Particular HPV strain linked to improved prognosis for throat cancer

Source: medicalxpress.com Author: provided by University of North Carolina Health Care When it comes to cancer-causing viruses like human papillomavirus, or HPV, researchers are continuing to find that infection with one strain may be better than another. In an analysis of survival data for patients with a particular type of head and neck cancer, researchers from the University of North Carolina Lineberger Comprehensive Cancer Center confirmed findings that a particular strain of HPV, a virus linked to a number of cancers, resulted in better overall survival for patients with oropharyngeal cancer than patients with other strains of the virus in their tumors. They believe their findings, reported in the journal Oral Oncology, are particularly important as physicians move to lessen treatment intensity for patients with HPV-linked oropharyngeal cancer in clinical trials to try to spare them negative side effects of radiation or drugs. They also found that a test used widely to determine patients' HPV status may not be sensitive enough to select patients for de-intensification. "What we demonstrate in this study is that the type of HPV can help us to better determine a patient's prognosis," said the study's senior author Jose P. Zevallos, MD, MPH, an associate member of UNC Lineberger and an associate professor in the UNC School of Medicine. "We think this is important because HPV positive patients do so well generally, and there's been a huge move nationally to take treatment down a couple notches to limit morbidity and side effects. The risk is that [...]

2016-09-29T08:04:03-07:00September, 2016|Oral Cancer News|

ASCO Urges Aggressive Efforts to Increase HPV Vaccination

Source: www.medscape.comAuthor: Zosia Chustecka Human papillomavirus (HPV) vaccines have now been available for 10 years, but despite many medical professional bodies strongly recommending the vaccine, uptake in the United States remains low. Data from a national survey show that about 36% of girls and 14% of boys have received the full schedule of HPV vaccines needed to provide protection (Vaccine. 2013;31:1673-1679). Now the American Society of Clinical Oncology (ASCO) has become involved, and in a position statement issued today the organization calls for aggressive efforts to increase uptake of the HPV vaccines to "protect young people from life-threatening cancers." "With safe and effective vaccines readily available, no young person today should have to face the devastating diagnosis of a preventable cancer like cervical cancer. But unless we rapidly increase vaccination rates for boys and girls, many of them will," ASCO President Julie M. Vose, MD, said in a statement. "As oncologists, we see the terrible effects of these cancers first hand, and we have to contribute to improving today's alarmingly low vaccination rates," she added. The new policy statement is published online April 11 in the Journal of Clinical Oncology. The statement notes that HPV vaccination has been previously recommended by many US medical societies, including the American Cancer Society, the American College of Obstetrics and Gynecology Committee, the American Dental Association, the American Head and Neck Society, the American Nurses Association, the American Pharmacists Association, the Association of Immunization Managers, the Society for Adolescent Medicine, and the Society of Gynecologic Oncology. [...]

2016-04-18T13:12:04-07:00April, 2016|Oral Cancer News|

Less Is More for HPV Oropharyngeal Cancer Reduced-intensity regimen clears disease in 86% of cases

Source: www.medpagetoday.comAuthor: Charles Bankhead SAN ANTONIO -- Less intense treatment of low-risk human papillomavirus (HPV)-related oropharyngeal cancer achieved a high rate of pathologic complete response (pCR) and favorable patient-reported outcomes, a preliminary trial showed. Overall, 37 of 43 (86%) patients achieved pCR with deintensified chemoradiation, including all but one evaluable primary tumor. The pCR rate was virtually identical to historical rates achieved with standard regimens, according to Bhishamjit Chera, MD, of the University of North Carolina (UNC) at Chapel Hill, and colleagues. Selected patient-reported adverse events peaked during the first 6 to 8 weeks and then declined thereafter. About 40% of patients required feeding tubes for a median duration of 15 weeks, but no patients required permanent feeding tubes, they reported here at the American Society for Radiation Oncology meeting. The regimen consists of lower doses of radiotherapy and concurrent cisplatin, administered over 6 weeks. With high-dose therapy, the radiation protocol requires an additional week. "Though we have limited follow-up, the pathological complete response rate with this reduced-intensity chemoradiotherapy regimen is very high in patients with favorable-risk oropharyngeal squamous-cell carcinoma," Chera said. "The early quality-of-life measurements are encouraging, particularly the data on swallowing. We are optimistic that these results with reduced-intensity treatment will translate into good long-term disease control with less toxicity." The study reflects the current trend and momentum in the management of HPV-positive oropharyngeal cancer, said Zain Husain, MD, of Yale Cancer Center in New Haven, Conn. "This is the second study to show that de-escalation of therapy might [...]

2015-10-21T14:59:53-07:00October, 2015|Oral Cancer News|

HPV Persistence Predicts Poor Prognosis in Head/Neck Cancer

Source: www.medscape.comAuthor: Roxanne Nelson, RN, BSN Among patients with human papillomavirus–positive oropharyngeal cancer (HPV-OPC), persistence of HPV following treatment is associated with a poorer prognosis. Results of a new study show that the persistence of HPV16 DNA, detected in oral rinses after treatment has ended, may be predictive of disease recurrence. In a cohort of 124 patients with HPV-OPC, HPV16 DNA was detected in oral rinses from 54% (n = 67) of patients at the time of their diagnosis. Following treatment, it was detected in only six patients after treatment, including five patients with persistent oral HPV16 DNA that was also detected at diagnosis. All five patients with persistent HPV16 experienced disease recurrence, with three eventually dying of their cancer. Conversely, only nine of 119 patients without persistent oral HPV16 DNA developed recurrent disease. "Our findings indicate that persistent HPV16 DNA in oral rinses may be a useful early marker of disease that has either recurred or never fully responded to treatment," said first author Eleni Rettig, MD, of the Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland. "In the clinical setting, this could one day be a part of routine surveillance after treatment for HPV-positive oropharyngeal cancers, in addition to clinical examination and imaging," she told Medscape Medical News. The study was published online July 30 in JAMA Oncology. Biomarker Potential? In an accompanying editorial, Julie E. Bauman, MD, MPH, and Robert L. Ferris, MD, PhD, both of the University of Pittsburgh, in Pennsylvania, [...]

DNA shed from head and neck tumors detected in blood and saliva

Source: www.medicalexpress.comAuthor: Wang et al., Science Translational Medicine (2015)  Schematic showing the shedding of tumor DNA from head and neck cancers into the saliva or plasma. Tumors from various anatomic locations shed DNA fragments containing tumor-specific mutations and human papillomavirus DNA into the saliva or the circulation. The detectability of tumor DNA in the saliva varied with anatomic location of the tumor, with the highest sensitivity for oral cavity cancers. The detectability in plasma varied much less in regard to the tumor’s anatomic location. Credit: Wang et al., Science Translational Medicine (2015)   On the hunt for better cancer screening tests, Johns Hopkins scientists led a proof of principle study that successfully identified tumor DNA shed into the blood and saliva of 93 patients with head and neck cancer. A report on the findings is published in the June 24 issue of Science Translational Medicine. "We have shown that tumor DNA in the blood or saliva can successfully be measured for these cancers," says Nishant Agrawal, M.D., associate professor of otolaryngology—head and neck surgery—and of oncology at the Johns Hopkins University School of Medicine. "In our study, testing saliva seemed to be the best way to detect cancers in the oral cavity, and blood tests appeared to find more cancers in the larynx, hypopharynx and oropharynx. However, combining blood and saliva tests may offer the best chance of finding cancer in any of those regions." Agrawal explains that inborn genetic predispositions for most head and neck cancers are rare, but [...]

HPV16 Antibodies Signal Even Better Oral Cancer Outcomes

Source: www.medscape.comAuthor: Neil Osterweil Another prognostic tool may be in the offing for clinicians to use in evaluating patients with oropharyngeal cancers, new research suggests. The presence in serum of three antibodies to human papillomavirus type 16 (HPV16) was predictive of better progression-free and overall survival in these patients, according to Kristina R. Dahlstrom, PhD, from the University of Texas MD Anderson Cancer Center, in Houston, and colleagues. Patients whose serum was positive for the presence of three specific antibodies to "early" (E) proteins involved in replication and growth of HPV16 had dramatically better rates of overall survival (OS) and progression-free survival (PFS) compared with patients whose serum was negative for the antibodies, they reported online June 15 in Clinical Cancer Research. Specifically, for those patients whose serum was positive for any E antibodies, 5-year estimated OS was 87.4%, compared with 42.2% for patients whose sereum was negative for all E antibodies (P < .001). The respective 5-year PFS rates were 82.9% and 46.1% (P < .001). "These results hint at a prognostic stratification of patients with HPV-related oropharynx cancer reflecting humoral immune response to HPV type 16 E proteins and thus may help in choosing immunotherapy approaches for such patients in future," said senior author Erich M. Sturgis, MD, MPH, a surgeon at MD Anderson, in comments to Medscape Medical News. Currently, the serology results are not strong enough to be used as clinical decision tools for choosing current therapies, she added. Their findings also suggest that vaccine-based immunotherapy targeted [...]

Professional Rodeo Competitors Join Fight Against Oral Cancer

Source: www.upr.orgAuthor: Melissa Allison  The number of oral cancer deaths related to tobacco use is on the rise nationwide according to the Oral Cancer Foundation. Brian Hill is the founder of the OCF and a survivor of the disease. Cody Kiser encourages the youth to not start using tobacco to help secure good health. Oral Cancer Foundation   “Up until about (the year) 2000 this was primarily a disease of older men who had smoked a lot or chewed tobacco during their lifetime,” Hill said. “About that point in time we started to see a shift in the cause of the disease.” Hill said tobacco is still a primary cause of oral cancers and adds that the oral human papillomavirus type 16 (HPV16) is new etiology that has forced the number of cases to accelerate. According to an October 2014 study by Johns Hopkins researchers the HPV16 causes cancers of the mouth and throat and that any form of tobacco use increases the risk of the virus. The research suggests as few as three cigarettes a day can increase the risk of infection by almost one-third. Hill created the foundation in 1999 to promote change by educating the public about risk factors that contribute to the disease. Among those risks is the use of spit tobacco. “The world of rodeo has been the realm of sponsorship by the tobacco industry for decades,” Hill said. “With the nicotine content in a can of dip equaling approximately that of 80 cigarettes, this addiction [...]

Study finds Oral HPV Infection Lasts Longer in Older Men

Author: StaffSource: winnipegfreepress.com FRIDAY, Jan. 9, 2015 (HealthDay News) -- One type of oral HPV (human papillomavirus) infection, HPV16, seems to last a year or longer in men over the age of 45 than it does in younger men, new research indicates. HPV16 is the form of HPV often associated with the onset of head and neck cancers (oropharyngeal), the study team noted. "Oral HPV16 is the HPV type most commonly found in HPV-driven oropharyngeal cancers, which have been increasing in incidence recently in the United States," said study author Christine Pierce Campbell in a American Association for Cancer Research news release. She is an assistant member in the department of Cancer Epidemiology and Center for Infection Research in Cancer at the Moffitt Cancer Center in Tampa, Fla. "We don't know how long oral HPV infection must persist to increase risk for head and neck cancer," she added, "but we assume it would be similar to cervical infection, where it is generally believed that infections persisting beyond two years greatly increase the risk of developing cervical cancer." The study was released online on Jan. 9 in Cancer Prevention Research. The researchers analyzed four years of samples from more than 1,600 men. The samples were collected every six months. During the study, 23 men had two or more positive oral HPV16 samples. Of these, 10 had HPV16 when the study began. In the group that had HPV16 at the start of the study, nine had infections that lasted a year or more. Additionally, [...]

2015-01-12T11:22:24-07:00January, 2015|Oral Cancer News|

The New Face of Oral Cancer

Source: nursing.advanceweb.comBy Jonathan BassettPosted on: April 22, 2013   For decades tobacco was the primary cause of oral cancer but a more insidious culprit has emerged.  Jerry Wilck had no reason to suspect anything. Why would he? He only smoked for a couple of years and gave it up more than 40 years ago. He didn't drink excessively, didn't have a family history of cancer, and took good care of himself. In fact, maybe the only reason the 59-year-old consulted an oral surgeon about the small sore on his tongue - the result of a habit of running this particular spot along his teeth - was that there happened to be such a specialist right there in his office. Wilck was a general practice dentist in Langhorne, Pa., and particularly attuned to anomalies of the soft tissues of the mouth. His oral surgeon took no chances and ordered a biopsy. Wilck was "floored" the night in March 2005 when the lab report arrived by fax from the oral pathology department at Temple University in Philadelphia - squamous cell carcinoma. Wilck immediately consulted with John Ridge, MD, PhD, FACS, chief of head and neck surgery at Temple's Fox Chase Cancer Center. After surgical removal of part of his tongue and lymph nodes from his neck, along with a round of physical and speech therapy, Wilck is now cancer free and has full use of his jaw, throat and voice. "I was lucky," confessed Wilck, who retired from practice in 2009 and now spends a [...]

2013-06-10T12:26:21-07:00June, 2013|OCF In The News, Oral Cancer News|

No increased risk of infection for long-term sex partners of people with HPV-related oral cancers

June 1, 2013 in Cancer Source: Medical Express  Spouses and long-term partners of patients with mouth and throat cancers related to infection with the human papilloma virus (HPV) appear to have no increased prevalence of oral HPV infections, according to results of a multicenter, pilot study led by Johns Hopkins investigators. The study's results suggest that long-term couples need not change their sexual practices, say the scientists. "While we can't guarantee that the partners of patients will not develop oral HPV infections or cancers, we can reassure them that our study found they had no increased prevalence of oral infections, which suggests their risk of HPV-related oral cancer remains low," says Gypsyamber D'Souza, Ph.D., M.P.H., associate professor of epidemiology at the Johns Hopkins University Bloomberg School of Public Health. She is expected to present the results of her study June 1 at the 2013 American Society of Clinical Oncology Annual Meeting. HPV-related oral cancers are rising in prevalence among white men in the United States, and fear of transmitting the virus can lead to anxiety, divorce, and curtailing of sex and intimacy among couples, says D'Souza. Persistent oral HPV infections are a risk for developing oropharyngeal cancers, located at the base of the tongue, tonsils, pharynx and soft palate. At the Johns Hopkins Hospital and three other hospitals, researchers conducted surveys and took oral rinse samples from 166 male and female patients with HPV-related oropharyngeal cancers and 94 spouses and partners. The scientists also studied patients' tumor samples and performed visual [...]

2013-06-03T10:07:24-07:00June, 2013|Oral Cancer News|
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