survival

Calls grow for treatment deintensification of HPV-positive OPC

Source: ww.pharmacytimes.com Author: Bryan Fitzgerald, PharmD, BCOP Health-System Edition, July 2021, Volume 10, Issue 4 Oropharyngeal cancer (OPC) is a type of head and neck cancer that affects structures in the back of the throat, including the base of the tongue, the posterior pharynx, the soft palate, and the tonsils.1 In the United States, rates of OPC are increasing each year, with an estimated 54,010 new cases in 2021.2 Well-established risk factors include alcohol abuse; exposure to tobacco, including chewing tobacco, cigarettes, and pipes; and infection with human papillomavirus (HPV). With an estimated 43 million infections in 2018, HPV is the most common sexually transmitted infection in the United States.3 HPV infection is causally linked with cancers of the anogenital region, including anal, cervical, penile, vaginal, and vulvar cancers. When HPV is spread orally, infections can also lead to the development of OPC. In the United States, more than 70% of OPC cases are caused by HPV.4 HPV is a group of more than 100 viruses, including certain high-risk strains associated with the development of cancer. The HPV-16 strain is responsible for causing the majority of HPV-positive (HPV+) OPC cases, with HPV-18, HPV-33, and HPV-35 also contributing, albeit significantly less than HPV-16.1 In these high-risk HPV strains, the viral genome encodes several oncogenic proteins that inhibit tumor suppressor proteins, leading to chromosomal instability and malignancy in infected cells. HPV+ OPC is considered a genetically distinct form of OPC. Compared with HPV-negative (HPC–) OPC cases, HPV+ OPC is associated with a [...]

Oral Cancer Foundation News Team - A2021-07-21T10:05:34-07:00July, 2021|Oral Cancer News|

Factors identified for poor long-term survival in RT-treated patients with oropharyngeal cancer

Source: www.cancertherapyadvisor.com Author: Susan Moench, PhD, PA-C Specific patient- and treatment-related factors were identified as potential survival detriments for patients with a history of oropharyngeal cancer (OPC) who received radiation therapy (RT) and were alive for at least 5 years following diagnosis, according to findings from a retrospective database review published in Cancer. Specifically, older age at diagnosis (≥55 years; standardized mortality ratio [SMR], 3.68), status as a current or former smoker (SMR, 3.28 vs 7.43), and the presence of tonsil (SMR, 4.39) or base of tongue tumors (SMR, 3.10) or category T4 tumors (SMR, 5.43) correlated with a higher risk for death. Previous research has demonstrated that patients with head and neck cancers who remain recurrence-free for 5 years following diagnosis have a very low risk of disease recurrence. However, less is known about the conditional long-term survival of this group of patients, represented by the 2-, 5- and 10-year overall survival (OS) probabilities for those without evidence of disease recurrence 5-years post-diagnosis. Furthermore, patient, disease-, and treatment-related factors associated with long-term survival in these patients are also not well understood. Of the 1699 patients included in this analysis, all were newly diagnosed with squamous cell carcinoma OPC between 1980 and 2012, had no cancer event for the 5 years that followed OPC diagnosis, and had been treated with RT without surgery at the University of Texas MD Anderson Cancer Center in Houston, Texas. Baseline characteristics of this patient cohort included a median age of 60 years. Most of [...]

Oral Cancer Foundation News Team - A2021-01-05T20:20:28-07:00January, 2021|Oral Cancer News|

Study shows checkpoint inhibitor prolongs survival in patients with certain head and neck cancers

Source: medicalxpress.com Author: Anne Doerr, Yale University The checkpoint inhibitor pembrolizumab (Keytruda) increases the survival time of patients with advanced head and neck cancers, according to a new global study led by Yale Cancer Center (YCC). The data was published today in the journal The Lancet. The findings of the phase 3 study show that, compared to the standard therapy, overall survival was significantly improved for participants with previously untreated recurrent or metastatic head and neck cancers. "This research demonstrates that this checkpoint inhibitor, with or without chemotherapy, should be the first drug used for these types of cancers," said the study's lead investigator, Barbara Burtness, M.D., a professor of medicine (medical oncology) and co-leader of developmental therapeutics at YCC. "This is a very positive advance in treatment for our patients." Burtness added that early results from this clinical trial, KEYNOTE-048, led to FDA approval earlier this year of pembrolizumab as first-line therapy in untreated recurrent or metastatic head and neck squamous-cell carcinoma, which include cancers of the oral cavity, oropharynx, hypopharynx and larynx. While the median survival benefit was calculated in months, some patients treated with pembrolizumab lived much longer and did significantly better than patients who were not treated with the checkpoint inhibitor, Burtness noted. The study looked at 882 participants enrolled in 200 medical centers in 37 countries, who were randomly assigned to one of three different groups: those receiving pembrolizumab, those treated with pembrolizumab and chemotherapy, and those getting the standard therapy with cetuximab and chemotherapy. [...]

Oral Cancer Foundation News Team - A2019-11-05T04:25:49-07:00November, 2019|Oral Cancer News|

Machine learning improves the diagnosis of patients with head and neck cancers

Source: www.sciencedaily.com Author: materials from Charité - Universitätsmedizin Berlin Researchers from Charité -- Universitätsmedizin Berlin and the German Cancer Consortium (DKTK) have successfully solved a longstanding problem in the diagnosis of head and neck cancers. Working alongside colleagues from Technische Universität (TU) Berlin, the researchers used artificial intelligence to develop a new classification method which identifies the primary origins of cancerous tissue based on chemical DNA changes. The potential for introduction into routine medical practice is currently being tested. Results from this research have been published in Science Translational Medicine. Every year, more than 17,000 people in Germany are diagnosed with head and neck cancers. These include cancers of the oral cavity, larynx and nose, but can also affect other areas of the head and neck. Some head and neck cancer patients will also develop lung cancer. "In the large majority of cases, it is impossible to determine whether these represent pulmonary metastases of the patient's head and neck cancer or a second primary cancer, i.e. primary lung cancer," explains Prof. Dr. Frederick Klauschen of Charité's Institute of Pathology, who co-led the study alongside Prof. Dr. David Capper of Charité's Department of Neuropathology. "This distinction is hugely important in the treatment of people affected by these cancers," emphasizes Prof. Klauschen, adding: "While surgery may provide a cure in patients with localized lung cancers, patients with metastatic head and neck cancers fare significantly worse in terms of survival and will require treatments such as chemoradiotherapy." When trying to distinguish between metastases [...]

Oral Cancer Foundation News Team - A2019-09-13T05:44:12-07:00September, 2019|Oral Cancer News|

Merck’s Keytruda wins FDA approval to treat head and neck cancer

Source: www.pharmalive.com Author: staff, Reuters Health Merck & Co Inc said on Tuesday its blockbuster cancer drug Keytruda won approval from the U.S. Food and Drug Administration to treat a type of head and neck cancer. The drug was approved for use as a monotherapy, as well as in combination with a common chemotherapy regimen, to treat previously untreated patients with head and neck squamous cell carcinoma, Merck said. The approval is based on results from a late-stage trial, where Keytruda showed a significant improvement in overall survival in cancer patients, Merck said. Keytruda, a type of immunotherapy called a PD-1 inhibitor, is already an approved treatment for several forms of cancer, including lung and skin cancers. Head and neck cancer includes tumors in the mouth, tongue, nose, sinuses, throat and lymph nodes in the neck. Merck estimates that there will be more than 65,000 new cases of head and neck cancer diagnosed in 2019 in the United States. Keytruda works by increasing the ability of patients’ immune system to help detect and fight tumor cells. The drug has been amassing approvals as a standalone therapy and in combination with other drugs to treat several forms of cancer. It is the leading immunotherapy for treating lung cancer, ahead of rival drugs from Bristol-Myers Squibb, Roche and AstraZeneca. Keytruda, first approved for advanced melanoma in 2014, is Merck’s most important growth driver. It has overtaken Bristol’s Opdivo as the industry’s immuno-oncology leader with sales expected to top $10 billion this year [...]

Oral Cancer Foundation News Team - A2019-06-12T07:49:37-07:00June, 2019|Oral Cancer News|

How aspirin may benefit some people with head and neck cancer

Source: www.medicalnewstoday.com Author: Catharine Paddock PhD, fact checked by Paula Field Recent research has tied regular use of nonsteroidal anti-inflammatory drugs, such as aspirin, to longer survival in some people with head and neck cancer. The researchers propose that there should now be a clinical trial to test the effectiveness and safety of nonsteroidal anti-inflammatory drugs (NSAIDs) for this purpose. They suggest that the effect that they observed is likely due to the NSAIDs reducing prostaglandin E2, a molecule that promotes inflammation. A paper on their findings now features in the Journal of Experimental Medicine. Head and neck cancers are cancers in which tumors develop in the nose, sinuses, larynx, throat, and mouth. In most cases, the tumors arise in the flat thin squamous cells that form the tissue lining of surfaces. For this reason, they bear the name head and neck squamous cell carcinomas (HNSCCs). In the United States, people with HNSCCs account for around 4 percent of all those with cancer. These types of cancer also tend to have a lower rate of survival compared with many other types. The main risk factors for HNSCC are tobacco use, heavy use of alcohol, sun exposure, and infection with the human papillomavirus (HPV). Aspirin and HNSCC Previous research has suggested that taking aspirin regularly can reduce the risk of developing HNSCCs. However, the recent study is the first to link the use of aspirin and other NSAIDs to longer survival in some people who already have HNSCC. It found that, [...]

Oral Cancer Foundation News Team - A2019-01-28T19:30:02-07:00January, 2019|Oral Cancer News|

Restaging raises hope against HPV oral cancer

Source: atlantajewishtimes.timesofisrael.com Author: Cady Schulman Jason Mendelsohn was diagnosed with Stage 4 tonsil cancer from HPV in 2014 after finding just one bump on his neck. He survived thanks to a variety of treatments, including a radical tonsillectomy and neck dissection to remove 42 lymph nodes, seven weeks of chemotherapy, radiation and a feeding tube. But if Mendelsohn’s cancer had been discovered today, just four years later, it would have been classified as Stage 1. That’s because HPV-related oral cancers now have a high survival rate through a better response to treatment, said Meryl Kaufman, a speech pathologist specializing in head and neck cancer management who worked for Emory University’s department of head and neck surgery for 10 years. “Cancer staging is taking into account the HPV-related cancers,” said Kaufman, who now owns her own practice. “It was kind of all lumped together. The survival rates for people who have HPV-related cancers are much higher than the typical head and neck cancers associated with smoking and drinking.” For Mendelsohn, finding out that patients with HPV-related cancers likely face easier treatments and higher success rates made him extremely happy. “If I was diagnosed and I heard Stage 1 instead of Stage 4, while it’s still cancer, it would make me feel like I could beat it,” said Mendelsohn, who made a video for his children a month after his diagnosis with advice for their lives after he was gone. “When I hear Stage 4 to Stage 1, I think people have [...]

Oral Cancer Foundation News Team - A2018-05-07T13:07:45-07:00May, 2018|Oral Cancer News|

Study provides new guidelines for assessing severity of head and neck cancers

Source: eurekalert.org Author: press release Cedars-Sinai Medical Center Cedars-Sinai investigators have developed a new, more accurate set of guidelines for assessing the severity of head and neck cancers and predicting patient survival. The new guidelines, outlined in a study recently published in the Journal of Clinical Oncology, center around counting the number of malignant lymph nodes found in each patient. "The greater the number of malignant lymph nodes, the less favorable the patients' chances of survival," said Allen S. Ho, MD. Ho is director of the Head and Neck Program at the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai and lead author of the study. "This new approach could dramatically simplify staging systems." For decades, doctors have determined the stage and predicted the progression of head and neck cancers based primarily on nodal size, location and how far the cancer has spread beyond the lymph nodes, but they have given less importance to the number of cancerous nodes. As a result, staging and treatment recommendations, based on current national guidelines, "are the same whether a patient has two or 20 positive lymph nodes," said Zachary S. Zumsteg, MD, assistant professor of Radiation Oncology at Cedars-Sinai and the study's senior author. With the new system, based on the number of cancerous lymph nodes, patients are separated into similarly sized groups with distinct outcomes, Zumsteg said. "Our study demonstrated a better way to assess cancer severity, which will improve our ability to predict outcomes and give patients more personalized treatment." The Cedars-Sinai [...]

Oral Cancer Foundation News Team - A2018-01-24T09:24:42-07:00January, 2018|Oral Cancer News|

Number of metastatic nodes a predictor for survival in oral cancer

Source: www.onclive.com Author: Jason Harris The presence of metastatic lymph nodes was directly correlated with poorer survival in patients with oral cancer. Mortality risk rose continuously with the number of metastatic nodes without plateau, according to findings published in the Journal of Clinical Oncology. Investigators found that the effect was most pronounced with up to 4 lymph nodes (hazard ratio [HR], 1.34; 95% CI, 1.29-1.39; P < .001). Extranodal extension (HR, 1.41; 95% CI, 1.20-1.65; P <.001) and lower neck involvement (HR, 1.16; 95% CI, 1.06-1.27; P <.001) were also predictors for increased mortality. Citing the need for more precise staging metrics and treatment stratification, the investigators assessed the effect of quantitative metastatic nodal burden in a large population of patients with oral cavity cancer. Researchers selected oral cavity cancers because of their surgical treatment paradigm with more complete pathologic nodal data. “Metastatic nodal burden is a central predictor of mortality in patients with oral cavity cancer, with each additional metastatic lymph node conferring escalated risk of mortality,” first author Allen S. Ho, MD, Department of Surgery, Cedars-Sinai Medical Center, and co-investigators wrote. “Classic factors such as lymph node size and contralateral nodal metastasis lack independent prognostic value when accounting for number of metastatic nodes.” “Our data suggest that deeper integration of quantitative nodal burden could better calibrate the wide spectrum of risk that staging systems presently capture. Such adjustments would be a promising means to more effectively articulate patient prognosis, tailor clinical trial design, and ultimately advance clinical decision [...]

Oral Cancer Foundation News Team - A2017-10-25T14:05:01-07:00October, 2017|Oral Cancer News|

Halving radiation therapy for HPV-related throat cancer offers fewer side effects, similar outcomes

Source: www.eurekalert.org Author: Mayo Clinic press release Mayo Clinic researchers have found that a 50 percent reduction in the intensity and dose of radiation therapy for patients with HPV-related throat cancer reduced side effects with no loss in survival and no decrease in cure rates. Results of a phase II study were presented today at the 59th Annual Meeting of the American Society for Radiation Oncology in San Diego by Daniel Ma, M.D. a radiation oncologist at Mayo Clinic. "A common approach for treating HPV-related throat cancer is a combination of surgery followed by daily radiation therapy for six to 6½ weeks," says Dr. Ma. "However, the radiation treatment can cause a high degree of side effects, including altered taste, difficulty swallowing, dry mouth, stiff neck and damage to the jaw bone." Dr. Ma says that patients with HPV-related throat cancer tend to be young and, once treated, are likely to live a long time with possibly life-altering side effects from the standard treatment. "The goal of our trial was to see if an aggressive reduction of radiation therapy (two weeks of radiation twice daily) could maintain excellent cure rates, while significantly reducing posttreatment side effects, improving quality of life and lowering treatment costs." Researchers followed 80 patients with HPV-related oropharyngeal squamous cell cancer with no evidence of residual disease following surgery and a smoking history of 10 or fewer pack years. That's the number of years smoking multiplied by the average packs of cigarettes smoked per day. At two [...]

Oral Cancer Foundation News Team - A2017-09-26T07:17:21-07:00September, 2017|Oral Cancer News|