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Head and Neck Cancer

A Laryngectomy Altered How I See Myself in the World

There is a 2-decades-long separation between the time I was diagnosed with oropharyngeal squamous cell carcinoma in 1996 and my laryngectomy in 2016. The surgery was necessary because of the long-term damage to my larynx from the radiation therapy I received. In 1996, I had a low-grade sore throat...

Head and Neck Cancer
Immunotherapy

Expert Point of View: Glenn J. Hanna, MD, and Sherene Loi, MD, PhD

The ASCO Post asked for comment from Glenn J. Hanna, MD, Director of the Center for Salivary and Rare Head and Neck Cancers, Dana-Farber Cancer Institute, and Assistant Professor of Medicine at Harvard Medical School. Dr. Hanna said it is important to put the findings of KEYNOTE-4121 into context...

Head and Neck Cancer
Immunotherapy

KEYNOTE-412: Pembrolizumab Plus Chemoradiation Falls Short in Locally Advanced Head and Neck Cancer

Pembrolizumab plus chemoradiation failed to demonstrate a statistically significant improvement in event-free survival vs chemoradiation alone in patients with locally advanced head and neck squamous cell carcinoma, but favorable numerical trends were demonstrated, according to results of the phase ...

Head and Neck Cancer
Survivorship

Some Head and Neck Cancer Survivors May Be at Greater Risk for Long-Term Gastrostomy Tube Use

A small subset of patients who have undergone treatment for head and neck cancer may require a gastrostomy tube many years into survivorship, according to a new study published by Galloway et al in the International Journal of Radiation Oncology, Biology, and Physics. The findings were also...

Head and Neck Cancer
Immunotherapy

Indian Trial Explores Addition of Low-Dose Nivolumab to Chemotherapy in Advanced Head and Neck Cancer

In an Indian single-center phase III trial reported in the Journal of Clinical Oncology, Vijay Patil, MBBS, MD, DM, and colleagues found that the addition of low-dose nivolumab to triple metronomic chemotherapy significantly improved overall survival in patients with newly diagnosed or recurrent...

Head and Neck Cancer

Pembrolizumab Plus Chemoradiation Therapy Falls Short in Locally Advanced Head and Neck Cancer

Pembrolizumab plus chemoradiation therapy failed to demonstrate a statistically significant improvement in event-free survival vs chemoradiation therapy alone in patients with locally advanced head and neck squamous cell carcinoma, but favorable numerical trends were demonstrated, according to...

Head and Neck Cancer
Immunotherapy

Pembrolizumab With or Without Chemotherapy vs Cetuximab/Chemotherapy in Recurrent or Metastatic Head and Neck Cancer

As reported in the Journal of Clinical Oncology by Kevin Harrington, MD, PhD, and colleagues, updated results of the phase III KEYNOTE-048 trial showed enduring survival benefits with first-line pembrolizumab alone and pembrolizumab/chemotherapy vs cetuximab/chemotherapy in patients with recurrent...

head and neck cancer
immunotherapy

Jean-Pascal Machiels, MD, PhD, on Head and Neck Cancer: Recent Data on Pembrolizumab and Chemoradiation Therapy

Jean-Pascal Machiels, MD, PhD, of Belgium’s Cliniques universitaires Saint-Luc (UCLouvain), discusses the primary results of the phase III KEYNOTE-412 study of pembrolizumab plus chemoradiation therapy (CRT) vs placebo plus CRT for patients with locally advanced head and neck squamous cell carcinoma (Abstract LBA5).

Head and Neck Cancer

Concurrent Chemoradiation Therapy With Weekly Cisplatin for Locally Advanced Head and Neck Squamous Cell Carcinoma

When combined with radiotherapy as definitive treatment of locally advanced head and neck squamous cell carcinoma, cisplatin at a dose of 40 mg/m2 weekly is noninferior to cisplatin at 100 mg/m2 every 3 weeks, according to the results of the ConCERT trial.1 These findings were presented by Atul...

Head and Neck Cancer

Can Patients With Low-Risk Nasopharyngeal Cancer Be Treated Safely With Radiotherapy Alone?

Intensity-modulated radiation therapy (IMRT) alone may be considered an effective treatment option for “low-risk” T1–2N1 and T3N0 nasopharyngeal carcinoma, according to trial data presented by Jun Ma, MD, MS, Professor of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China,...

Head and Neck Cancer

First-Line Cisplatin Plus Gemcitabine or Fluorouracil for Advanced Nasopharyngeal Carcinoma: Final Overall Survival Analysis

As reported in the Journal of Clinical Oncology by Hong et al, the final overall survival analysis of the Chinese phase III GEM20110714 trial showed a significant benefit with gemcitabine/cisplatin vs fluorouracil/cisplatin as first-line treatment for recurrent or metastatic nasopharyngeal...

Head and Neck Cancer
Issues in Oncology

HPV Vaccination and Projected Oropharyngeal Cancer Incidence Through the Year 2045

In a population-based age-period-cohort study reported in JAMA Oncology, Zhang et al estimated that current human papillomavirus (HPV) vaccination rates will have a limited impact on overall oropharyngeal cancer incidence through 2045, due to a high risk of oropharyngeal cancer in unvaccinated...

Head and Neck Cancer

Primary Transoral Surgery and Reduced-Dose Adjuvant Radiation Therapy for HPV-Positive Locally Advanced Oropharyngeal Cancer

As reported in the Journal of Clinical Oncology by Robert L. Ferris, MD, PhD, and colleagues, the phase II ECOG-ACRIN E3311 trial has shown high progression-free survival rates and good functional outcomes in patients with intermediate-risk human papillomavirus (HPV; p16)-positive locally advanced...

Head and Neck Cancer

De-escalation of Radiation Therapy for HPV-Positive, Intermediate-Risk Oropharyngeal Cancer

De-escalated adjuvant radiotherapy appears to be safe in patients with surgically resectable, human papillomavirus (HPV)--positive oropharyngeal cancers, particularly in patients without extranodal extension or pN2 disease by American Joint Committee on Cancer (AJCC) 8th edition. These findings...

Head and Neck Cancer

Radiotherapy Alone vs Concurrent Chemoradiotherapy in Low-Risk Nasopharyngeal Cancer

In a Chinese phase III trial reported in JAMA, Tang et al found that radiotherapy alone was noninferior to concurrent chemoradiotherapy in failure-free survival in patients with low-risk nasopharyngeal carcinoma. Study Details In the open-label multicenter trial, 341 patients were randomly assigned ...

Head and Neck Cancer

Midtreatment Imaging De-escalates Therapy for Half of Study Patients With Oropharyngeal Cancer

Positron-emission tomography (PET) scans obtained before and midway through treatment may be used to de-escalate therapy for patients with oropharyngeal cancer, leading to fewer side effects, according to data presented at the 2022 Multidisciplinary Head and Neck Cancers Symposium.1 An interim...

Head and Neck Cancer

Blood Test Predicts Recurrence of HPV-Driven Oropharyngeal Cancer After Treatment

A blood-basedliquid biopsy may accurately predict recurrence of human papillomavirus (HPV)-driven oropharyngeal squamous cell carcinoma following treatment, according to data presented at the 2022 Multidisciplinary Head and Neck Cancers Symposium.1 Results of the large, multi-institutional study...

Head and Neck Cancer

Induction Chemotherapy With Paclitaxel, Cisplatin, and Capecitabine vs Cisplatin and Fluorouracil for Nasopharyngeal Carcinoma

In a Chinese phase III trial reported in JAMA Oncology, Li et al found that induction chemotherapy with paclitaxel, cisplatin, and capecitabine (TPC) prior to concurrent chemoradiation was associated with improved failure-free survival vs induction therapy with cisplatin and fluorouracil (PF) in...

Head and Neck Cancer

Expert Point of View: Gary Walker, MD, MPH, MS

Gary Walker, MD, MPH, MS, a head and neck radiation oncologist at Banner MD Anderson Cancer Center, Arizona, expressed concern about the disparities identified in the adoption of advanced radiation therapy techniques for patients with head and neck cancer. “Despite widespread availability of...

Head and Neck Cancer

Are Disadvantaged Patients Less Likely to Receive Advanced Radiotherapy Techniques for Head and Neck Cancer?

Advanced radiotherapy techniques may reduce the risk of severe and debilitating toxicity associated with radiation, but not all patients have equal access to these modalities, according to data presented at the 2022 Multidisciplinary Head and Neck Cancers Symposium.1 Retrospective analysis of the...

Head and Neck Cancer
Immunotherapy

Tislelizumab Plus Chemotherapy Improves Progression-Free Survival in Nasopharyngeal Cancer

The addition of the checkpoint inhibitor tislelizumab to first-line chemotherapy significantly reduced the risk of disease progression or death by 50% and, despite a 49% crossover rate, numerically boosted overall survival in patients with recurrent or metastatic nasopharyngeal cancer, Zhang et al...

Head and Neck Cancer

Head and Neck Cancer 2021–2022 Almanac

Head and neck cancer is the seventh most common cancer in the world, with 1.1 million new diagnoses reported annually.1 In the United States, the incidence of oral and pharyngeal cancers is over 54,000 cases per year, resulting in over 11,000 yearly deaths.2 Although smoking and alcohol consumption ...

Head and Neck Cancer

ASCO Endorses New ASTRO Guideline on the Use of Radiation Treatment of Metastatic Brain Cancer

ASCO has endorsed the recommendations put forth in a new guideline, developed by the American Society for Radiation Oncology (ASTRO), on the use of radiation therapy for the management of brain metastases.1,2 Although ASTRO—in conjunction with ASCO and the Society for Neuro-Oncology (SNO)—recently...

Head and Neck Cancer

Enzalutamide in Advanced Androgen Receptor–Positive Salivary Gland Cancer

In a phase II trial (Alliance A091404) reported in the Journal of Clinical Oncology, Ho et al found that enzalutamide showed some activity in advanced androgen receptor–positive salivary gland cancer but failed to meet the predefined criterion for a successful strategy.   Study Details     In the...

Head and Neck Cancer

Adhering to a Healthy Diet After a Head and Neck Cancer Diagnosis May Boost Survival

Patients with squamous cell carcinoma of the head or neck were 93% less likely to die of any cause during the first 3 years after diagnosis if they ate a healthy diet high in nutrients found to deter chronic disease, according to results published by Vieytes et al in Frontiers in Nutrition. The...

Head and Neck Cancer
Immunotherapy

Tumor Grade and Response to Immune Checkpoint Inhibition in Recurrent or Metastatic Mucosal HNSCC

In a single-institution retrospective cohort study reported in JAMA Otolaryngology–Head & Neck Surgery, Alkhatib et al found a higher rate of response to immune checkpoint inhibitor treatment among patients with histologic high-grade vs low-grade recurrent or metastatic mucosal head and neck...

Head and Neck Cancer

Risk of Oropharyngeal Cancer After a Positive HPV16-E6 Serology Test

In an analysis from the Human Papillomavirus Cancer Cohort Consortium (HPVC3) reported in the Journal of Clinical Oncology, Robbins et al found substantial risks of oropharyngeal cancer over time among persons, particularly males, with positive results on human papillomavirus (HPV) 16-E6 serologic...

Head and Neck Cancer

Study Finds Black and Hispanic Men With Throat Cancer Are Experiencing Higher Mortality; White Men Are Increasingly Being Diagnosed at a Late Stage

Hispanic and Black men are dying from human papillomavirus (HPV)-associated throat cancer at a higher rate than White men, and most new cases being diagnosed in non-Hispanic White men are late-stage disease, according to a new study published by Villalona et al in the Annals of Cancer ...

Head and Neck Cancer
Immunotherapy

Role of Combined Positive Score With Treatment Outcomes in Recurrent or Metastatic Head and Neck Cancer

In an analysis of the KEYNOTE-048 trial reported in a research letter in JAMA Oncology, Yu et al identified outcomes with pembrolizumab alone or combined with chemotherapy vs cetuximab plus chemotherapy in patients with recurrent or metastatic head and neck squamous cell carcinoma with a low or...

head and neck cancer
immunotherapy

Nabil F. Saba, MD, on Head and Neck Squamous Cell Carcinoma: Phase II Findings on Pembrolizumab and Cabozantinib

Nabil F. Saba, MD, of Winship Cancer Institute of Emory University, discusses new data from a trial of pembrolizumab and cabozantinib in patients with recurrent metastatic head and neck squamous cell carcinoma. The study met its primary endpoint of overall response rate. The regimen was well tolerated and exhibited encouraging clinical activity in this patient population (Abstract 6008).

head and neck cancer

Sue S. Yom, MD, PhD, on Oropharyngeal Cancer and the Feasibility of a Cell-Free DNA Plasma Assay

Sue S. Yom, MD, PhD, of the University of California, San Francisco, discusses a translational analysis from the NRG-HN002 study. This phase II trial established the feasibility of the tumor tissue–modified viral (TTMV) human papillomavirus DNA assay in clinical trial specimens. The goal is to use such an assay to measure tumor volume, levels of TTMV over the course of treatment, and the association of TTMV to treatment outcomes (Abstract 6006).  

head and neck cancer
supportive care

Carryn M. Anderson, MD, on Head and Neck Cancer: New Data on Avasopasem Manganese for Oral Mucositis

Carryn M. Anderson, MD, of the University of Iowa Hospital, discusses phase III results of the ROMAN trial of avasopasem manganese for patients with severe oral mucositis who are receiving chemoradiotherapy for locally advanced, nonmetastatic head and neck cancer. Compared with placebo, avasopasem manganese improved severe oral mucositis (Abstract 6005).

Head and Neck Cancer
Pain Management

Gabapentin May Be an Effective Alternative to Opioids for Patients With Head and Neck Cancer Receiving Radiation

Patients with head and neck cancer undergoing radiation therapy may be less likely to require opioids or a feeding tube if they received a higher dose of prophylactic gabapentin before their treatment, findings from a team of radiation oncologists showed. Their report, published by Ma et al in JAMA ...

Head and Neck Cancer

Treatment De-escalation in HPV-Associated Oropharyngeal Cancer Using Primary Radiotherapy vs Transoral Surgery

As reported in JAMA Oncology by David Palma, MD, PhD, and colleagues, enrollment in the phase II ORATOR2 trial, which was designed to evaluate overall survival after de-escalated treatment with primary radiotherapy vs transoral surgery in human papillomavirus (HPV)-related oropharyngeal squamous...

Head and Neck Cancer
Immunotherapy

Tislelizumab Plus Chemotherapy Improves Progression-Free Survival in Nasopharyngeal Cancer

The addition of the checkpoint inhibitor tislelizumab to first-line chemotherapy significantly reduced the risk of disease progression or death by 50% and, despite a 49% crossover rate, numerically boosted overall survival in patients with recurrent or metastatic nasopharyngeal cancer, Zhang et al...

Head and Neck Cancer
Health-Care Policy

Effect of Changes to California Medicaid Dental Benefits on Earlier Diagnosis of Oral Cavity Cancer

In a study reported in a research letter in JAMA Oncology, Kana et al found that changes to Medicaid dental benefits in California from comprehensive to emergency services—and then back to comprehensive—were associated with reduced, then increased, percentages of cases of oral cavity cancer...

Head and Neck Cancer

Association of Pretreatment Lymphocyte Count With Overall Survival and Benefit of Addition of Cisplatin to Radiotherapy in Oropharyngeal Squamous Cell Carcinoma

In a UK observational cohort study reported in the Journal of Clinical Oncology, Price et al found that pretreatment absolute lymphocyte count (ALC) was associated with overall survival and predictive of benefit of the addition of cisplatin to radiotherapy in patients with oropharyngeal squamous...

Head and Neck Cancer

Expert Point of View: Gary Walker, MD, MPH, MS

Gary Walker, MD, MPH, MS, a head and neck radiation oncologist at Banner MD Anderson Cancer Center, Arizona, expressed concern about the disparities identified in the adoption of advanced radiation therapy techniques for patients with head and neck cancer. “Despite widespread availability of...

Head and Neck Cancer

Are Disadvantaged Patients Less Likely to Receive Advanced Radiotherapy Techniques for Head and Neck Cancer?

Advanced radiotherapy techniques may reduce the risk of severe and debilitating toxicity associated with radiation, but not all patients have equal access to these modalities, according to data presented at the 2022 Multidisciplinary Head and Neck Cancers Symposium.1 Retrospective analysis of the...

Head and Neck Cancer
Immunotherapy

Outcomes With Pembrolizumab, Pembrolizumab/Chemotherapy, and Cetuximab/Chemotherapy by PD-L1 CPS in Recurrent/Metastatic Head and Neck Cancer

In a post hoc analysis of the KEYNOTE-048 trial reported in the Journal of Clinical Oncology, Barbara Burtness, MD, and colleagues found that survival results with pembrolizumab and pembrolizumab/chemotherapy vs cetuximab/chemotherapy in patients with recurrent or metastatic head and neck squamous...

Head and Neck Cancer

Induction Chemotherapy With Paclitaxel, Cisplatin, and Capecitabine vs Cisplatin and Fluorouracil for Nasopharyngeal Carcinoma

In a Chinese phase III trial reported in JAMA Oncology, Li et al found that induction chemotherapy with paclitaxel, cisplatin, and capecitabine (TPC) prior to concurrent chemoradiation was associated with improved failure-free survival vs induction therapy with cisplatin and fluorouracil (PF) in...

Head and Neck Cancer

Blood Test Predicts Recurrence of HPV-Driven Oropharyngeal Cancer After Treatment

A blood-basedliquid biopsy may accurately predict recurrence of human papillomavirus (HPV)-driven oropharyngeal squamous cell carcinoma following treatment, according to data presented at the 2022 Multidisciplinary Head and Neck Cancers Symposium.1 Results of the large, multi-institutional study...

Head and Neck Cancer

Midtreatment Imaging De-escalates Therapy for Half of Study Patients With Oropharyngeal Cancer

Positron-emission tomography (PET) scans obtained before and midway through treatment may be used to de-escalate therapy for patients with oropharyngeal cancer, leading to fewer side effects, according to data presented at the 2022 Multidisciplinary Head and Neck Cancers Symposium.1 An interim...

head and neck cancer

Elizabeth D. Cash, PhD, on Addressing the Psychological Aspects of Head and Neck Cancer

Elizabeth D. Cash, PhD, of the University of Louisville, discusses depression among patients with head and neck cancer, the impact it can have on prognosis, and the importance of helping patients cope through screening for depressive symptoms and treatment with collaborative care models.

head and neck cancer

Michelle Mierzwa, MD, on Oropharyngeal Cancer: Early Results on De-escalated Radiotherapy

Michelle Mierzwa, MD, of the University of Michigan, discusses early findings from a phase II trial of FDG-PET (fluorodeoxyglucose–positron-emission tomography) de-escalated radiotherapy for patients with p16-positive orophyaryngeal cancer. An interim analysis suggests that for approximately half of patients with stage I or II disease, this type of treatment may decrease toxicity and improve quality of life.

head and neck cancer
immunotherapy

David S. Hong, MD, on New Findings on Tisotumab Vedotin-tftv in Patients With Head and Neck Squamous Cell Carcinoma

David S. Hong, MD, of The University of Texas MD Anderson Cancer Center, discusses results from a phase II cohort, which suggest favorable antitumor activity with tisotumab vedotin-tftv in patients with head and neck squamous cell carcinoma that has progressed after treatment with a platinum-containing regimen. Additional research is warranted, says Dr. Hong, in the second-line setting as well as in treatment-naive patients in combinations with pembrolizumab and carboplatin.

head and neck cancer

Peter Zeng, MD/PhD Candidate: Immune Cell Signature Predicts Survival in HPV-Associated Head and Neck Cancer

Peter Zeng, MD/PhD Candidate, at Ontario’s Western University, discusses a three-gene prognostic classifier tool, known as UWO3, which was validated in six external cohorts and shown to identify patients with human papillomavirus–related head and neck cancer that is likely to recur following aggressive radiation de-escalation.

head and neck cancer

Nancy Lee, MD: Toward Personalization of Radiotherapy for HPV-Related Oropharyngeal Carcinoma

Nancy Lee, MD, of Memorial Sloan Kettering Cancer Center, discusses results from the 30ROC trial, which showed that intratreatment FMISO [(18)F-fluoromisonidazole] PET response could identify patients with human papillomavirus–positive oropharyngeal carcinoma who may be sensitive to radiation therapy. Based on this information, researchers were able to de-escalate radiotherapy to 30 Gy from the standard 70 Gy, in the setting of chemotherapy (Keynote II).

head and neck cancer

Glenn J. Hanna, MD, on Oropharyngeal Squamous Cell Carcinoma: Detecting Occult Recurrence

Glenn J. Hanna, MD, of Dana-Farber Cancer Institute and Harvard Medical School, discusses findings that show human papillomavirus circulating tumor DNA (HPV ctDNA) may be useful as part of surveillance monitoring of patients with oropharyngeal squamous cell carcinoma. Dr. Hanna reports that 93% of patients who had no clinical evidence of disease developed a positive HPV ctDNA test during surveillance follow-up and subsequently had confirmed disease recurrence.

Head and Neck Cancer

Postoperative Weekly vs Every-3-Week Cisplatin in Chemoradiation for Locally Advanced Head and Neck Cancer

In a Japanese phase II/III trial (JCOG1008) reported in the Journal of Clinical Oncology, Kiyota et al found that overall survival with once-weekly cisplatin in postoperative chemoradiation was noninferior to every-3-week cisplatin for patients with high-risk locally advanced squamous cell...

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