnose these diseases. To form saliva, the salivary gland uses the soluble component of blood, known as serum, as its starting material. Physicians have dreamed for years of using saliva-based tests instead of blood tests. Among other conveniences, such a shift would remove the need for needles. Last year, oral biologist David Wong of the University of California, Los Angeles, and his colleagues reported progress toward one saliva test, showing that levels of four of the 3000 messenger RNA molecules typically found in human saliva were consistently elevated in oral cancer patients, but not in healthy patients. Recently, the UCLA team had an accuracy of 94% when attempting to diagnose oral cancer in 320 patients using these 4 RNAs as markers. But oral cancer was just the beginning. At the meeting yesterday, Wong reported that his team has also examined the saliva from groups of 10 people with either type II diabetes, breast cancer, or Sjogren's syndrome, an autoimmune disease that afflicts mostly women and destroys the salivary gland and pancreas. By using a gene chip to compare the salivary RNA of people in each disease [...]

2/19/2006 Thousand Oaks, CA Ralph W. Moss, PhD Integrative Cancer Therapies, Vol. 5, No. 1, 63-82 (2006) In September 2005, CA: A Cancer Journal for Clinicians published a warning by Gabriella D’Andrea, MD, against the concurrent use of antioxidants with radiotherapy and chemotherapy. However, several deficiencies of the CA article soon became apparent, not least the selective omission of prominent studies that contradicted the author’s conclusions. While acknowledging that only large-scale, randomized trials could provide a valid basis for therapeutic recommendations, the author sometimes relied on laboratory rather than clinical data to support her claim that harm resulted from the concurrent use of antioxidants and chemotherapy. She also sometimes extrapolated from chemoprevention studies rather than those on the concurrent use of antioxidants per se. The article overstated the degree to which the laboratory data diverged in regard to the safety and efficacy of antioxidant therapy: in fact, the preponderance of data suggests a synergistic or at least harmless effect with most high-dose dietary antioxidants and chemotherapy. The practical recommendations made in the article to avoid the general class of antioxidants during chemotherapy are inconsistent, in that if antioxidants were truly a threat to the efficacy of standard therapy, antioxidant-rich foods, especially fruits and vegetables, ought also be proscribed during treatment. Yet no such recommendation is made. Furthermore, the wide-scale use by both medical and radiation oncologists of synthetic antioxidants (eg, amifostine) to control the adverse effects of cytotoxic treatments is similarly overlooked. In sum, this CA article is incomplete: there [...]

2/19/2006 The Netherlands Paul Roepman et al. Cancer Research 66, 2361-2366, February 15, 2006 Genome-wide mRNA expression measurements can identify molecular signatures of cancer and are anticipated to improve patient management. Such expression profiles are currently being critically evaluated based on an apparent instability in gene composition and the limited overlap between signatures from different studies. We have recently identified a primary tumor signature for detection of lymph node metastasis in head and neck squamous cell carcinomas. Before starting a large multicenter prospective validation, we have thoroughly evaluated the composition of this signature. A multiple training approach was used for validating the original set of predictive genes. Based on different combinations of training samples, multiple signatures were assessed for predictive accuracy and gene composition. The initial set of predictive genes is a subset of a larger group of 825 genes with predictive power. Many of the predictive genes are interchangeable because of a similar expression pattern across the tumor samples. The head and neck metastasis signature has a more stable gene composition than previous predictors. Exclusion of the strongest predictive genes could be compensated by raising the number of genes included in the signature. Multiple accurate predictive signatures can be designed using various subsets of predictive genes. The absence of genes with strong predictive power can be compensated by including more genes with lower predictive power. Lack of overlap between predictive signatures from different studies with the same goal may be explained by the fact that there are more predictive [...]