Expert Point of View: Tanguy Y. Seiwert, MD
Tanguy Y. Seiwert, MD, moderator of the session on the phase II trial of neoadjuvant nivolumab with or without ipilimumab in patients with oral cavity cancer, underscored concerns about differences in outcome measures. Dr. Seiwert is Director of the Head and Neck Cancer Oncology Disease Group and...
Phase II Trial Finds Neoadjuvant Immunotherapy Feasible in Oral Cavity Cancer
The results of a phase II study suggest that a short course of immunotherapy prior to surgery for oral cavity cancer may trigger tumor regression, possibly providing long-term benefits for patients. According to data presented at the 2020 Multidisciplinary Head and Neck Cancers Symposium,1 a 3-week ...
Immune-Restorative Agent May Boost Immunotherapy Response in Advanced Head and Neck Cancer
Immune modulation with checkpoint inhibitors has shown beneficial effects in advanced head and neck squamous cell carcinoma, but responses have been limited to a small number of patients. According to data presented at the 2020 Multidisciplinary Head and Neck Cancers Symposium, however, an...
Expert Point of View: Sue Sun Yom, MD, PhD
Sue Sun Yom, MD, PhD, Professor of Radiation Oncology & Otolaryngology–Head and Neck Surgery at the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, said there is “reasonableness to further investigation” of the combination of programmed cell death...
Pembrolizumab Plus Radiotherapy Worthy of Further Study in Locally Advanced Squamous Cell Head and Neck Cancer
The combination of the checkpoint inhibitor pembrolizumab and definitive radiation therapy appears to be a safe and feasible option for patients with locally advanced head and neck cancer who are not eligible for cisplatin, according to data presented at the 2020 Multidisciplinary Head and Neck...
Sue Sun Yom, MD, PhD, on HPV-Associated Oropharyngeal Cancer: Challenges in De-intensifying Radiation Therapy
Sue Sun Yom, MD, PhD, of the University of California, San Francisco, talks about the variety of evolving ways to deintensify radiation therapy, the critical need to counsel patients on the risks and benefits, and the ethical importance of respecting patient preferences in choosing their cancer therapies.
Jared Weiss, MD, on Squamous Cell Carcinoma of the Head and Neck: When Standard Therapy is Contraindicated
Jared Weiss, MD, of the University of North Carolina, Chapel Hill, discusses outcomes for patients with stage III or IV disease who are ineligible for the standard treatment of cisplatin plus radiotherapy. His data suggest that treatment with pembrolizumab/radiotherapy instead is tolerable, with improvements seen in progression-free and overall survival (Abstract LBA1).
Jonathan D. Schoenfeld, MD, MPH, on Oral Cavity Cancer: Neoadjuvant Nivolumab With or Without Ipilimumab
Jonathan D. Schoenfeld, MD, MPH, of Dana-Farber Cancer Institute and Brigham and Women’s Hospital, discusses phase II study results with the PD-1 inhibitor nivolumab or the combination of PD-1/CTLA-4 inhibition with nivolumab/ipilimumab in patients with newly diagnosed untreated oral cavity cancer (Abstract 1).
Gopal K. Bajaj, MD, MBA, on Reducing Opioid Use in Patients With Head and Neck Cancer Undergoing Radiotherapy
Gopal K. Bajaj, MD, MBA, of the Inova Schar Cancer Institute, discusses the results of a small study that showed prophylactic gabapentin can be safely and effectively used to significantly reduce pain and the use of opioids in patients undergoing radiotherapy or chemoradiotherapy for head and neck squamous cell carcinoma.
David Adelstein, MD, on Guidelines for Treating HPV-Associated Oropharyngeal Squamous Cell Carcinoma
David Adelstein, MD, of the Cleveland Clinic, discusses the hypothesis that treatment can be de-intensified in patients with HPV-associated oropharyngeal cancer and a good prognosis.
Jill Gilbert, MD, on HPV-Associated Oropharyngeal Cancer: Challenges in De-intensifying Systemic Therapies
Jill Gilbert, MD, of Vanderbilt University Medical Center, discusses this ongoing area of investigation and which patients can safely undergo a de-intensification of treatment. Based on two randomized trials, cetuximab should not be substituted for cisplatin as a de-intensification strategy in HPV-positive oropharyngeal cancer.
Assuntina G. Sacco, MD, on Head and Neck Squamous Cell Carcinoma: Trial Results on Pembrolizumab and Cetuximab
Assuntina G. Sacco, MD, of the University of California, San Diego, discusses the results of a small phase II study, which suggest that pembrolizumab plus cetuximab may show activity for platinum-refractory/-ineligible patients with recurrent or metastatic head and neck squamous cell carcinoma (Abstract 15).
Nadeem Riaz, MD, on Established and Emerging Biomarkers for Immunotherapy in Head and Neck Cancer
Nadeem Riaz, MD, of Memorial Sloan Kettering Cancer Center, discusses the biomarkers that have emerged for immunotherapy and their tumor microenvironments, from PD-L1 staining and the Combined Positive Score to next-generation genomic technologies.
Carryn M. Anderson, MD, on Reducing Severe Oral Mucositis and Its Effect on Patient Outcomes
Carryn M. Anderson, MD, of the University of Iowa Hospital, discusses the investigational agent GC4419, previously shown to be safe and effective in decreasing the duration, incidence, and severity of oral mucositis in patients receiving concurrent cisplatin and radiation for oral cavity and oropharyngeal squamous cancers. The 2-year tumor outcome data suggest that GC4419 does not seem to compromise tumor control (Abstract LBA2).
Francis P. Worden, MD, on the Role of Induction Chemotherapy in Laryngeal Preservation
Francis P. Worden, MD, of the University of Michigan Health System Comprehensive Cancer Center, explores the use of novel biomarkers that may help predict response to induction chemotherapy and survival in patients with locally advanced laryngeal cancer.
FDA Pipeline: Priority Review in Lung Cancer, Breakthrough Therapy Designation in Head and Neck Cancer, and More
This week, the U.S. Food and Drug Administration (FDA) granted Priority Review to brigatinib for the treatment of ALK-positive lung cancer and Breakthrough Therapy designation to a potential first-in-class oral antagonist of inhibitors of apoptosis proteins for the treatment of head and neck...
2020 Head and Neck Cancers Symposium: Immune Restorative Agent May Boost Immunotherapy Response in Advanced Head and Neck Cancer
Immune modulation with checkpoint inhibitors has shown benefit in advanced head and neck squamous cell carcinoma, but responses have been limited to a small number of patients. According to data presented by Gregory T. Wolf, MD, FACS, Professor Emeritus in the Department of Otolaryngology-Head and...
2020 Head and Neck Cancers Symposium: Adjuvant Everolimus for Advanced Head and Neck Cancer
The mTOR inhibitor everolimus may extend progression-free survival for patients with advanced head and neck cancer who are at high risk for recurrence after standard treatment. Patients enrolled in a randomized phase II trial who received the agent were more likely to be cancer-free 1 year after...
2020 Head and Neck Cancers Symposium: Nivolumab With or Without Ipilimumab for the Neoadjuvant Treatment of Patients With Oral Cavity Cancer
Results from a new clinical trial suggest that neoadjuvant immunotherapy for oral cavity cancers may elicit tumor regression, which could provide long-term benefit for patients. Findings were presented by Jonathan D. Schoenfeld, MD, MPH, of Dana-Farber/Brigham and Women's Cancer Center, and...
2020 Head and Neck Cancers Symposium: Pembrolizumab Plus Radiotherapy for Platinum-Ineligible Patients With Locally Advanced HNSCC
A new phase II trial has found that the combination of radiation therapy and pembrolizumab led to improved survival outcomes and acceptable toxicity for patients with locally advanced head and neck squamous cell carcinoma (HNSCC). The combination therapy may offer a new treatment option for...
FDA Pipeline: Priority Reviews in Lung Cancers, Lymphoma
This week, the U.S. Food and Drug Administration (FDA) granted Priority Review to treatments for non–small cell and small cell lung cancers, as well as for diffuse large-B cell lymphoma (DLBCL); Breakthrough Therapy designation to an antibody-drug conjugate for bladder cancer; and a double Fast...
FDA Pipeline: Priority Reviews in Lymphoma, Lung Cancer, GIST, and Breast Cancer
This week, the U.S. Food and Drug Administration (FDA) granted Priority Review to agents in lymphoma, lung cancer, gastrointestinal stromal tumors, and breast cancer, and granted Fast Track designation to a first-in-class radioenhancer hafnium oxide nanoparticle in head and neck cancer. Priority...
Plasma Circulating Tumor HPV DNA for the Detection of Recurrent HPV-Associated Oropharyngeal Cancer
In a study reported in the Journal of Clinical Oncology, Bhishamjit S. Chera, MD, and colleagues found that surveillance for circulating tumor human papillomavirus (HPV) DNA was accurate in identifying disease recurrence in patients with curatively treated HPV-associated oropharyngeal squamous cell ...
Do Socioeconomic Factors Play a Role in Outcomes for HPV-Positive Head and Neck Cancer?
Survival outcomes for patients with human papillomavirus (HPV)-positive squamous cell carcinoma of the head and neck have made significant gains in recent years, but new research published by Pike et al in JNCCN—Journal of the National Comprehensive Cancer Network has found some groups have not...
Gabapentin and Methadone for Patients Undergoing Treatment of Head and Neck Cancer
With nearly all patients who undergo treatment for cancer of the head and neck experiencing oral mucositis, effective pain control is one of the main goals of physicians and care teams. Looking to provide more effective relief for patients—while also reducing the need for opioid painkillers—a team...
Patients With HPV-Positive and HPV-Negative Oropharyngeal Cancer May Have Different Rates of Mortality
New research indicates that there is a higher risk of early death among patients with oropharyngeal cancer not associated with human papillomavirus (HPV) vs those whose tumors are HPV-positive. The findings are published by Fullerton et al in Cancer. The incidence of oropharyngeal cancer is...
T-DM1 Shows Activity in HER2-Amplified Salivary Gland Cancer in Small Patient Sample of NCI-MATCH
The antibody-drug conjugate ado-trastuzumab emtansine (T-DM1) showed activity in HER2-amplified salivary gland tumors, according to data published by Jhaveri et al in Annals of Oncology. The publication is for ‘Arm Q,’ which is one of nearly 40 single-arm phase II treatments in the NCI-Molecular...
Saliva Test May Play A Role in the Early Detection of HPV-Related Oropharyngeal Cancer
A report by Wang et al in The Journal of Molecular Diagnostics described the use of acoustofluidics, a noninvasive method that analyzes saliva for the presence of human papillomavirus type 16 (HPV-16), the pathogenic strain of the disease associated with oropharyngeal cancers. This novel technique...
Pembrolizumab vs Cetuximab Plus Chemotherapy in Recurrent or Metastatic Head/Neck Squamous Cell Cancer
As reported in The Lancet by Barbara Burtness, MD, of the Department of Medicine, Yale University School of Medicine, and colleagues, the phase III KEYNOTE-048 trial has shown improved overall survival with first-line pembrolizumab plus chemotherapy vs cetuximab plus chemotherapy among patients...
FDA Pipeline: Priority Reviews in SCLC, Bladder Cancer, Colorectal Cancer
Recently, the U.S. Food and Drug Administration (FDA) granted Priority Reviews for treatments in extensive-stage small cell lung cancer (SCLC), non–muscle invasive bladder cancer, and BRAF V600E–mutant colorectal cancer. The Agency also recently issued multiple Breakthrough Therapy designations and ...
Acupuncture May Reduce Radiation-Induced Dry Mouth for Patients With Head and Neck Cancer
After receiving acupuncture treatment 3 days a week during the course of radiation treatment, patients with head and neck cancer experienced less dry mouth, according to study results published by Garcia et al in JAMA Network Open. The results are from the first randomized, placebo-controlled,...
Early Research Shows Potential New Targets in Treating Glioblastoma, Colorectal Cancer, and Pancreatic Ductal Adenocarcinoma
Glioblastoma multiforme, colorectal cancer, and pancreatic ductal adenocarcinoma represent some of the most difficult-to-treat cancers and collectively cause more than 114,000 deaths each year in the United States. A trio of recently published basic research studies in these cancers have found...
Immunotherapy for Head/Neck Squamous Cell Carcinoma: Questions Raised by KEYNOTE-048
There is a new first-line treatment option for patients with newly diagnosed, recurrent, or metastatic head and neck squamous cell carcinoma. As reported by Burtness et al in The Lancet, pembrolizumab improved overall survival vs the standard-of-care regimen of cetuximab and platinum-based...
PIK3CA Mutation Status and Disease-Free Survival in Patients With HPV-Associated Head and Neck Cancer Treated With Deintensified Chemoradiotherapy
In a study reported in the Journal of the National Cancer Institute, Beaty et al found that the presence of a PIK3CA mutation was associated with poorer disease-free survival among patients receiving deintensified definitive chemoradiotherapy for human papillomavirus (HPV)-associated oropharyngeal...
Nivolumab vs Chemotherapy in Advanced Esophageal Cancer
Nivolumab improved overall survival compared with chemotherapy in previously treated patients with esophageal squamous cell carcinoma in the final analysis of the phase III ATTRACTION-3 study. The data were presented at the European Society for Medical Oncology (ESMO) Congress 2019 Presidential...
Pembrolizumab With or Without Chemotherapy vs Cetuximab Plus Chemotherapy in Recurrent or Metastatic HNSCC
As reported in The Lancet by Barbara Burtness, MD, and colleagues, the phase III KEYNOTE-048 trial has shown improved overall survival with first-line pembrolizumab plus chemotherapy vs cetuximab plus chemotherapy among patients with recurrent or metastatic squamous cell carcinoma of the head and...
Head and Neck Melanoma in Adolescents and Young Adults: 1995 to 2014
Head and neck melanoma appears to be on the rise in young people in the United States and Canada, according to a study by Nosayaba Osazuwa-Peters, BDS, PhD, MPH, CHES, of the Saint Louis University (SLU) School of Medicine, and colleagues. Because the prognosis of head and neck melanoma is...
Remembering Craig Alguire
It is with great sadness that we report Craig Alguire, MD, 42, died on October 11, 2019, at his home in Grand Rapids, Michigan. Diagnosed with grade 4 glioblastoma multiforme in 2015, Dr. Alguire chronicled the effects the cancer was having on his life in his Patient’s Corner column, published in...
AACR-NCI-EORTC: Activity of Tipifarnib in Patients With HRAS-Mutant Head and Neck Squamous Cell Carcinoma
A small phase II study investigating the efficacy and safety of the investigational farnesyl transferase inhibitor tipifarnib in patients with recurrent and metastatic HRAS-mutant head and neck squamous cell carcinoma found the agent produced objective responses in the patient population. Based on...
Superoxide Dismutase Mimetic for Reducing Severe Oral Mucositis From Concurrent Radiotherapy and Cisplatin in Head and Neck Cancer
In a phase IIb trial reported in the Journal of Clinical Oncology, Anderson et al found that the superoxide dismutase mimetic GC4419 was effective in reducing the duration, incidence, and severity of severe oral mucositis in patients with head and neck cancer receiving concurrent radiotherapy and...
Superoxide Dismutase Mimetic for Reducing Severe Oral Mucositis From Concurrent Radiotherapy and Cisplatin in Head and Neck Cancer
In a phase IIb trial reported in the Journal of Clinical Oncology, Anderson et al found that the superoxide dismutase mimetic GC4419 was effective in reducing duration, incidence, and severity of severe oral mucositis in patients with head and neck cancer receiving concurrent radiotherapy and...
Swallowing-Related Quality of Life After Radiotherapy vs Surgery for Oropharyngeal Squamous Cell Carcinoma
In the phase II ORATOR trial reported in The Lancet Oncology, Anthony Nichols, MD, and colleagues found a statistical but not clinically meaningful improvement in swallowing-related quality of life outcomes 1 year after treatment with radiotherapy vs transoral robotic surgery and neck dissection...
Addition of Induction Gemcitabine/Cisplatin to Chemoradiotherapy in Nasopharyngeal Carcinoma
In a Chinese phase III trial reported in The New England Journal of Medicine, Yuan Zhang, MD, PhD, and colleagues found that the addition of gemcitabine/cisplatin induction chemotherapy to standard platinum-based chemoradiotherapy improved recurrence-free survival vs chemoradiotherapy alone in...
Effect of Patient General Preference for More vs Less Medical Care on Intensity of Posttreatment Thyroid Cancer Surveillance
In an analysis reported in the Journal of Clinical Oncology, Evron et al found that patients with thyroid cancer who were declared disease-free after initial treatment were more likely to have increased numbers of physician visits and imaging tests if they reported a generalized preference for...
Researchers Examine the Rise in HPV-Related Oropharyngeal Cancers
Human papillomavirus (HPV) causes nearly all cervical cancers and is attributed to some cancers of the vagina, vulva, penis, anus, and oropharynx. Although most HPV infections are asymptomatic and usually resolve within 1 to 2 years, persistent infections can lead to precancer and cancer. According ...
ESMO 2019: Personalized Treatment for Head and Neck Cancer Based on Geriatric Assessment
Fit elderly patients aged 70 years and older with head and neck squamous cell carcinoma were able to undergo rigorous treatment that provided benefit similar to that observed in younger patients. However, elderly patients with head and neck squamous cell carcinoma classified by geriatric assessment ...
HPV-Positive Oropharyngeal Cancer Burden Rising Among White Men in the United States
White men older than age 65 will have the greatest burden of oropharyngeal cancer by the year 2030, according to Maura L. Gillison, MD, PhD, Professor and Endowed Chair at MD Anderson Cancer Center in Houston. But there is some good news, she said at the 2019 Winship Cancer Institute of Emory...
Addition of Induction Gemcitabine/Cisplatin to Chemoradiotherapy in Nasopharyngeal Carcinoma
In a Chinese phase III trial reported in The New England Journal of Medicine, Zhang et al found that the addition of gemcitabine/cisplatin induction chemotherapy to standard platinum-based chemoradiotherapy improved recurrence-free survival vs chemoradiotherapy alone in locoregionally advanced...
Sue Sun Yom, MD, PhD, on Oropharyngeal Cancer: Deintensifying Radiation Therapy Plus Chemotherapy
Sue Sun Yom, MD, PhD, of the University of California, San Francisco, discusses phase II results showing that swallowing-related quality of life after deintensified chemoradiation therapy may improve in patients with p16-positive, nonsmoking-associated, locoregionally advanced disease (Abstract LBA10).
David Routman, MD, on Oropharyngeal Squamous Cell Carcinoma and HPV Circulating Tumor DNA
David Routman, MD, of the Mayo Clinic, discusses his study findings showing that detectable human papillomavirus circulating tumor DNA in the postoperative setting may be linked to disease progression, which may help improve patient selection for treatment intensity (Abstract LBA5).
