High-risk sexual behavior alone may not increase risk for oropharyngeal cancer

Source: www.healio.com Author: Matthew Shinkle High-risk sexual behavior may not be the primary contributor to the development of oropharyngeal squamous cell carcinoma, according to data published in Cancers. Although patients with oropharyngeal squamous cell carcinoma appear more likely to self-report having their first sexual intercourse before age 18 years, study findings did not show an association between high-risk sexual behavior and the disease, researchers wrote. “The consistent absence of high-risk sexual behavior in the overwhelming majority of HPV-driven oropharyngeal squamous cell carcinomas stands against the argument of a lowered frequency of HPV-driven oropharyngeal squamous cell carcinoma in our cohort ... that would have lowered the chance to detect an impact on high-risk sexual behavior on the development of HPV-driven oropharyngeal squamous cell carcinoma,” Gunnar Wichmann, PhD, head of the ENT ResearchLab at University of Leipzig Medical Center, and colleagues wrote. Background and methodology Certain studies have provided evidence to establish a potential link between high-risk sexual behavior, the persistence of HPV DNA in saliva and the presence of oncogenic high-risk HPV subtypes in oropharyngeal squamous cell carcinoma. Researchers conducted a case-control study of patients with oropharyngeal squamous cell carcinoma and propensity score-matched unaffected controls from a large population-based German cohort study. The investigators interviewed patients and provided them with questionnaires on main risk factors — including age, sex, tobacco smoking and alcohol consumption — as well as logging information regarding sexual behavior categories. The study included 329 patients with head and neck squamous cell carcinoma, of whom 317 patients answered [...]

Cancer experts warn about wave of HPV-related cancers in adults

Source: www.eurekalert.org Author: Ohio State University Wexner Medical Center Experts are concerned about rapidly rising rates of HPV-related throat and mouth cancers, noting that if this trend continues they could quickly be among the most common forms of cancer in adults between ages 45 and 65. Recent estimates suggest that middle throat cancer (known medically as oropharyngeal cancer) may become one of the top three cancers among middle-aged men in the United States by 2045, and the most common form of cancer among elderly men in the next 10 years. According to Matthew Old, MD, a head and neck surgeon at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James), this rise of middle throat cancers in this age group is due to the direct impact of human papillomavirus (HPV) infection before modern vaccines were introduced in 2006. HPV is a large group of viruses spread through skin-to-skin and oral contact that occurs during sexual activity. The virus spreads easily, and an estimated 98% of the population has been exposed to it. HPV can remain dormant for decades. High-risk strains of the virus have long been linked to increased risk of cervical cancer; however, data from the past decade shows high-risk HPV is also strongly linked to cancers of the head and neck (mouth, base of tongue and throat). In 2006, Gardasil introduced an HPV vaccine, which is administered in youth between the ages of 9 and [...]

Mayo Clinic Minute: Innovative technology to treat head and neck cancers

Source: www.telegraphherald.com Author: Deb Balzer, Mayo Clinic News Network In the U.S., HPV is linked to about 70% of throat and mouth cancers. And more than 70% of those cancers are diagnosed in men, according to the Centers for Disease Control and Prevention. Treatment for throat and mouth cancers, also referred to as oropharyngeal or head and neck cancers, depends on location and stage of the cancer as well as other factors. Dr. Phillip Pirgousis, a Mayo Clinic head and neck surgeon, says patients now have safer, less invasive surgical treatments for head and neck cancers available to them thanks to innovative technology. “The tonsils in the back of the throat and the lymph node tissue in the back of the tongue,” Pirgousis says. And cancers in these two locations can be a challenge. “Many of the challenges are often related to the location of the primary tumor because the throat and voice box area are very difficult to get access to,” he says. That’s where innovation with robotics allows for better tumor visualization, better lighting and better outcomes in terms of complete tumor removal. “We’re talking about big, open surgeries versus minimally invasive surgeries where we can access these difficult locations with making facial incisions,” he says. “And having less impact on breathing, speaking, swallowing and communicating. The surgical robot has improved the ability for us to not only completely remove tumors, but to remove them safely,” Pirgousis says. Transoral robotic surgery Transoral robotic surgery is a minimally invasive [...]

HPV testing, p16 IHC may be needed for oropharyngeal cancer trials

Source: www.cancernetwork.com Author: Russ Conroy Human papillomavirus and p16 discordance may correlate with a worse prognosis for oropharyngeal cancer, according to data from an individual patient data analysis. Patients with discordant p16-negative, human papillomavirus (HPV)–positive or p16-positive, HPV-negative oropharyngeal cancer had a significantly worse prognosis compared with patients who had p16-positive and HPV-positive disease and a better prognosis compared with those who have p16-negative and HPV-negative disease. The data suggest the need for routine p16 immunohistochemistry and mandated HPV testing in clinical trials for oropharyngeal cancer, according to findings from the HNCIG-EPIC-OPC individual patient data analysis. The 5-year overall survival (OS) rate was 81.1% (95% CI, 79.5%-82.7%) for patients with p16-positive, HPV-positive disease; 40.4% (95% CI, 38.6%-42.4%) for those with p16-negative, HPV-negative disease; 53.2% (95% CI, 46.6%-60.8%) for those with p16-negative, HPV-positive disease; and 54.7% (95% CI, 49.2%-60.9%) for those with p16-positive, HPV-negative disease. Additionally, 5-year disease-free survival (DFS) was 84.3% (95% CI, 82.9%-85.7%), 60.8% (95% CI, 58.8%-62.9%), 71.1% (95% CI, 64.7%-78.2%), and 67.9% (95% CI, 62.5%-73.7%) for each respective patient group. Investigators of this multi-center, international individual patient data analysis included retrospective and prospective cohorts with a minimum size of at least 100 patients with primary squamous cell carcinoma of the oropharynx. Patients underwent cross-sectional imaging; histological confirmation by biopsy; and treatment with surgery, radiotherapy, chemotherapy, or combination therapy for oropharyngeal cancer. The primary end points of the analysis included OS, DFS, and the proportion of patients in the overall cohort who showed different p16 and HPV result combinations. [...]

Tech innovation offers hope for head/neck cancer treatment

Source: www.miragenews.com Author: University of Colorado Anschutz Medical Campus Over the past decade, human papillomavirus (HPV) has increasingly been identified as a significant cause of certain head and neck cancers – for example, evidence suggests it causes 70% of oropharyngeal cancers in the United States. Further, over the past three decades, incidence of HPV-driven cancers has increased substantially worldwide and in the U.S. While there are well-established screening tools, as well as vaccines, for HPV-driven cancers such as cervical cancer, there are fewer resources for HPV-driven head and neck cancers. As a result, researchers are working with a sense of urgency to develop innovative therapeutics to treat them. One groundbreaking therapeutic has shown significant promise in a phase 1 clinical trial led by Antonio Jimeno, MD, PhD, co-leader of the University of Colorado Cancer Center Developmental Therapeutics Program and the CU Cancer Center head and neck cancer SPORE grant. Research results published today show that a microfluidic squeezing technology used on peripheral blood mononuclear cells (PBMCs), a type of immune cell, helps stimulate anti-tumor activity in a subtype of HPV16-positive cancers, including head and neck, cervical, and anal cancers. “This technology is quite novel,” Jimeno explains. “As opposed to other cell therapies that require a patient’s cells to be genetically modified, this involves a different way of manipulating cells that does not lead to genetic modifications. It makes the process faster and perhaps more agile as to what you can direct the cells against.” “Sending them to boot camp” This [...]

HPV, PD-L1 move to the forefront of biomarkers for head and neck cancers

Source: www.onclive.com Author: Silas Inman The frontline treatment for patients with head and neck cancer is largely dominated by surgery and radiation therapy, with ongoing efforts to find biomarkers and other strategies to better individualize care. The leading markers used to tailor therapy are human papillomavirus (HPV) status, which typically signals the aggressiveness of the disease, and PD-L1 expression level, which may help guide selection of immune checkpoint inhibitor (ICI) therapy. These markers are gaining notice in different settings. HPV status has broad applicability across head and neck cancers, whereas the clinical utility of PD-L1 expression remains a more nuanced question. HPV-Positive Tumors Approximately 70% of head and neck cancers, specifically oropharyngeal cancers, are positive for HPV, with most cases associated with the HPV-16 subtype. These tumors appear most commonly in nonsmoking White men with a mean age of diagnosis of 60.3 years (SD, 10.8) for oropharyngeal cancer and 63.2 years (SD, 12.7) for other types of head and neck cancers.1,2 Moreover, HPV-positive tumors typically fall into a low- to intermediate-risk category, with 5-year overall survival (OS) outcomes far superior compared with rates for HPV-negative tumors, which are typically caused by smoking. For patients with HPV-associated head and neck cancers, the 5-year OS rate ranges from 75% to 80% compared with 45% to 50% for those with HPV-negative tumors.3 In many cases, although the prognosis is more favorable for patients with HPV-positive tumors, the treatment is the same as it is for HPV-negative tumors. However, with the introduction of ICIs [...]

Parsing the genetic drivers of head and neck cancers

Source: today.ucsd.edu Author: UC San Diego press release Head and neck cancer, which kills more than 400,000 persons worldwide each year, has multiple causes. The human papilloma virus (HPV), a sexually transmitted infection, is one, but the most common and lethal subtype are HPV-negative head and neck cancers, which account for 3 percent of all malignancies in the United States and 15,000 deaths annually. “Typically, head and neck cancers begin in the squamous cells that line the mucosal surfaces, such as inside the mouth and throat and there are multiple treatment options, including surgery, radiation and chemotherapy,” said Ezra Cohen, MD, co-director of the Gleiberman Head and Neck Cancer Center at Moores Cancer Center at UC San Diego Health. “But these cancers are complex and no single treatment works for every patient every time, which is why immune checkpoint inhibitors were developed, which use antibodies to make tumor cells visible to a patient’s immune system.” Immune checkpoint therapy (ICT) first emerged in the 1990s and has progressed dramatically in recent years, but drug resistance in head and neck cancer cases remains prevalent, poorly understood and largely unidentified by current biomarker tests, said Cohen. Currently available Food and Drug Administration-approved PD-1 (a protein) immune checkpoint antibody therapy produces durable responses in 15 percent of patients with head and neck squamous cancer. The remaining 85 percent receive no benefit and may, in fact, experience severe, immune-related adverse effects.  Like other types of head and neck cancer, the HPV-negative subtype has multiple risk [...]

2022-11-17T21:39:36-07:00November, 2022|Oral Cancer News|

A shift in focus for head and neck cancer treatment

Source: www.curetoday.com Author: Marijke Vroomen Durning, RN When Cindy Stemple of Westerville, Ohio, noticed a sore on her tongue, the last thing she imagined was that she may have head and neck cancer. After all, she was only 27 years old. She finally went to see her dentist when the sore wouldn’t heal. Since Stemple didn’t have any known risk factors for head and neck cancer, the dentist didn’t expect cancer either. After trying several treatments, they decided it was time for a biopsy. Stemple still wasn’t concerned. “It wasn’t even in the realm of possible things,” she says. “I didn’t even take anybody to the appointment when I got the results and found out it was cancer because it was the furthest thing from my mind.” She received a diagnosis of stage 3 oral squamous cell carcinoma — which is a cancer that occurs in the mouth and/or throat. Tremendous Change in Head and Neck Cancer Historically, head and neck cancer, the seventh most common cancer globally, was predominantly diagnosed in older individuals and was often linked to tobacco and alcohol use. As smoking rates began to decline, so did tobacco- and alcohol-related cases among older individuals. But head and neck cancer rates began rising in another group — younger and middle-aged adults — driven by HPV infections, predominantly HPV type 16, which has been shown to be a clear risk factor for head and neck cancer as well as cervical cancer. HPV-positive oropharyngeal cancers in the United States [...]

2022-09-21T06:29:44-07:00September, 2022|Oral Cancer News|

OmniPathology announces the launch of its oropharyngeal HPV PCR test

Source: www.globenewswire.com Author: press release OmniPathology, an independent, physician-owned and operated pathology lab, today announced the launch of a new oral test for human papillomavirus (HPV) that can cause cancer. The Oral HPV Test is a lab-developed test (LDT) performed on a Roche cobas® 6800 and 8800 high-throughput platforms. The Oral HPV Test detects 14 high-risk strains of HPV. It is performed via a throat swab submitted to OmniPathology, a CLIA-certified laboratory in Pasadena, for testing. Patients who test positive are advised to undergo a thorough examination by an ear, nose, and throat (ENT) doctor and may require close follow-up. Detection and removal of early oral and oropharyngeal premalignant lesions can help significantly reduce the risk of progression to cancer. This test will be offered to primary care and GYN physicians, LGBTQIA+ clinics, dentists, oral surgeons, and ENT practices across the country as part of routine examinations of patients. “Launching this oropharyngeal HPV test is an exciting milestone for OmniPathology, especially since this is an underserved area for diagnostic testing. As an organization led by science and driven by service, OmniPathology continues to offer state-of-the-art molecular testing that can impact patient care and enhance the quality of the services our physician clients offer to their patients,” said Mohammad Kamal M.D., founder and CEO of OmniPathology. “We continue to build our testing menu to target sexually transmitted infections and other viral diseases.” Oral HPV has no symptoms and is spread through skin-to-skin contact. Risk factors for oral HPV include oral sex, [...]

NF-κB over-activation portends improved outcomes in HPV-associated head and neck cancer

Source: medicalxpress.com Author: staff, Impact Journals LLC A new research paper has been published in Oncotarget, titled "NF-κB over-activation portends improved outcomes in HPV-associated head and neck cancer." Head and neck squamous cell carcinoma (HNSCC) is a devastating disease that impairs fundamental tissues involved in respiration, phonation and digestion. HNSCC is primarily caused by exposure to either ethanol and tobacco or the human papillomavirus (HPV). Among patients with HPV+ HNSCC, there is a growing clinical demand to develop robust stratification tools to accurately identify patients with good or poor prognosis. According to the research, "While oncologic outcomes for HPV+ HNSCC are generally favorable, treatment paradigms developed for HPV-negative disease burden many survivors of HPV+ HNSCC with lifelong debilitating treatment-associated side effects. On the other hand, ~30% of HPV+ HNSCC patients exhibit a more aggressive disease course and suffer recurrence." Somatic mutations or deletions in TRAF3 or CYLD identified a subset of HPV+ HNSCC associated with improved outcome. A cross talk between canonical and non-canonical NF-κB signaling suggests that TRAF3 and CYLD affect both NF-κB pathways. "Herein, we demonstrate that an RNA-based classifier trained on tumors harboring these mutations may improve prognostic classification," state the researchers. To improve on genomic classification, the researchers designed the current study to provide a foundation for development of NF-κB related, RNA based classification strategies to better identify HPV+ HNSCC patients with good or poor prognosis that could potentially aid in future efforts towards treatment personalization. "This report validates and expands on our findings that significant [...]

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