Study Shows Equivalence of Sentinel Node Biopsy vs Neck Node Dissection in Operable Oral or Oropharyngeal Cancer
In the French phase III Senti-MERORL trial reported in the Journal of Clinical Oncology, Renaud Garrel, MD, PhD, of the University Hospital Center of Montpellier, France, and colleagues, found that sentinel node biopsy was equivalent to neck lymph node dissection in 2-year neck node...
Stereotactic Radiosurgery May Delay Cognitive Deterioration vs Whole-Brain Radiotherapy for Multiple Brain Metastases
Stereotactic radiosurgery appears to be a new standard of care for patients with four or more nonmelanoma brain metastases, perhaps replacing whole-brain radiotherapy in this setting, according to a potentially practice-changing phase III study presented at the 2020 American Society for Radiation...
My Age May Have Been a Barrier to Timely Diagnosis of Glioblastoma Multiforme
I think my age and apparent good health contributed to a delay in my diagnosis of glioblastoma multiforme. The first symptom I had of the cancer appeared on December 26, 2014, when I was 32 years old. My family and I had just gotten home from celebrating the Christmas holiday with our relatives...
Second-Line Pembrolizumab Improves Overall Survival vs Chemotherapy in Patients with Advanced Esophageal Cancer
As reported in the Journal of Clinical Oncology by Takashi Kojima, MD, of the National Cancer Center Hospital East, Kashiwa, Japan, and colleagues, the phase III KEYNOTE-181 trial has shown that second-line pembrolizumab improved overall survival vs the investigator choice of chemotherapy in...
Selpercatinib Shows Activity in RET Fusion–Positive NSCLC and RET-Altered Thyroid Cancer
As reported inThe New England Journal of Medicine by Alexander Drilon, MD, of Memorial Sloan Kettering Cancer Center, New York, and colleagues and by Lori J. Wirth, MD, of Massachusetts General Hospital, and colleagues, the phase I/II LIBRETTO-001 trial has shown marked activity of the RET kinase ...
Radiotherapy With Cisplatin vs Cetuximab in Previously Untreated Patients With Locoregionally Advanced Head and Neck Cancer
In the Swedish ARTSCAN III trial reported in the Journal of Clinical Oncology, Gebre-Medhin et al found that radiotherapy with concomitant cetuximab did not improve outcomes vs radiotherapy with cisplatin in patients with previously untreated, locoregionally advanced head and neck squamous cell...
First-Line Pembrolizumab Plus Chemotherapy Improves Survival in Esophageal Cancer
As first-line therapy for advanced esophageal cancer, pembrolizumab added to chemotherapy improved overall survival in the KEYNOTE-590 population. Not only did patients with high PD-L1 expression benefit, the value of checkpoint inhibition was observed for the whole population, the trial’s...
Dana-Farber Announces Center for Salivary and Rare Head and Neck Cancers
Dana-Farber Cancer Institute has launched the Center for Salivary and Rare Head and Neck Cancers to treat patients with rare and occasionally aggressive cancers arising from the head and neck. The Center is among the first in the country specifically dedicated to the care and therapeutic research...
Novel IAP Blocker Plus Chemoradiotherapy Improved Outcomes in Head and Neck Cancer Trial
Xevinapant, an investigational inhibitor of apoptosis proteins (IAP) blocker, prolonged overall survival when added to standard chemoradiotherapy for locally advanced head and neck squamous cell carcinoma, according to an updated analysis of a randomized, placebo-controlled phase II study presented ...
Sentinel Node Biopsy vs Neck Node Dissection in Operable Oral or Oropharyngeal Cancer: Equivalence Trial
In a French phase III trial (Senti-MERORL) reported in the Journal of Clinical Oncology, Garrel et al found that sentinel node biopsy demonstrated oncologic equivalance to neck lymph node dissection in 2-year neck node recurrence–free survival in patients with operable cT1–T2N0 oral/oropharyngeal...
Oral Cancer Pain May Predict Likelihood of Metastasis
Oral cancer may be more likely to spread in patients experiencing high levels of pain, according to a team of researchers who found genetic and cellular clues as to why metastatic oral cancers are so painful. These findings were published by Bhattacharya et al in Scientific Reports. Researchers...
Neck Tumor
The text and photographs here are excerpted from a four-volume series of books titled Oncology: Tumors & Treatment, A Photographic History, The Anesthesia Era 1845–1875 by Stanley B. Burns, MD, FACS, and Elizabeth A. Burns. The photograph appears courtesy of Stanley B. Burns, MD, and The Burns...
Neoadjuvant Chemotherapy Alone vs Chemoradiation in Esophageal Cancer: No Difference Found in Long-Term Survival
Improved local-regional tumor control may not be enough to justify the increased morbidity of adding neoadjuvant radiation to chemotherapy in esophageal and gastroesophageal junction cancers, according to a pair of studies presented during the 2020 Society of Surgical Oncology (SSO) International...
Ezra E.W. Cohen, MD, on Head and Neck Cancer: Avelumab and Chemoradiotherapy in Locally Advanced Disease
Ezra E.W. Cohen, MD, of the University of California, San Diego, discusses primary results of the phase III JAVELIN trial of locally advanced squamous cell carcinoma of the head and neck, in which the immune checkpoint inhibitor avelumab was combined with chemoradiotherapy followed by avelumab maintenance. Although the study results were negative, Dr. Cohen suggests other regimens that may prove to be effective (Abstract 910O).
Addition of Debio 1143 to Cisplatin Chemoradiotherapy in Locoregionally Advanced Head and Neck Cancer
In a French Head and Neck Radiotherapy Oncology Group phase II trial reported in The Lancet Oncology, Sun et al found that the addition of Debio 1143 (a small-molecule antagonist of inhibitor of apoptosis proteins) to high-dose cisplatin chemoradiation improved locoregional disease control in...
Assessment of Potential Abscopal Effect of SBRT Added to Nivolumab in Metastatic Head and Neck Cancer
In a single-center phase II trial reported in the Journal of Clinical Oncology, McBride et al found that use of stereotactic body radiotherapy (SBRT) for a potential abscopal effect together with nivolumab did not improve objective response rate vs nivolumab alone in patients with metastatic head...
Transoral Robotic Surgery May Improve Outcomes in Early-Stage Oropharyngeal Cancer
Robotic surgery for patients with early-stage oropharyngeal squamous cell cancer may be associated with improved health outcomes, including better long-term survival, according to a study published by Nguyen et al in JAMA Oncology. Transoral robotic surgery is a minimally invasive procedure in...
Addition of Locoregional Radiotherapy to Chemotherapy for Metastatic Nasopharyngeal Carcinoma
In a Chinese phase III trial reported in JAMA Oncology, You et al found that the addition of locoregional radiotherapy to chemotherapy improved overall survival in patients with chemotherapy-sensitive metastatic nasopharyngeal carcinoma. Study Details The open-label trial included 126 previously...
New Guideline for Locally Advanced Esophageal Cancer Supports Multimodality Therapy and Multidisciplinary Treatment
ASCO has released a new guideline for the treatment of locally advanced esophageal cancer that will provide a context for the current standards of care, fill gaps in clinicians’ knowledge of therapy options, and help define future treatment.1 An expert panel developed the guideline based on 17...
Nivolumab/Ipilimumab Shows Benefit in Patients With Non–Small Cell Lung Cancer and Brain Metastases
The combination of nivolumab plus ipilimumab was at least as effective as chemotherapy in front-line therapy for patients with advanced non–small cell lung cancer (NSCLC) and brain metastases at baseline, according to the results of a post hoc analysis from part 1 of the phase III CheckMate 227...
Facing Death and Appreciating Life
I have had to come to terms with my own mortality three times in my life and I’m only 46. When I was 17, I was diagnosed with end-stage renal disease and experienced renal failure 2 years later. I underwent my first kidney transplant at 21, just before starting medical school. Finally, I thought my ...
Number of Hospitalizations May Be an Important Indicator of Survival for Patients With Head and Neck Cancer
Patients who were unexpectedly hospitalized for dehydration, fever, or other events while undergoing radiotherapy for head and neck cancer were at a higher risk for less favorable outcomes, according to a study published by Anurag K. Singh, MD, and colleagues in Oral Oncology. Researchers found...
Christopher Nutting, MD, PhD, on Head and Neck Cancer: Dysphagia-Optimized vs Standard IMRT
Christopher Nutting, MD, PhD, of the Royal Marsden Hospital and Institute of Cancer Research, discusses phase III results from the first study to demonstrate the functional benefit of swallow-sparing intensity-modulated radiotherapy in oro- and hypopharyngeal cancers (Abstract 6508).
FDA Approves Nine-Valent HPV Vaccine for the Prevention of Certain HPV-Related Head and Neck Cancers
On June 12, Merck announced that the U.S. Food and Drug Administration (FDA) had approved an expanded indication for Gardasil 9—a human papillomavirus (HPV) nine-valent vaccine—for the prevention of oropharyngeal and other head and neck cancers caused by HPV types 16, 18, 31, 33, 45, 52, and 58....
Pembrolizumab Plus Chemoradiotherapy for Locally Advanced Head and Neck Squamous Cell Carcinoma
In a phase Ib study reported in the Journal of Clinical Oncology, Powell et al found that the addition of pembrolizumab to curative chemoradiotherapy was safe and associated with response in patients with locally advanced head and neck squamous cell carcinoma. Study Details The U.S. multicenter...
Selpercatinib for Lung and Thyroid Cancers With RET Gene Mutations or Fusions
On may 8, 2020, selpercatinib was granted accelerated approval for the following indications: Adult patients with metastatic RET fusion-positive non–small cell lung cancer (NSCLC) Adult and pediatric patients ≥ 12 years of age with advanced or metastatic RET-mutant medullary thyroid cancer who...
Transoral Resection Followed by Low-Dose Radiation for Some Oropharyngeal Cancers
The final results of the randomized phase II ECOG-ACRIN E3311 trial were presented by Robert L. Ferris, MD, PhD, and colleagues during the ASCO20 Virtual Scientific Program (Abstract 6500) and in today's Head and Neck Cancer Oral Abstract Session. The trial, conducted in patients undergoing...
New ASCO Guideline Addresses Head/Neck Squamous Cell Carcinoma of Unknown Primary
ASCO has released a new clinical guideline titled, “Diagnosis and Management of Squamous Cell Carcinoma of Unknown Primary in the Head and Neck: ASCO Guideline.”1 The guideline, promulgated by an international expert panel, is intended to “provide evidence-based recommendations to practicing...
Pam Baker DeGuzman, PhD, on Assessing Distress During Telemedicine Visits With Rural Survivors of Head and Neck Cancer
Pam Baker DeGuzman, PhD, of the University of Virginia School of Nursing, discusses her study findings on the use of the NCCN Distress Thermometer, which identified and addressed distress in patients treated for head and neck cancer who were then referred to speech pathologists, lymphedema specialists, and social workers (Abstract HSR20-082).
Better Mental Health Screening Needed for Survivors of Head and Neck Cancer
The threat posed by head and neck cancer extends well beyond the physical disease, according to research presented at the 2020 Multidisciplinary Head and Neck Cancers Symposium.1,2 The pair of studies underscored the high costs of survivorship, including elevated rates of chronic pain, substance...
Study Finds Chemoradiation Plus Bevacizumab Safe and Feasible in Locally or Regionally Advanced Nasopharyngeal Cancer
The addition of bevacizumab to the current standard of care of chemoradiation therapy is safe and feasible for the treatment of locally or regionally advanced nasopharyngeal cancer, according to data presented at the 2020 Multidisciplinary Head and Neck Cancers Symposium.1 “I’m pleased to report...
Expert Point of View: Charu Aggarwal, MD, MPH
Charu Aggarwal, MD, MPH, Leslye M. Heisler Assistant Professor for Lung Cancer Excellence at the Perelman Center for Advanced Medicine, University of Pennsylvania, underscored the paucity of treatment options for metastatic head and neck squamous cell carcinoma. “Even though pembrolizumab is...
Pembrolizumab Plus Cetuximab Shows Antitumor Activity in Squamous Cell Head and Neck Cancer
The first trial to evaluate anti–programmed cell death protein 1 (PD-1) blockade combined with epidermal growth factor receptor (EGFR) inhibition in head and neck squamous cell carcinoma demonstrates promising activity of the drug combination in patients with platinum-refractory or -ineligible...
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...
Expert Point of View: Tanguy Y. Seiwert, MD
Moderator of the session, Tanguy Y. Seiwert, MD, Director of the Head and Neck Cancer Oncology Disease Group and Assistant Professor of Oncology at Johns Hopkins University, in Baltimore, underscored the “dramatically good” preclinical data supporting the use of mTOR inhibitors in advanced...
Study Suggests Adjuvant Everolimus May Benefit Patients With Advanced Head and Neck Cancer
The mTOR inhibitor everolimus, used to treat breast and kidney cancers, may benefit patients with advanced squamous cell carcinoma of the head and neck, according to data presented at the 2020 Multidisciplinary Head and Neck Cancers Symposium.1 The results of an investigator-initiated, phase II...
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.
