HPV-associated head and neck cancer blood test shows promise as a test to replace tissue biopsy

Date: December 2nd, 2021 Author: Massachusetts Eye and Ear Infirmary Source: MedicalXpress Featured Image Courtesy of Mass Eye and Ear Infirmary: Daniel L. Faden, MD, a head and neck surgical oncologist and investigator in the Mike Toth Head and Neck Cancer Research Center at Mass Eye and Ear, and assistant professor of otolaryngology–head and neck surgery at Harvard Medical School. Credit: Mass Eye and Ear   Researchers at Mass Eye and Ear and Mass General Hospital have developed a blood test, or liquid biopsy, for head and neck cancer associated with the human papilloma virus (HPV) that was shown in a new study to be more accurate, faster and cheaper than conventional testing methods. In the study, published December 2 in Clinical Cancer Research, a journal of the American Association for Cancer Research, liquid biopsy was more than 98 percent accurate and obtained a diagnosis 26 days quicker on average than conventional tissue biopsy. The cost of the novel test was 38 percent lower than standard methods. When the researchers combined the liquid biopsy with findings from routine imaging and physical exam to create a fully non-invasive diagnostic approach, diagnostic accuracy remained greater than 95 percent. With HPV-associated head and neck cancer rates on the rise, there is a great need for more accurate, less-invasive, faster and less expensive diagnostic tests, according to authors of the study. "Current diagnostic approaches for HPV-associated head and neck cancers are imperfect and invasive, which means patients often need repeat biopsies to get to [...]

2021-12-06T11:31:49-07:00December, 2021|Oral Cancer News|

Treatment Paradigms Are Shifting for Locally Advanced HPV-Positive Head and Neck Cancers

Date: November 18th, 2021 Authors: Kaveh Zakeri, MD, MAS, Nancy Y. Lee, MD Source: OncLive The standard of care for patients with locally advanced head and neck squamous cell carcinomas does not substantially differ according to human papillomavirus (HPV) status in the National Comprehensive Cancer Network guidelines.1 Resectable tumors can be treated with surgery followed by adjuvant therapy. Alternatively, definitive chemoradiation therapy with cisplatin is the other dominant treatment paradigm. Incidence of HPV-associated oropharyngeal squamous cell carcinoma has increased rapidly and is associated with higher overall survival (OS) compared with cancers caused by smoking and alcohol.2,3 Given the unique biology of HPV-associated oropharyngeal disease, a separate staging system was developed for these tumors.4 HPV-associated oropharyngeal cancers are more radiosensitive and chemosensitive than cancers caused by smoking and alcohol, yet the traditional treatment paradigms—including high doses of radiation and chemotherapy—were developed prior to the epidemic of HPV-associated disease. De-escalation of therapy has been proposed for HPV-associated oropharyngeal cancer based on data demonstrating high OS and progression-free survival (PFS).5 De-escalation of therapy has been investigated for both definitive surgical and chemoradiation therapy paradigms. Most de-escalated approaches focus on selecting patients according to clinical features, such as disease stage and smoking status, whereas personalized de-escalation reduces treatment intensity for patients according to treatment response. Transoral Robotic Surgery Followed by Adjuvant Radiotherapy Transoral robotic surgery (TORS) is a minimally invasive approach that reduces morbidity compared with traditional, open surgery for patients with oropharyngeal cancers. TORS is a standard of care option for patients with [...]

2021-12-06T11:00:39-07:00December, 2021|Oral Cancer News|

An Occult HPV-Driven Oropharyngeal Squamous Cell Carcinoma Discovered Through a Saliva Test

Source: Frontiers in Oncology Date: March 31st, 2020 Authors: Kai Dun Tang, Sarju Vasani, Touraj Taheri, Laurence J. Walsh, Brett G. M. Hughes, Lizbeth Kenny, and Chamindie Punyadeera Oropharyngeal cancer (OPC) caused by human papillomavirus (HPV) is a rising global concern. Early lesions are small and are often located in difficult to access areas (such as the crypts of the tonsils or base of tongue). Unlike cervical cancer, there is no standard or routine screening program for HPV-driven OPC. HPV DNA from OPC tumors may shed directly into saliva, and this can be used as a biomarker for early diagnosis. In this study, we report the first-ever clinically occult OPC in an asymptomatic patient discovered through a saliva test. This case relied upon serial measurements of HPV-16 DNA in saliva, which fell to undetectable levels following low morbidity, curative treatment. Introduction The incidence of high-risk human papillomavirus (HR-HPV−16,-18,-33) driven oropharyngeal cancer (OPC) is rapidly increasing in developed countries (1–3). HPV-driven OPCs have surpassed cervical cancer as the most common HPV-driven cancer in the USA. The prevalence of HR-HPV has been reported as 3.7% of the USA population, with a bimodal age distribution of incidence (4). It remains unclear why some individuals go on to develop OPC, while others clear the initial HPV infection (5). The strong association between HR-HPV infection and cervical cancer has led to screening programmes in primary healthcare settings, resulting in earlier diagnosis and a reduction in cancer deaths (6). Unlike cervical cancer, no screening test is [...]

2020-05-26T11:07:07-07:00May, 2020|Oral Cancer News|

Blood Test Spot On for HPV Cancer Recurrence

Source: MedPage Today Date: April 1st, 2020 Author: Charles Bankhead   A blood test for tumor-associated human papillomavirus (HPV)-DNA had near-perfect accuracy for identifying oropharyngeal cancer patients at high risk of recurrence after treatment, a prospective study showed. Overall, 28 patients tested positive for circulating tumor (ct) HPV-DNA, including 16 patients who had two consecutive positive tests. All but one of the 16 patients subsequently had biopsy-proven disease recurrence. No patient who had only negative tests developed recurrent disease. The findings have clear and immediate implications for clinical practice, including earlier initiation of salvage therapy for patients with recurrent disease, reported Bhisham S. Chera, MD, of the UNC Lineberger Comprehensive Cancer Center in Chapel Hill, North Carolina, and colleagues in the Journal of Clinical Oncology. "With regard to how this is applicable to clinical practice, I think it improves the effectiveness, it improves the efficiency, and it reduces the cost and financial toxicity to patients," Chera told MedPage Today. "This blood test's performance is really good: Negative predictive value (NPV) 100%, two consecutive positive tests, 94% positive predictive value (PPV). This performs better than any physical examination, PET/CT, or fiberoptic re-examination in identifying cancer recurrence. Right now, I think this is the best surveillance tool we have." The findings extended those of a previous report, which showed that a persistently negative ctHPV-DNA test ruled out disease recurrence. HPV infection accounts for a majority of new cases of oropharyngeal cancer in the U.S. After years of rapid increases in prevalence and [...]

2020-04-06T15:57:39-07:00April, 2020|Oral Cancer News|

Prevalence of Oral HPV Infection Declines in Unvaccinated Individuals

Source: Infectious Disease Advisor Date: September 30th, 2019 Author: Zahra Masoud Oral human papillomavirus (HPV) prevalence has decreased in unvaccinated men, possibly as a result of herd protection, but the incidence of such infection has remained unchanged in unvaccinated women from 2009 to 2016 in the United States, according to a study published in the Journal of the American Medical Association. Since 2011 for women and 2006 for men, prophylactic HPV vaccination for prevention of anogenital HPV infection has been recommended for routine use in the United States. Previous studies have demonstrated that this vaccine has high efficacy in reducing the prevalence of oral HPV infection. However, the vaccine is not indicated to prevent oral HPV infection or oropharyngeal cancers because there are few results from randomized trials. Further, there has been a lack of surveillance studies reporting on herd protection against oral HPV infection, which is defined as a form of indirect protection from infectious diseases that occurs when a large percentage of the population has become immune/vaccinated, thereby providing protection for individuals who are not immune/not vaccinated. Therefore, this study investigated evidence for herd protection against oral HPV infection in unvaccinated men and women in the United States using temporal comparisons of oral HPV prevalence for 4 vaccine types and 33 non-vaccine types. This study was conducted across 4 cycles (from 2009 to 2016) of the National Health and Nutrition Examination Survey (NHANES), using a cross-sectional, stratified, multistage probability sample of the civilian population in the United States. For the examination [...]

2019-10-01T16:15:25-07:00October, 2019|OCF In The News|

Robotic surgery for oropharyngeal cancer not better than radiation therapy, study finds

Source: News Medical Date: June 7, 2019 Author: Reviewed by James Ives, M.Psych (Editor) In 2012, scientists at Lawson Health Research Institute launched the world's first clinical trial comparing robotic surgery to radiation therapy for the treatment of oropharyngeal cancer (cancer at the back of the throat). The team is now reporting findings from the seven-year study which challenges beliefs that surgery leads to better swallowing outcomes, suggesting instead that radiation results in better quality of life for patients. For Betty Ostrander, an operating room nurse from Tillsonburg, Ontario, a throat cancer diagnosis was life-changing. Betty was 59 when she discovered a small lump on the right side of her neck. After seeking medical care and testing, she was told she had oropharyngeal cancer. "I remember thinking 'I'm healthy, I eat right and I exercise; this can't be happening to me.' But it was, and it was scary," recalls Betty. "One of the first questions I asked was whether there were any clinical trials available." Betty was one of 68 research participants in the ORATOR trial. The study included six centres from across Canada and Australia, including London Health Sciences Centre's (LHSC) London Regional Cancer Program. Participants were randomized to receive either precision radiation therapy, often combined with chemotherapy, or transoral robotic surgery (TORS). TORS is a surgical method for treating throat cancer which uses a small 3D camera and miniature robotic instruments to remove tumors. LHSC was the first center in Canada to offer TORS in 2011. "Early studies [...]

2019-06-10T10:11:19-07:00June, 2019|Oral Cancer News|

Queensland scientist develops new HPV cancer vaccine

Source: 9News Date: May 22, 2019 Author: 9News Staff *click Source to view video* Former Australian of the Year Professor Ian Frazer has developed a vaccine aimed at treating HPV-related cancers of the head, neck, throat and tongue. While funding is still being finalised, a trial of the vaccine is being prepared for people with incurable oropharyngeal cancers. Professor Frazer, the Scottish-born immunologist who developed and patented the vaccine against HPV-related cervical cancer, has been working on this vaccine for nearly 15 years. While the cervical cancer vaccine works as a preventative, this new vaccine is a treatment therapy. It works by teaching the patient’s immune system to target the cancer cells containing HPV. The patient will then be given immunotherapy drugs that supercharge the immune system. “This is all about a new way to treat cancer using the body's defence against infection,” Professor Frazer said. “This might give a second chance at life.” HPV-related throat cancer kills three Australians every day. “It's going to become a major problem in Australia, in fact in the US we've seen an increase in HPV-related throat cancers by 225 per cent," head and neck radiation oncologist Sandro Porceddu said. Professor Porceddu will conduct the trial at the Princess Alexandra Hospital. It should begin towards the end of this year if a further $700,000 in necessary funding is found. © Nine Digital Pty Ltd 2019

2019-05-22T16:06:08-07:00May, 2019|Oral Cancer News|

Lowering Radiation Dose Could Improve QoL, Cut Costs in Oral Ca

Source: MedPage Today, Medpage.com Date: October 25th, 2018 Author: Elizabeth Hlavinka SAN ANTONIO -- Radiation de-intensification was tied to a quicker rebound in a number of quality of life (QoL) measures and reduced costs for patients with HPV-associated oropharyngeal cancer, a pair of studies found. With lower doses of radiotherapy (RT), QoL measures including speech, pain, and socialization still generally worsened after treatment, but returned to baseline within 3 to 6 months, reported Kevin Pearlstein, MD, of the University of North Carolina in Chapel Hill. And more aggressive de-intensification led to a 22% cost reduction for treatment overall ($45,884 versus $57,845 with standard care), with 33% lower costs for RT itself and 50% lower costs for post-treatment care (P=0.01), according to findings presented by Mark Waddle, MD, of the Mayo Clinic in Jacksonville, Florida. The studies were presented here at the American Society for Radiation Oncology (ASTRO) meeting during a session on improving outcomes while minimizing toxicity in oropharyngeal cancer. In the research from Pearlstein's group, patients reported global QoL scores of 81 at baseline (using the 100-point EORTC QLQ-C30 questionnaire, where higher scores connote better health), which dipped to 69 at 3 months post-treatment, then rose to 75 at 6 months. Global QoL scores increased to 82 and 84 by months 12 and 24, respectively. Common long-term side effects such as sticky saliva, taste, and ability to swallow did not return to baseline within months 3 to 6, but continued to improve between months 12 and 24. Pearlstein noted [...]

2018-10-25T15:18:41-07:00October, 2018|Oral Cancer News|

HPV Vaccination Linked to Decreased Oral HPV Infections

Author: NCI Staff Date: June 5th, 2017 Source: www.cancer.org New study results suggest that vaccination against the human papillomavirus (HPV) may sharply reduce oral HPV infections that are a major risk factor for oropharyngeal cancer, a type of head and neck cancer. The study of more than 2,600 young adults in the United States found that the prevalence of oral infection with four HPV types, including two high-risk, or cancer-causing, types, was 88% lower in those who reported receiving at least one dose of an HPV vaccine than in those who said they were not vaccinated. About 70% of oropharyngeal cancers are caused by high-risk HPV infection, and the incidence of HPV-positive oropharyngeal cancer has been increasing in the United States in recent decades. In the United States, more than half of oropharyngeal cancers are linked to a single high-risk HPV type, HPV 16, which is one of the types covered by Food and Drug Administration (FDA)-approved HPV vaccines. “In an unvaccinated population, we would estimate that about a million young adults would have an oral HPV infection by one of these vaccine HPV types. If they had all been vaccinated, we could have prevented almost 900,000 of those infections,” said senior study author Maura Gillison, M.D., Ph.D., of the University of Texas MD Anderson Cancer Center. Dr. Gillison presented the new findings at a May 17 press briefing ahead of the 2017 annual American Society of Clinical Oncology (ASCO) meeting, held June 2–6 in Chicago. A Rapidly Rising Cancer Oropharyngeal [...]

2017-06-05T14:39:41-07:00June, 2017|Oral Cancer News|

Smokeless Tobacco Use and the Risk of Head and Neck Cancer: Pooled Analysis of US Studies in the INHANCE Consortium.

Source: www.pubmed.gov Author: Wyss AB, Gillison ML, Olshan AF Abstract Previous studies on smokeless tobacco use and head and neck cancer (HNC) have found inconsistent and often imprecise estimates, with limited control for cigarette smoking. Using pooled data from 11 US case-control studies (1981-2006) of oral, pharyngeal, and laryngeal cancers (6,772 cases and 8,375 controls) in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium, we applied hierarchical logistic regression to estimate odds ratios and 95% confidence intervals for ever use, frequency of use, and duration of use of snuff and chewing tobacco separately for never and ever cigarette smokers. Ever use (versus never use) of snuff was strongly associated with HNC among never cigarette smokers (odds ratio (OR) = 1.71, 95% confidence interval (CI): 1.08, 2.70), particularly for oral cavity cancers (OR = 3.01, 95% CI: 1.63, 5.55). Although ever (versus never) tobacco chewing was weakly associated with HNC among never cigarette smokers (OR = 1.20, 95% CI: 0.81, 1.77), analyses restricted to cancers of the oral cavity showed a stronger association (OR = 1.81, 95% CI: 1.04, 3.17). Few or no associations between each type of smokeless tobacco and HNC were observed among ever cigarette smokers, possibly reflecting residual confounding by smoking. Smokeless tobacco use appears to be associated with HNC, especially oral cancers, with snuff being more strongly associated than chewing tobacco. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. *This news story [...]

2016-10-31T14:31:13-07:00October, 2016|Oral Cancer News|
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