Natick company develops test to detect head and neck cancer that could lead to earlier diagnosis

Source: www.bostonherald.com
Author: Alexi Cohan

A saliva-based diagnostic test that can detect HPV-related head and neck cancer has the potential to catch the disease earlier and even serve as a standard screening method, which the medical community currently lacks.

Oropharyngeal squamous cell carcinoma, a cancer caused by human papillomavirus that develops in the mouth and throat, is expected to cause more than 10,000 deaths this year, according to the American Cancer Society. Cases have been increasing significantly in men in recent years.

But there is no screening method for this cancer right now, said Charlotte Kuperwasser, chief of clinical operations at Natick-based diagnostics company Naveris. She said most men who contract it will notice a lump in their throat and go to the doctor. But by that time, the cancer could be quite advanced.

The new saliva test developed by Naveris has been shown to detect HPV-associated head and neck cancer with high accuracy, which is a first-of-its-kind study result and could offer a patient-friendly way to catch the cancer early.

“Saliva is actually a very easy source, very non-invasive. It doesn’t require a medical professional to collect, it could even be done at home so there’s a lot of advantages to saliva,” Kupperwasser told the Herald.

Researchers at Washington University School of Medicine in St. Louis used the test to successfully analyze saliva for HPV genomes that are specific for DNA released from cancerous tumors. The study results highlighted the potential to use the test to catch the cancer early.

“Then, you can actually intervene and make a difference and prevent these cancers from showing up,” Kupperwasser said.

The saliva test builds off a Naveris blood test that detects HPV-associated head and neck cancer earlier than is possible with cancer imaging. That technology is already being used by hundreds of doctors.

Finding a way to detect HPV-related cancer early can’t come soon enough. Kupperwasser said by 2035, HPV cancers are expected to become the third leading cancer type among white men.

“The incidence is going up dramatically and the prevalence is getting to be so high,” Kupperwasser said.

Human papillomavirus is the most common sexually transmitted virus and infection in the United States. More than one of five U.S. adults are infected with a high-risk strain of HPV that can potentially develop into cancer.

But many people might not have any symptoms of HPV, which can take decades to turn into cancer.

Kupperwasser said a similar situation unfolded with cervical cancer in the United States. Cases were going up and a screening mandate was put into place, helping significantly.

She said the same thing could happen with the saliva test if it were used as a standard screening method.

The saliva test could be available to patients within 18 months, but it remains in clinical trials, said Kupperwasser.

Naveris’ new saliva test detects head and neck cancer

Source: www.biospace.com/
Author: staff

A new clinically-validated saliva test has been shown to detect HPV-associated head and neck cancer with high accuracy, a first-of-its-kind study result.

Researchers at Washington University School of Medicine in St. Louis used the Naveris, Inc. test to analyze saliva for sequences of the human papilloma virus (HPV) genome that are specific for HPV DNA released from malignant tumors. The test successfully distinguishes this tumor-tissue modified virus from non-cancerous sources of HPV DNA and precisely measures the number of tumor-tissue modified viral HPV (TTMV-HPV) DNA strands present in a saliva sample.

The study results point to the potential for a significant improvement in early detection of the most common type of head and neck cancer, HPV-associated oropharyngeal squamous cell carcinoma.

“Naveris’ patient-friendly saliva test has the potential to radically advance early detection of HPV-positive head and neck cancer, which has been growing rapidly among men in the United States. Early detection of these cancers would make a dramatic difference in patient outcomes,” said Piyush Gupta, PhD, CEO of Naveris.

The study quantified participants’ tumor-tissue modified viral HPV DNA in saliva samples and compared it to the levels found in their blood by utilizing Naveris’ NavDx® test. The results showed that TTMV-HPV DNA was commonly found in the saliva of HPV-associated head and neck cancer patients (44/46 cases), and at 18 times higher levels in the saliva samples than in the blood samples. One sample had undetectable TTMV-HPV and one was indeterminate for HPV DNA.

Washington University researchers are presenting an abstract of the study at the American Society of Clinical Oncology (ASCO) 2021 annual meeting.

“The results of our study highlight the potential of accurately analyzing saliva to improve the early detection of HPV-associated oropharyngeal squamous cell carcinoma. If validated in larger studies, this test could lead to earlier diagnosis and treatment,” said the study’s principal investigator Jose P. Zevallos, MD, chief of the division of Head and Neck Surgery in the Department of Otolaryngology at Washington University School of Medicine.

Naveris’ new saliva test is based upon the proprietary technology employed by the NavDx® blood test that is in use at centers of excellence treating HPV-associated oropharyngeal cancer across the United States. NavDx® is a liquid biopsy test that detects HPV-associated head and neck cancer earlier than is possible with imaging and is provided exclusively in the United States through the Naveris national reference CAP-accredited laboratory.

About Oropharyngeal Cancer:
Oropharyngeal cancer, which can develop at the base of the tongue, tonsils, and the middle part of the throat, used to be closely associated with smoking and heavy drinking. Today, however, oropharyngeal cancer is primarily caused by human papillomavirus (HPV) infection, the most common sexually transmitted virus and infection in the United States. More than one of five U.S. adults are infected with a high-risk strain of HPV that can potentially develop into cancer.1

Cases of HPV-positive oropharyngeal cancer have been increasing at an exponential rate among men in the United States over the last two decades2. About 54,000 cases of oropharyngeal and oral cavity cancer are expected in the nation this year and more than 10,000 deaths.3

Oropharyngeal cancers usually are not identified early because they grow slowly in locations that are not easy to see. By the time the cancers are recognized they frequently have spread to the lymph nodes and are difficult to treat. Early detection, however, enables highly effective treatment.

About Naveris, Inc.
Naveris, Inc. is a molecular diagnostics company developing and commercializing novel blood and saliva tests to enhance the early detection and clinical management of viral-associated cancers. The company’s NavDx® blood test, which uses proprietary technology to detect tumor tissue modified HPV, is in use at leading cancer treatment centers and academic medical centers throughout the United States.

A new answer for helping patients with xerostomia

Source: www.dentistryiq.com
Author: John Kringel

Helping patients with xerostomia can be especially challenging. Set aside for a moment the dental complications that result, such as rampant caries and mucositis. Severe symptoms like difficulty swallowing, sleeping, and talking can ruin the sufferer’s daily quality of life at the most basic level. Yet the available interventions1 come down to lifestyle tips such as sucking on ice chips, chewing sugar-free gum, and using a humidifier at night.

Dr. Jeffrey Cash, a dentist in Richmond, Virginia, has experienced the frustration of dealing with xerostomia from multiple perspectives. He was initially moved by his hospital-based residency working with head-and-neck cancer patients.

“My conversations with patients who had tried the standard suggestions without finding relief generally went like this: ‘Can’t you do anything else for me? I’m miserable. I can’t eat properly. I wake up four times a night because I can’t breathe.’ My answer, which felt terrible, amounted to ‘welcome to the new normal.’ ”

Within a year of graduation, Dr. Cash learned exactly what these patients had experienced when he underwent chemotherapy as a part of his own cancer treatment.

“Shortly after starting chemo, I developed severe dryness which led to mucositis. It was so uncomfortable I didn’t want to swallow or eat anything that would scratch the tissue.”

The combined experience as a dentist and a xerostomia sufferer started Dr. Cash on a decades-long mission to invent a new treatment option that would be immediate, continuous, and predictable.

That aspiration became a reality in 2021 with the launch of Voutia.2 Voutia3 is a wearable device incorporating a quiet, lightweight micro-pump, a water bottle, and ultrafine tubing. It closely mimics natural saliva flow by providing continuous moisture replenishment directly to the mouth. About the size of a cell phone and engineered for 24/7 use, Voutia is nearly imperceptible in normal social interaction.

Patients seeking relief will continue to show up at dental practices. While the causes are medical and systemic, xerostomia is naturally seen as a dental issue since the symptoms manifest orally. It’s a common condition with an estimated prevalence of 6% at age 50, increasing to between 15% and 30% by age 65 and over.4

According to the American Dental Association, the prevalence of xerostomia rises to nearly 100% for those receiving radiation therapy for head and neck cancer and for patients with Sjögren’s syndrome.1 Compound those statistics with an aging population and the increasing number of prescriptions for medications having dry mouth as a side effect, and it becomes clear that dentists will remain on the front line in terms of supporting xerostomia sufferers.

“I used what happened to me as the motivating force to create a new tool for our treatment armamentarium,” said Dr. Cash. “Unless you’ve experienced it [xerostomia] firsthand, it’s hard to understand just how profoundly this condition affects the daily life of that person sitting in your waiting room.”

Editor’s note: This article first appeared in Through the Loupes newsletter, a publication of the Endeavor Business Media Dental Group. Read more articles at this link and subscribe here.

References
1. Oral health topics. Xerostomia (dry mouth). American Dental Association. Department of Scientific Information, Evidence Synthesis & Translation Research, ADA Science & Research Institute, LLC. Updated February 22, 2021. https://www.ada.org/en/member-center/oral-health-topics/xerostomia
2. Voutia device provides a new answer for chronic dry mouth sufferers. News release. The Reflective Agency. February 12, 2021. https://www.einnews.com/pr_news/535445173/voutia-device-provides-a-new-answer-for-chronic-dry-mouth-sufferers
3. Voutia home page. https://voutia.com/
4. Navazesh M, Kumar SKS. Xerostomia: prevalence, diagnosis, and management. Inside Dental Assisting. 2009;5(10):10-15.

Patients with oral cancer may get relief from dry mouth through MU research

Source: www.columbiamissourian.com
Author: Tia Alphonse

Gary Rackers bit his tongue one night, and it began to bleed. Thinking it wasn’t serious, he waited a couple of weeks, but something still didn’t feel right.

So, he asked his wife to take a look. She was shocked, Rackers said. His tongue was black.

After seeing his family physician and a local ear, nose and throat doctor in Jefferson City, Rackers was referred to Ellis Fischel Cancer Center. There, he connected with a physician who specialized in surgical treatment for patients with head and neck cancers. He was diagnosed with squamous cell carcinoma — a common oral cancer. The doctor ended up surgically removing half of Rackers’s tongue and nearly all of his teeth, and he began radiation and chemotherapy treatments.

Since then, Rackers said he‘s had 33 radiation treatments and three rounds of chemotherapy. He is pleased and proud of the work his physician did, he said. Because of her, he’s in the recovery phase: “I’m doing good…and I’m feeling good.”

Many head and neck cancer patients like Rackers lose their ability to produce saliva after radiation treatment. He said it doesn’t affect him much during the day, but his mouth gets quite dry at night. Dry mouth frequently disturbs his sleep, he said, causing him to often fetch water or juice for relief.

“If I could get through the night,” he said, the days are easy.

MU researcher and former dentist Olga Baker hopes to help patients like Rackers by dedicating her efforts to something most of us take for granted — saliva. Through her research, she hopes to find better solutions to combat dry mouth, particularly among cancer patients whose glands have been destroyed by radiation therapy.

When she practiced dentistry, Baker said she encountered many patients who struggled with dry mouth. Although the condition is often viewed as insignificant, those who underproduce saliva often develop mouth sores, cavities and a host of other issues. Baker said she has even worked with patients who have trouble talking because their inner cheeks stick to their teeth without natural lubrication from saliva. She has also treated patients who feel as if they are choking at night without the fluid to keep their airways moist.

Multiple groups of people suffer from chronic dry mouth. Patients who undergo radiation treatment for neck and head cancer are among a common group that often loses the function of salivary glands. After treatment, many of these glands stop working and can no longer naturally produce saliva, Baker said. She has seen patients who suffer from Sjögren’s syndrome, an autoimmune disease that causes inflammation that destroys the salivary glands. Other patients are born without functioning salivary glands at all.

“For these patients, there is no cure,” Baker said. “So, we’re working on different options.”

In the past, she worked to produce artificial saliva from plant-based resources and researched resolvins, lipids derived from the Omega-3 fatty acids commonly found in fish oil. This can be a potential treatment for dry mouth in Sjögren’s syndrome patients. These kind of solutions provide temporary relief, working as a spray that can be applied throughout the day to mimic the effects of saliva lubrication.

Baker’s current research into saliva production is dedicated to finding a more long-term solution to dry mouth, specifically for patients whose glands have been destroyed by radiation therapy. The therapy Baker is researching uses a specialized hydrogel that targets the affected glands. She has zeroed in on a protein called laminin-111, which is important to the embryonic process and has long been associated with regenerative properties. Baker said her previous research found that the protein helped restore salivary gland function when only single molecules were used.

She looked at recent studies on the way trimers, a combination of three molecules of a given protein, could give greater results than single molecules. She became interested in testing trimers of laminin-111 on salivary glands to see whether the protein could further restore salivary function in mice.

The experiment tested mice that had undergone radiation treatment and lost salivary function. Proteins from the treatment are put into hydrogels to make a more efficient delivery system. The gel was applied to the mice, and their saliva secretion was monitored. The treatment has proved effective in mice that lose salivary gland function due to radiation. Baker said the next step is to expand her research into larger animals and ultimately do clinical trials on human patients.

Meanwhile, Rackers is adjusting to his recovery. He said he no longer eats spicy foods, and he can’t stand the tanginess of condiments like barbecue and mustard. He can, however, still enjoy most foods.

“Tonight, I’m making smoked sausage, fried potatoes and steamed vegetables,” he said. “And I can eat that.”

2021-02-04T20:59:31-07:00February, 2021|Oral Cancer News|

Botanical drug is shown to help patients with head and neck cancers

Source: newsroom.ucla.edu
Author: Duane Bates, UCLA Research Brief

Findings
In a UCLA-led phase I clinical trial, a new plant-based drug called APG-157 showed signs of helping patients fight oral and oropharyngeal cancers. These cancers are located in the head and the neck.

APG-157 is made up of multiple compounds produced by plants, including curcumin. UCLA Jonsson Comprehensive Cancer Center researchers found that treatment with this botanical drug resulted in high concentrations of curcumin and its byproducts circulating in the blood and absorbed by tumor tissues within three hours after being taken orally.

APG-157 reduced the concentration of cytokines — proteins involved in inflammation — in the saliva when administered to cancer patients. The therapy also reduced the relative abundance of Bacteroides species, a group of gram-negative bacteria. Gram negative refers to a group of dangerous bacteria that have an outer layer which hides them from the immune system. The relative abundance of gram-negative bacteria compared to the presence of other types of bacteria is correlated with oral cancer.

APG-157 also resulted in the expression of genes that are associated with attracting immune system T cells to the tumor area. This therapy could have a beneficial effect when used in combination with immunotherapy drugs that help immune system T cells recognize and kill tumors.

The treatment did not have any adverse effects on the study’s participants.

Background
Cancers of the head and neck account for 4% of all cancers. About 650,000 new cases are reported each year around the world. People with advanced head and neck cancers have a low survival rate and current treatment options such as surgery, radiation and chemotherapy can have adverse effects. Therefore, more effective and less toxic therapies are needed to help improve the quality of life and outcome for those with these cancers.

APG-157 is a botanical drug developed under the FDA’s Botanical Drug Guidance, which includes requirements for production of plant-based therapies that are marketed as prescription medications. The drug is made up of botanical compounds including curcumin from the Curcuma longa plant, which is commonly referred to as turmeric and is a member of the ginger family.

Curcumin is one of the medicinally active or therapeutic molecules that has been tested as a possible treatment to help fight multiple cancers because it is an antioxidant that reduces swelling and inflammation. However, there is poor absorption into the bloodstream when curcumin is taken orally. In this study, UCLA researchers found that when APG-157 is taken through oral mucosal absorption, patients have high levels of curcumin circulating in their blood and absorbed by cancer tissues.

Method
UCLA researchers conducted the study of APG-157 comparing 12 people who had oral and oropharyngeal cancer with a control group of 13 people who did not have cancer. The reason both the people with cancer and without cancer were part of the study was to show that the drug was not toxic to either people with cancer or those without cancer.

The medication was given each hour for three hours and was delivered as a lozenge that slowly dissolved in the mouth. Blood and saliva samples were collected beforehand — each of the three hours the medication was administered — and 24 hours after the last dosage. The medication was given to 12 people (some who had cancer and some who did not) and a placebo was given to 13 people. Blood and electrocardiogram tests did not show increased toxicity in the people who took the active medication in comparison with the people who took the placebo, regardless of whether they had cancer or not.

For the cancer patients who took the medication, there was a decrease in Bacteroides and an increase in T cells in the tumor tissue as compared to cancer patients who took the placebo. Neither the subjects nor the investigators knew whether the drug or a placebo was given when reviewing the blood and saliva test results of the blinded study.

Impact
APG-157 is a botanical drug that has low toxicity. It works effectively to reduce inflammation that contributes to the growth of cancer cells. It also attracts T cells to the tumor micro-environment. When used in combination with immunotherapy drugs, APG-157 might have the ability to make the immune system more effective in attacking head and neck cancers. With potential to inhibit the growth of Bacteroides species, APG-157 could also improve cancer therapy through oral microbial changes.

Authors
Dr. Marilene Wang from UCLA was the corresponding author. Other UCLA authors include: Saroj Basak, Alexander Yoon, Marco Morselli, Chan Jeong, Anela Tosevska, Tien Dong, Hassan Nasser, Venu Lagishetty, Rong Guo, Dipti Sajed, Kym Faull, Jonathan Jacobs, Matteo Pellegrini, Daniel Sanghoon Shin and Eri Srivatsan. Authors from Uniformed Services University of the Health Sciences in Maryland and Aveta Biomics also participated in the study.

Journal
The research is published in CANCER, a journal published by the American Cancer Society.

Funding
Funding for the study was provided by Aveta Biomics.

Disclosures
Authors Parag Mehta, Sharmila Mudgal and Luis Avila are employed by Aveta Biomics. They had no role in the recruitment of people for this study or the collection and analyses of the samples. They, as with all the authors, did not have any information on the subjects, therapy or placebo given until completion of the study.

2020-02-06T08:55:08-07:00February, 2020|Oral Cancer News|

Test that looks at your spit to tell if you have mouth or throat cancer caused by HPV ‘could save thousands of lives if rolled out for doctors to use’

Source: www.dailymail.co.uk
Author: Connor Boyd, Health Reporter

A saliva test that diagnoses mouth and throat cancer caused by HPV could save thousands of lives each year, a study suggests. Scientists at Duke University in North Carolina discovered the test was 80 per cent accurate at spotting the killer diseases.

Doctors say it is able to detect the cancers early on, giving patients much higher hopes of surviving their battle. Before it can be used in hospitals around the world, further trials will be needed to confirm the technology works. But the researchers are hopeful, claiming the cheaper test – which gives results in as little as 10 minutes – has significant ‘potential’.

Rates of oral cancers are soaring in the Western world, with the number of patients diagnosed in the UK having doubled in a generation. US doctors have also seen a similar spike in the diseases, which can be caused by human papilloma virus (HPV).

The infection – spread through oral sex, as well as anal and vaginal intercourse – is thought to cause around 70 per cent of all cases. Other risk factors include drinking excessive amounts of alcohol over long periods of time and smoking cigarettes.

Professor Tony Jun Huang, study co-author, said there are around 115,000 cases of oropharyngeal cancers each year across the world. He said it is ‘one of the fastest-rising cancers in Western countries due to increasing HPV-related incidence, especially in younger patients’.

Orophayngeal cancer starts in the oropharynx, the back of the throat which includes the base of the tongue and tonsils. It sits under the branch of head and neck cancers, which also includes mouth cancer – another type that can be caused by HPV. Detecting the disease early can boost survival odds from 50 per cent to 90 per cent, according to the NHS. But patients are often not diagnosed until they become advanced, partly because their location makes them difficult to see during routine clinical exams.

The new test uses a chip developed to isolate tiny micro-particles, known as exosomes, in saliva.These particles are secreted into body fluids and several types of cancers are known to multiply their numbers. Exosomes are responsible for transferring molecules between cancer and various cells.

The new test isolates them by filtering out larger particles in the saliva and probing the exosomes for DNA shed by tumours. It also scans fluid in the mouth for HPV-16, one strain of the STI that can put people at risk of oropharyngeal cancer. The test takes five minutes to conduct and a further five to process the results. Experts also said it is cheap – but did not elaborate on the cost. In comparison, current biopsies take around eight hours because they need to be sent away to be assessed by a surgeon.

Professor Huang said: ‘It is paramount that surveillance methods are developed to improve early detection and outcomes.’ He added the successful detection of HPV from saliva ‘offers advantages including early detection, risk assessment, and screening’.

The test was a collaboration between Duke University, the University of California and University of Birmingham in Britain.

Orophayngeal cancer killed 2,722 Britons last year and took the lives of 9,750 people in the US, figures show. New cases of the disease in the UK have risen to 8,302 a year, a jump of 135 per cent compared with 20 years’ ago.

According to the researchers, this technology can also be used to analyse blood, urine, and plasma. The findings were published in the Journal of Molecular Diagnostics.

The Oral Health Foundation last month urged people to wise up to the causes of the ‘devastating’ disease, mainly HPV and alcohol. Dr Nigel Carter OBE, chief executive of the OHF, said: ‘While most cancers are on the decrease, cases of mouth cancer continue to rise at an alarming rate.

‘Traditional causes like smoking and drinking alcohol to excess are quickly being caught by emerging risk factors like the human papillomavirus (HPV).

‘We have seen first-hand the devastating affect mouth cancer can have on a person’s life.’

2019-12-14T11:12:24-07:00December, 2019|Oral Cancer News|

Tackling the complications from oral cancer and treatment

Source: www.medscape.com
Author: Tara Haelle

Complications from oral cancer and the toxic effects of treatment — including demineralization, caries, fibrosis, candidiasis, pain, sensitivity, and aesthetic concerns — can continue long after any evidence of cancer is apparent, experts reported at the World Dental Congress 2019.

One of the major toxic effects is changes in saliva, said Joel Epstein, DMD, director of cancer dentistry at the Cedars Sinai Health System in Los Angeles and director of dental oncology at the City of Hope Comprehensive Cancer Center in Duarte, California.

Another problem area — one that is often ignored — is taste, he told Medscape Medical News.

And toxic effects are common, he added, citing one study that showed that 16% of patients experienced dental toxicity in the year after undergoing radiotherapy. The rates increased to 36% after 3 years, 55% after 5 years, and 74% after 7 years.

For patients undergoing cancer therapy, dentists should look at overall oral hygiene, decay prevention, lip lubrication, dental emergencies, and oral mucosal infections, Epstein told the audience during his presentation on the management of patients with oral cancer, both during and after treatment.

Fortunately, there are a lot of things that dentists can help with, he pointed out. For example, fluoride can be used to promote mineralization and chlorhexidine rinse can be used to reduce cariogenic bacteria.

And photobiomodulation therapy, or low-level laser light therapy, can be used for the prevention of mucositis, which can be particularly painful, he added. Pain related to oral mucositis can be treated with transdermal fentanyl, 2% morphine mouth rinse, and 0.5% doxepin mouth rinse.

Dentists also need to emphasize prevention and monitor survivors for recurrence. “The highest-risk person for cancer,” said Epstein, “is the person who has already had cancer.”

Recognizing Worrisome Lesions
It can be difficult to determine which abnormalities in the mouth are cause for concern, said Mark Lingen, DDS, PhD, from the University of Chicago Pritzker School of Medicine. For example, candidiasis and squamous cell carcinoma can look similar, he pointed out.

Lingen opened the session on oral cancer prevention, early diagnosis, and patient management with an interactive exercise. He showed images of various oral lesions and it did not take long to winnow out the audience members who could correct identify all the worrisome lesions without false positives.

Some of the images were fairly textbook, said attendee Andrew Barnes, a dental hygienist from Santa Rosa, California, but others were a helpful refresher.

“Some of the more subtle stuff, you would look at it and think, ‘that’s nothing’,” Barnes told Medscape Medical News. “You need to be reminded that that might not be nothing.” In contrast, other images might appear concerning but probably aren’t cancerous.

The review of images was particularly helpful, said James Friedman, DDS, a dentist in private practice in Greenbrae, California. “I was one of the first people to sit down because I thought something wasn’t as serious as it turned out to be,” he said.

The use of cytology for the evaluation of suspicious lesions in patients who are resistant to biopsy or who live far from a provider who does biopsies, presented by Takashi Inoue, DDS, from the Tokyo Dental College, was also helpful, Friedman added.

The prevention guidelines, also presented by Lingen, were more familiar to Barnes and Friedman, and are part of conversations they have with their patients everyday about quitting smoking, reducing alcohol use, practicing good oral hygiene, and getting vaccinated against human papillomavirus (HPV), the most common cause of oral cancer.

Although the HPV vaccine has typically been regarded as the province of pediatricians, dental providers have taken an increasingly active role in preventing 70% of the 13,500 new cases of oropharyngeal cancer diagnosed each year in the United States.

“Dentists should be at least as involved as the medical community in advising vaccination for HPV,” said Epstein. “HPV cancers are preventable, but only by immunization, and it’s part of healthcare delivery that dentists should be more involved in.”

Although the prevention of oral cancer is a mainstay of daily dental practice, far fewer dentists feel confident about caring for patients who have oral cancer, said Epstein. In one study of Michigan dentists, for example, 55% of respondents said they did not feel adequately trained to care for patients with oral cancer, and 72% said they were interested in additional education.

The first part of this education is learning how to discuss bad news with patients. Epstein explained that he uses a version of the SPIKES protocol to talk to patients about a new oral cancer diagnosis.

Understanding a patient’s preferences can guide the provider’s approach, Epstein told the audience. “Some want a frank picture, the worst-case scenarios, while others want optimistic views” and a clear picture of all the treatment options from the start.

World Dental Congress (WDC) 2019.

2019-12-04T09:04:47-07:00December, 2019|Oral Cancer News|

UB center helps bring local dental products to market

Source: www.buffalo.edu
Author: Marcene Robinson

Stocked on the shelves of Western New York pharmacies is a bottle of dry mouth spray Lubricity, a product developed and manufactured locally by You First Services, Inc. with the support of the University at Buffalo Center for Dental Studies.

Through the partnership, the UB Center for Dental Studies verified the effectiveness of Lubricity through clinical trials, helping bring the product to market and contribute to the growth of You First Services as a budding employer in the region.

Since its establishment in 1988, the UB Center for Dental Studies has built an extensive history of performing scientific and clinical studies for new products by major companies around the world, including Johnson & Johnson and Colgate-Palmolive.

However, the center also works with local manufacturers, providing access to cutting-edge technology, state-of-the-art facilities and guidance from experienced researchers. Since its inception, the center has completed more than $15 million in research projects with contracts ranging from $10,000 to $450,000.

“Ease of accessibility to university scholars is one of the major benefits of having a research university like UB in our community, said Sebastian Ciancio, DDS, director of the Center for Dental Studies and Distinguished Service Professor in the UB School of Dental Medicine.

“Our Center for Dental Studies has helped manufacturers bring a number of useful products to the marketplace to improve oral health of consumers.”

Approved by the U.S. Food and Drug Administration in 2018, Lubricity, works as a saliva substitute for those who suffer from dry mouth. A side effect of more than 500 medications, dry mouth doubles the rate of dental decay compared to people without the condition, and increases the risk of pathogenic and fungal infections, says Ciancio.

The mouth spray, which contains hyaluronic acid, commonly known as “nature’s lubricant,” says Ciancio, is the commercialization of research concepts developed by late UB Distinguished Professor Robert Baier.

Lubricity, which can also be found online at Walmart, Walgreens and Amazon, and in independent pharmacies and hospitals pharmacies, is the flagship product and one of the early successes of You First Services. Formed in 2013, the company has grown from a fledgling startup housed in the UB Technology Incubator at Baird Research Park to a multimillion-dollar manufacturer of oral health care and sterilization products.

The company has received multiple peer-reviewed grants for programs in its disinfection and sterilization and infectious diseases control divisions, and earned the 2018 Bright Buffalo Niagara Industry Partner Award.

In addition to retaining space at Baird Research Park, in 2017, You First Services constructed a $2.6 million pharmaceutical manufacturing facility in Buffalo with the goal of creating 28 full-time jobs in the region.

The company also employs 12 UB alumni, and has provided paid internships to nearly a dozen UB students from fields that include engineering, biological sciences, business, communications and architecture.

“We are very proud of our long-standing relationship and for the incredible quality of the research programs here at the University at Buffalo, said Satish Sharma, MD, executive chairman and chief executive officer of You First Services Group of Companies and research associate professor of urology in the Jacobs School of Medicine and Biomedical Sciences at UB.

“The Center for Dental Studies’ scientific performance in terms of productivity, impact and excellence has remained outstanding. We at YFS will continue to work together with the University at Buffalo to continue to develop our programs to make a significant impact on the overall economy of the state and region.”

The UB Center for Dental Studies recently performed clinical trials for You First Services’ second product MetaQil, a mouth rinse that treats dysgeusia, a metallic taste disorder that occurs due to a number of causes, including damage to oral tissues by chemotherapy. The condition causes patients to experience a loss of taste or an overwhelming metallic taste.

The center performed a clinical trial of more than 50 local participants, who were treated with either MetaQil or a placebo. The study found that nearly 85% of participants reported a significant reduction in metallic taste while using the product.

MetaQil is available in local pharmacies and online.

The Center for Dental Studies and You First Services will continue to explore opportunities for research collaboration and clinical trials. To learn more about the UB Center for Dental Studies, visit the center’s website.

Oral cancer prognostic signature identified

Source: www.eurekalert.org
Author: press release

Researchers in Brazil have identified a correlation between oral cancer progression and the abundance of certain proteins present in tumor tissue and saliva. The discovery offers a parameter for predicting progression of the disease – whether cervical lymph node metastasis is present, for example – and points to a strategy for overcoming the limitations of clinical and imaging exams. It could also help guide the choice of an ideal treatment for each patient.

The study began in the discovery phase with a proteomic analysis of tissue from different tumor areas using 120 microdissected samples. In the verification phase, prognostic signatures were confirmed in approximately 800 tissue samples by immunohistochemistry and in 120 samples by targeted proteomics.

The study was supported by São Paulo Research Foundation – FAPESP and conducted at the National Energy and Materials Research Center (CNPEM) in partnership with the São Paulo State Cancer Institute (ICESP), the University of Campinas’s Piracicaba Dental School (FOP-UNICAMP), the Institute of Computing from the same university, the University of São Paulo’s Mathematics and Computer Science Institute (ICMC) in São Carlos, and the Dental School of the West Paraná University (UNIOESTE), in addition to other institutions in Brazil and abroad.

“The data led to robust results that are highly promising as guides to defining the severity of the disease. We suggested potential markers of the disease in the first phase of the study and verified these markers in the second phase, enhancing the reliability of the findings and showing that these markers are effective in classifying patients with cervical lymph node metastasis,” said Adriana Franco Paes Leme, a researcher at CNPEM’s National Bioscience Laboratory (LNBio) and the corresponding author of the article published in Nature Communications.

Mouth cancer, also known as oral squamous cell carcinoma (OSCC), is the most common type of malignant head and neck tumor. Prevalence and mortality are high, with some 300,000 new cases diagnosed per year worldwide and 145,000 deaths. Although it is relatively easy to detect, typically when a dentist notices an oral lesion, the disease is usually diagnosed when it is already at an advanced stage.

“We worked on the study for five years until we achieved this breakthrough,” Paes Leme told. “It was divided into two phases. In the first, we used discovery proteomics to identify and quantify tumor tissue proteins. The second phase of the study consisted of analyses using immunohistochemistry and targeted proteomics, for when you know precisely which proteins you want to quantify.”

Proteomics focuses on the identification, localization and functional analysis of the proteins in a sample, which may consist of tissue or cells, for example. The proteins are quantified, post-translational modifications are detected, and their activity and interactions are assessed.

Bioinformatics and machine learning
The study funded by FAPESP had two phases. In the first phase, the researchers used laser microdissection and proteomics to map the proteins in mouth cancer tissue and correlate them with the clinical characteristics of patients. This analysis permitted the identification of several proteins, such as CSTB, NDRG1, LTA4H, PGK1, COL6A1, ITGAV, and MB, with differing levels of abundance depending on tumor area and links to key clinical outcomes.

In the second phase, after identifying and quantifying proteins in the 120-odd tumor tissue samples, the researchers deployed two protein verification strategies.

“One strategy consisted of gauging the abundance of the selected proteins in independent tissue samples using immunohistochemistry with antibodies. The other consisted of monitoring the same preselected targets in patients’ saliva,” Paes Leme said.

Saliva was chosen because this cancer is located in the mouth, where proteins could be secreted by neoplastic cells. “Saliva is a promising source of markers, as well as being a fluid obtained by noninvasive collection,” she explained. “We verified the proteins in saliva from 40 patients. Technical triplicates were analyzed to achieve the highest possible confidence level for the results in this phase of the study.”

After analyzing the saliva samples, the researchers used bioinformatics and machine learning techniques to arrive at prognostic signatures, verifying which of the proteins or peptides selected in the first phase could distinguish between patients with and without cervical lymph node metastasis.

“In addition, we had valuable information about the clinical evolution of the patients who took part in the study as volunteers by donating samples of their saliva,” Paes Leme said.

From this result, it was possible to identify three specific peptides – LTA4H, COL6A1, and CSTB – that can be used as a signature to classify patients with and without cervical lymph node metastasis, offering the potential to help doctors overcome the limitations of clinical exams and guide personalized treatment strategies.

Affordable biosensors
The scientists are now working on a new study designed to use translational techniques to build affordable biosensors capable of detecting prognostic signatures in patients’ saliva.

Peptides currently have to be identified and quantified by mass spectrometry and proteomics, which are costly techniques and not often available in clinics and hospitals.

“We want to develop a simpler and cheaper method that can easily be used by health professionals to assess the progression of the disease on the basis of tests that can be performed in a dentist’s or doctor’s office, or in clinical labs. In the study we’ve just published, we were able to identify this prognostic signature by mass spectrometry. We now plan to develop a biosensor with a focus on the use of this signature so that it can be adopted for clinical use and help guide treatment decisions”, Paes Leme said.

2018-12-06T12:27:03-07:00December, 2018|Oral Cancer News|

Ask the Dentist: Cancer patients should be aware how radiotherapy can affect saliva

Source: www.irishnews.com
Author: Lucy Stock

SALIVA – we normally give little thought to our spit but we definitely notice when it’s not there. Every day in the UK 31 people are diagnosed with a head and neck cancer. With increasing numbers of people undergoing radiotherapy for head and neck cancers there are more people living with the side-effects of not having enough saliva.

Dry mouth, termed xerostomia, is common after radiotherapy. It’s not only extremely uncomfortable, it makes speaking and swallowing more difficult and alters how things taste. Food can taste saltier, metallic; you can lose your sense of taste totally; and perhaps even worse, foods can taste foul, like sour milk.

Not being able to chew and swallow easily can reduce how much you eat and how well you eat, leading to weight loss and poor nourishment.

Saliva performs numerous jobs. It starts digestion by breaking down food and flushes food particles from between the teeth. Crucially, saliva contains minerals such as calcium and phosphate that keep teeth strong. So no saliva means that teeth decay rapidly and extensively. Even voice quality can change.

Without enough saliva, bacteria and other organisms in the mouth take the opportunity to grow uncontrollably. Nasty sores and mouth infections, including yeast thrush infections, are run-of-the-mill.

Luckily a dry mouth is usually a temporary nuisance that clears up in about two to eight weeks but it can take six months or longer for the salivary glands to start producing saliva again after radiotherapy ends.

In a 2017 study, out of several treatments tested, the drug pilocarpine gave the most significant improvement in dry mouth following radiotherapy. However, you may experience a side effect, albeit short lived, from this medication and it can take a couple of months to work.

Artificial salivas are available as lozenges, sprays and gels, the downside being that their benefits last only a few hours. The Biotene range is specially designed to help relieve dry mouths and includes toothpastes, mouthwashes and gels to give comfort and protect the teeth.

You can buy small atomiser spray bottles from most chemists and fill them with water or fluoride mouthwash. If you cannot swallow, your nurse or doctor can give you a nebuliser to moisten your mouth and throat. Always visit your dentist before cancer treatments to maximise the health of your mouth.

Relieve a dry mouth by:

  • Sipping water often
  • Avoiding drinks with caffeine which dry out the mouth
  • Chewing sugarless gum
  • Avoiding spicy or salty foods, which may cause pain
  • Avoiding tobacco or alcohol
  • Using a humidifier at night.
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