8/30/2005 staff CancerConsultants (cancerconsultants.com) According to a study published in the Journal of Clinical Oncology, patients with head and neck cancers are more likely to benefit from accelerated radiation therapy if a high proportion of their cancer cells have receptors for epidermal growth factor, a growth factor that plays a role in cell proliferation and survival. Approximately 40,000 people in the United States are diagnosed with head and neck cancer every year. Cancers of the head and neck include cancers of the nasal cavity and sinuses, mouth, and throat. According to the American Cancer Society, 11,000 people died from head and neck cancer in 2004. Standard treatment for head and neck cancer is largely determined by the stage (extent to which the cancer has spread) and by the specific locations within the head or neck area where the cancer has spread. Among head and neck cancer patients receiving radiation therapy, one reason for treatment failure is the accelerated regrowth of cancer cells that can occur during fractionated radiation therapy (radiation therapy that is split into smaller doses and administered over the course of several days). To overcome this problem, researchers have investigated accelerated radiation therapy schedules. According to these schedules, higher daily doses of radiation are given over fewer days. Some patients may be more likely than others to benefit from these accelerated schedules. One factor that may influence patient response to different radiation therapy approaches is the presence of epidermal growth factor receptors (EGFR) on cancer cells. Epidermal growth [...]

8/30/2005 Frankfurt, Germany press release Bloomberg News (bloomberg.com) Merck KGaA, which owns non-U.S. rights to ImClone Systems Inc.'s Erbitux cancer treatment, submitted to regulators new data on the drug's ability to treat head-and-neck cancers, aimed at boosting its sales in Europe. It submitted its application to the European Medicines Agency and the Swiss regulator Swissmedic, the Darmstadt, Germany-based drugmaker said today in an e-mailed statement. ImClone and its marketing partner Bristol-Myers Squibb Co. have applied to the U.S. Food and Drug Administration to extend the drug's use in the U.S. Merck KGaA Chief Executive Bernhard Scheuble, who negotiated European rights to the drug from ImClone in 1998 for $60 million, aims to widen its use beyond colon cancer, for which it's approved in Europe and the U.S. Merck's sales from Erbitux came to 94 million euros ($115.5 million) during the first half of the year, compared with the 77 million euros it generated in all of 2004, its first year on the market. Erbitux is approved for patients whose bowel cancer has spread and who aren't benefiting from other treatments. The drug was approved in Europe and the U.S. on the basis of phase II clinical data that showed its ability to shrink tumors. Three phases of studies are generally required for regulatory approval. Difficult to Treat The additional sales potential from head-and-neck cancers, which are notoriously difficult to treat, is lower than for other cancer types, Groschke said in an Aug. 29 telephone interview. ``This indication is significantly smaller [...]

8/29/2005 Denmark staff The Lancet Oncology, August, 2005 reported by Newswise.com Danish scientists have identified which head and neck cancer patients will benefit from additional drug treatment during radiotherapy, in a paper published online today by The Lancet Oncology. Tumours that have low concentrations of oxygen (hypoxia) are resistant to radiotherapy. A drug called nimorazole (a hypoxia radiosensitiser) can improve the outcome of radiotherapy for patients with these types of tumours. However, at the moment there is no way to identify people with tumours that lack oxygen, who need this additional drug treatment, from those that only need radiotherapy. Researchers knew that the concentration of a protein called osteopontin was associated with tumours that lacked oxygen. Jens Overgaard (Aarhus University Hospital, Denmark) and colleagues assessed whether blood concentration of osteopontin could predict patients’ responses to nimorazole. The investigators measured the concentration of osteopontin in 320patients on a trial comparing nimorazole and radiotherapy with placebo and radiotherapy. Patients were grouped into high, intermediate, and low concentrations of osteopontin and the team recorded their outcome. They found that patients with high concentrations of the protein assigned placebo had a poorer prognosis than those with high concentrations on nimorazole. Professor Overgaard states: “. . . high plasma concentration of osteopontin predicted clinically relevant, modifiable hypoxia-induced resistance to radiotherapy, and this finding might help to identify patients who will benefit from treatment with a hypoxia modifier such as nimorazole during radiotherapy. By contrast, use of nimorazole was not effective in patients with low or [...]

8/29/2005 editorial Heraldnet (www.heraldnet.com) Perhaps country singer Gretchen Wilson is confused by her status as a role model; it doesn't mean she should model how to roll a wad of chewing tobacco into her lower lip. For her recent tobacco promotion, the country singer is now joining an ever-expanding group of not-so-worthy pop idols. Wilson, 32, a role model among teenage females who frequent her concerts, has been flashing a can of chewing tobacco to the crowd during her recent performances of new song "Skoal Ring," a song simply about the wonders of chew. Glamorizing chewing tobacco to an audience of impressionable young fans goes a long way to undermine every anti-tobacco campaign created to convince youths to avoid the cancer-causing habit. On stage, Wilson's gestures with her small can of tobacco may seem innocent and playful, but they can be detrimental. The female population has been a growing victim of lung cancer for decades. About 21 percent of U.S. females are smokers, according to the Center for Disease Control and Prevention, far from the U.S. goal of cutting the number of smokers to 12.5 percent by 2010. Lung cancer rates increased 600 percent among women in the second half of the 20th century, and deaths from lung cancer now significantly outnumbers deaths from breast cancer. Smokeless tobacco, a more glamorized, if shocking, form of ingesting tobacco, will only continue this trend. This stiff-lower-lip form of tobacco ingestion dramatically increases a person's chance of getting oral cancer. Unfortunately, Wilson isn't [...]

8/26/2005 Detroit, MI Sharon Terlep Detroit News (www.detnews.com) A test done with a device that's essentially a toothbrush can help fight oral cancer -- one of the stealthiest, deadliest and costliest cancers plaguing minorities in Metro Detroit. The simple test, called a brush biopsy, can detect oral cancer long before it takes hold, saving patients' lives and sparing them costly medical bills. Oral health care experts hope the test will become as prevalent as mammograms, which have become a key to early detection of breast cancer. Many of those most at risk for oral cancer don't know an exam exists, however. Delta Dental Plans of Michigan and the Detroit Oral Cancer Prevention Project have teamed up on a regional campaign to encourage people, especially African-American men, who are at the highest risk for the disease, to get oral cancer tests. "It's a stealth problem that no one talks about," said Amid Ismail, director of the Detroit Oral Cancer Prevention Project and University of Michigan professor of dentistry. "It is unacceptable that the problem of oral cancer is not publicly known in Detroit." Oral cancer kills about 30,000 Americans a year and is especially prevalent in Detroit. The city each year ranks among the top five metropolitan areas for oral cancer rates. Smoking, drinking alcohol and exposure to ultraviolet rays are all risk factors for oral cancer. Donald Jones worried for weeks because his tongue was changing color. The 66-year-old Detroiter decided to get a test, which was negative, after seeing [...]

8/26/2005 England C. Scully British Dental Journal (2005); 199, 203-207 The incidence of oral cancer amongst young adults is increasing in many European and high incidence countries. Most oral cancer is aetiologically linked to the use of tobacco and/or alcohol but nearly two decades ago, we produced the first evidence for the presence of viral nucleic acids in oral squamous cell carcinoma (OSCC) tissues, hypothesising that there may be a viral involvement in at least some OSCC. Subsequently, human papilloma viruses (HPV) in particular have been implicated in OSCC. Antibody responses to HPV are seen and HPV-DNA detected in tumours by us and many others, the virus being mainly HPV-16, the genotype associated with ano-genital cancer. Recent studies have indicated that HPV may be aetiologically important particularly in some types of oropharyngeal cancer, at least in tonsillar carcinogenesis, and may represent an alternative pathway in carcinogenesis to the established factors of tobacco and alcohol. Studies of patients with OSCC have suggested possible sexual transmission of HPV. Author's affiliation: Dean, Director of Studies and Research, Eastman Dental Institute for Oral Health Care Sciences, University of London, 256 Gray's Inn Road, London, WC1X 8LD OCF Note: Welcome to the 21st century doctors....OCF reported peer reviewed articles with this conclusion more than a year ago.

8/26/2005 Hampshire, England Fleur Pijpers, Richard Faint & Nish Saini Nature Reviews Drug Discovery 4, 623-624 (2005); Unmet needs across the oncology market remain high, with most traditional therapies representing a trade-off between levels of specificity, efficacy and toxicity. The development of therapeutic cancer vaccines, designed to confer active, specific immunotherapy directed against tumour-associated antigens (TAAs), could be the ideal solution for the successful eradication of some cancers. Cancer vaccines offer the prospect of high specificity, low toxicity and prolonged activity. However, although there is a solid technical and scientific rationale behind the development of vaccines, this theory has yet to be consistently translated into clinical practice and, to date, most cancer vaccines have been associated with high rates of clinical failure. Beyond scientific hurdles, the relative immaturity and lack of precedence in the cancer vaccine market has also brought to light an entirely new spectrum of clinical, regulatory and strategic challenges. Challenges in an unprecedented market From a clinical perspective, cancer vaccines are most likely to complement current oncology therapies rather than serve as replacements. However, some cytotoxics have known immunosuppressive properties, and therefore the optimal scheduling of chemotherapy administration needs to be defined in order to avoid compromising the activity of therapeutic cancer vaccines. The design of clinical trials for cancer vaccines and the regulatory assessment of vaccine technologies raise additional issues: as a result of their mode of action and hypothetical prolonged antitumour activity, the optimal assessment of cancer vaccines might require a shift away from the [...]

8/25/2005 California Allison Bruce Ventura County Star (venturacountystar.com) Amgen started this year with new drug Kepivance, which received U.S. Food and Drug Administration approval at the end of 2004. Kepivance is awaiting approval for sale in the European Union. Company spokeswoman Trish Hawkins said the drug is doing well in the U.S. market, where it is approved to treat patients with blood cancers who require a bone marrow transplant. The company is testing the drug for patients with head and neck cancer or a type of lung cancer. Kepivance treats severe oral mucositis, a sometimes debilitating side effect in patients undergoing chemotherapy. Sometimes mouth sores become so severe patients cannot swallow their own saliva, Hawkins said. Amgen said the potential market could be 11,000 patients in the U.S. "It's the first and only therapy approved to treat and reduce severe oral mucositis," she said of Kepivance. "It's the first thing physicians have even had available to help manage mucositis."

8/25/2005 London, England Jan Battles The Times of London (222.timesonline.co.uk) Cancer of the mouth and throat, normally found in elderly male smokers, is emerging at alarming levels in young non-smoking Irish women. A study of patients treated at St James’s hospital in Dublin has found that an increasing number of women under 30, who don’t smoke or drink, are getting the cancer. Researchers do not know what is behind the emergence of the illness in young female non-smokers, but diet may be a factor. They want to investigate whether foodstuffs that have come on the market in the past few decades, including carbonated drinks and chewing gum, could be a cause. Oral and throat cancer is aggressive, and is the sixth most common tumour worldwide. Among those who have died from it are George Harrison, the former Beatle, and John Diamond, a British journalist, who had to have most of his tongue removed after suffering from a tumour. Despite advances in treatment the prognosis remains poor, with little improvement in five-year survival during the past four decades. The death rate associated with it is high as the cancer is often discovered late in its development. The incidence of the disease worldwide has increased since the 1960s. Smoking is the main risk factor, while alcohol consumption also has an influence. The researchers examined medical records of 30 patients under 40 diagnosed with mouth or throat cancer at St James’s hospital in Dublin between 1993 and 2003. They compared them with 100 [...]

8/24/2005 Batlimore, MD Shahnaz Begum et al. Clinical Cancer Research Vol. 11, 5694-5699, August 15, 2005 Purpose: Human papillomavirus 16 (HPV-16) has been implicated as a causative agent in a subset of head and neck squamous cell carcinomas (HNSCC). This study was undertaken to discern the distribution and timing of HPV viral integration during tumorigenesis of the upper respiratory tract. Experimental Design: A tissue array was assembled from a consecutive group of 176 patients with HNSCCs. The array was evaluated by HPV-16 in situ hybridization and p16 immunohistochemistry. Patients with HPV-positive tonsillar cancers who had undergone bilateral tonsillectomies were selected for more complete mapping of viral integration. Results: HPV-16 was detected in 38 of the 176 (22%) cases by in situ hybridization. When stratified by site of origin, HPV-16 was detected in 37 of 45 cancers arising from the oropharynx but in only 1 of 131 tumors arising from nonoropharyngeal sites (82% versus 0.8%, P < 0.00001). P16 expression was associated with the presence of HPV-16: 31 of 38 HPV-positive tumors exhibited p16 expression, whereas only 9 of the 138 HPV-negative tumors were p16-positive (82% versus 6%, P < 0.00001). In the bilateral tonsil sections, hybridization signals were strictly limited to the invasive cancers and associated dysplasias. P16 staining was widely distributed throughout the nonneoplastic crypt epithelium of individuals with and without tonsillar cancer. Conclusions: HPV-16 is strongly associated with carcinomas arising from the oropharynx, and integration is tightly coupled to the neoplastic process. Viral integration does not occur as [...]