Facing Death: Having the Difficult Conversation With Your Patients
Michael Becker, a former CEO for two biotechnology companies, discusses his terminal head and neck cancer diagnosis and his message for oncologists: be proactive and, at the appropriate time, talk with your patients about death and dying. For more information about Michael Becker’s blog and his HPV vaccine advocacy, visit mdbcancerjourney.com. To read about Michael Becker's advocacy efforts to increase vaccination rates for human papillomavirus-related cancers, see his Patient's Corner column "HPV-Related Cancers Like Mine Are Avoidable, So Why Aren't More Kids Being Vaccinated?" published in the May 10, 2018 issue of The ASCO Post.
Pembrolizumab Plus Chemoradiotherapy in HPV-Positive Head and Neck Cancer
The addition of pembrolizumab (Keytruda) to a chemoradiotherapy regimen yielded complete response rates of 85% in patients with human papillomavirus (HPV)-positive advanced squamous cell carcinoma of the head and neck. These findings from a phase Ib study were presented at the 2018 Society for...
Radiotherapy Plus Cetuximab or Cisplatin in HPV-Positive Oropharyngeal Carcinoma
In a noninferiority phase III trial (NRG Oncology RTOG 1016) reported in The Lancet, Gillison et al found that radiotherapy plus cetuximab (Erbitux) was associated with poorer overall survival vs radiotherapy plus cisplatin in patients with human papillomavirus (HPV)-positive oropharyngeal...
Pembrolizumab vs Standard of Care in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma
In the phase III KEYNOTE-040 trial reported in The Lancet, Cohen et al found that pembrolizumab (Keytruda) was associated with a “clinically meaningful prolongation of overall survival” vs investigator’s choice of standard therapies in patients with previously treated recurrent or ...
New Glioblastoma Translational Center at Penn Medicine
Penn Medicine has announced a new Translational Center of Excellence in the Abramson Cancer Center, focused on glioblastoma multiforme. The team will investigate new immune therapies for glioblastoma and, in particular, design and test new chimeric antigen receptor (CAR) T-cell therapies. “Penn...
Radiotherapy With Cisplatin or Cetuximab in Low-Risk, HPV-Positive Oropharyngeal Cancer
In the phase III De-ESCALaTE trial reported in The Lancet, Mehanna et al found no difference in severe toxicity with cisplatin vs cetuximab (Erbitux) plus radiotherapy in low-risk human papillomavirus (HPV)-positive oropharyngeal cancer. Cetuximab was associated with poorer recurrence and survival...
Multigene Classifier Test for Thyroid Nodules With Indeterminate Cytology
In a study reported in JAMA Oncology, Steward et al found that the use of a multigene genomic classifier test (ThyroSeq v3) could reduce the need for diagnostic surgery in a substantial proportion of patients with thyroid nodules with indeterminate cytology. The blinded prospective cohort...
DNA Vaccine Leads to Immune Responses in HPV-Related Head and Neck Cancer in Small Study
A therapeutic vaccine may boost antibodies and T cells, helping them infiltrate human papillomavirus (HPV)-related head and neck cancer tumors. Researchers from the Abramson Cancer Center of the University of Pennsylvania tested the immunotherapy in two groups of patients with advanced head and...
Pazopanib Plus Cetuximab in Metastatic Head and Neck Squamous Cell Carcinoma
As reported in The Lancet Oncology by Douglas Adkins, MD, of Washington University School of Medicine, Division of Medical Oncology, and colleagues, the addition of the angiogenesis inhibitor pazopanib (Votrient) to cetuximab (Erbitux) in a phase Ib and expansion cohort study showed activity in...
Phase III Study Supports Use of Cisplatin Over Cetuximab in HPV-Positive Oropharyngeal Cancer
In the United States and European countries, many oncologists are using cetuximab (Erbitux)/radiotherapy instead of cisplatin/radiotherapy in the treatment of human papillomavirus (HPV)-positive oropharyngeal cancer, based on the belief that cetuximab is equally effective with less toxicity than...
Pembrolizumab Improves Survival in Advanced Head and Neck Cancer
An overall survival advantage has now been shown for first-line immunotherapy in recurrent or metastatic head and neck cancer, researchers reported at the European Society for Medical Oncology (ESMO) 2018 Congress.1 In the phase III KEYNOTE-048 trial, treatment with the anti–programmed cell death...
Ivy Brain Tumor Center to Study Treatments for Brain Malignancies
The Ben and Catherine Ivy Foundation, in partnership with the Barrow Neurological Institute in Phoenix, has awarded a $50 million grant to establish a new translational science program focusing on early-phase, pharmacodynamic- and pharmacokinetic-driven clinical trials for aggressive brain tumors. ...
Durvalumab With or Without Tremelimumab in Recurrent or Metastatic HNSCC With Low/No PD-L1 Expression
In a randomized phase II trial reported in JAMA Oncology, Siu et al found that the combination of the programmed cell death ligand 1 (PD-L1) inhibitor durvalumab (Imfinzi) plus the cytotoxic T-lymphocyte–associated protein 4 (CTLA-4) inhibitor tremelimumab and durvalumab alone showed evidence ...
Suicide Risk Among Head and Neck Cancer Survivors
In a study reported in Cancer, Osazuwa-Peters et al found that the mortality rate from suicide among head and neck cancer survivors was twice as high as the pooled rate in survivors of 19 other cancers considered in the study. Only the rate of suicide in pancreatic cancer survivors was higher...
2018 ASTRO: Liquid Biopsy in HPV-Associated Oral Cancer Surveillance
A highly sensitive blood test that detects minute traces of cancer-specific DNA has been shown to accurately determine whether patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) are free from cancer following radiation therapy. Findings were presented by...
Thomas Galloway, MD, on Oropharyngeal Cancer: Improving Outcomes and Reducing Toxicity
Thomas Galloway, MD, of Fox Chase Cancer Center, summarizes a session on head and neck cancer that included findings on reducing oral mucositis, improving quality of life with deintensified chemoradiotherapy, and the costs of dose de-escalation (Scientific Session 31).
Bhisham Chera, MD, on Oropharyngeal Cancer: Expert Perspective on Surveillance
Bhisham Chera, MD, of the University of North Carolina, discusses using human papillomavirus found in plasma circulating tumor DNA to monitor cancer recurrence in HPV-associated oropharyngeal cancer (Abstract LBA6).
2018 ASTRO: Combined Radiation and Cisplatin in HPV-Related Head and Neck Cancer
A phase III trial has determined that cisplatin chemotherapy combined with radiation therapy showed high amounts of activity in human papillomavirus (HPV)-related head and neck cancer. Findings from NRG-RTOG 1016 were presented by Trotti et al the 60th Annual Meeting of the American Society for...
ESMO 2018: First-Line Immunotherapy for Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma
Pembrolizumab (Keytruda) improved survival in patients with head and neck cancer that has recurred or metastasized in the KEYNOTE-048 trial, according to late-breaking results from the study reported by Burtness et al at the European Society for Medical Oncology (ESMO) 2018 Congress (Abstract...
ESMO 2018: Cetuximab vs Cisplatin in Patients With HPV-Positive Oropharyngeal Cancer Receiving Radiotherapy
Patients with human papillomavirus (HPV)-positive throat cancer responded better to chemoradiotherapy than to cetuximab (Erbitux) with radiotherapy, according to late-breaking research reported by Mehanna et al at the European Society for Medical Oncology (ESMO) 2018 Congress (Abstract LBA9_PR)....
The Sontag Foundation: Turning a Difficult Diagnosis Into Action to Benefit Patients With Brain Cancer
When Frederick B. Sontag’s wife, Susan, was diagnosed in 1994 with grade III astrocytoma, the couple was understandably overwhelmed to hear that her expected survival was 3 years. At that time, there were few organizations providing resources to patients with brain tumors and their families. While...
Ezra E.W. Cohen, MD, on Head and Neck Cancer: Using Curative Immunotherapy
Ezra E.W. Cohen, MD, of the University of California, San Diego, discusses the effectiveness of anti–PD-1 therapy in patients with recurrent head and neck cancer and the studies that might help predict who will benefit, how to combine agents, and ways to reduce long-term toxicity.
DNA Vaccine Leads to Immune Responses in HPV-Related Head and Neck Cancer in Small Study
A therapeutic vaccine may boost antibodies and T cells, helping them infiltrate human papillomavirus (HPV)-related head and neck cancer tumors. Researchers from the Abramson Cancer Center of the University of Pennsylvania tested the immunotherapy approach in two groups of patients with...
Low- vs High-Dose Cisplatin Chemoradiotherapy in Squamous Cell Carcinoma of the Head and Neck
In an analysis of Veterans Affairs data reported in the Journal of the National Cancer Institute, Bauml et al found that weekly lower-dose cisplatin vs higher-dose cisplatin given every 3 weeks as part of concurrent definitive chemoradiotherapy may not adversely affect survival, while reducing...
ASCO Endorses CAP Guideline on HPV Testing in Head and Neck Carcinoma
As reported in the Journal of Clinical Oncology by Carole Fakhry, MD, MPH, of Johns Hopkins School of Medicine, and colleagues, ASCO has endorsed the 2018 College of American Pathologists (CAP) guideline on human papillomavirus (HPV) testing in head and neck carcinoma. The endorsement was based on...
Adding Nimotuzumab to Chemoradiation Improved Survival in Locally Advanced Head and Neck Cancer
IN PATIENTS with locally advanced squamous cell carcinoma of the head and neck, nimotuzumab—a humanized monoclonal antibody against the epidermal growth factor receptor—in combination with cisplatin and radiotherapy was superior to cisplatin and radiotherapy alone in improving progression-free...
Every Day Is a Bonus
I have always been plagued with nagging headaches, so when they intensified in late 2010, I wasn’t too concerned. But when my eyes began involuntarily moving rapidly back and forth as I was writing Christmas cards, I knew the symptoms were a sign of something serious. A magnetic resonance imaging...
Prediction of Survival and Disease Control in HPV-Negative Head and Neck Cancer Using Molecular Markers
A new method may predict the course of human papillomavirus (HPV)-negative head and neck cancer after radiochemotherapy. According to findings published by Hess et al in Clinical Cancer Research, five microRNAs (miRNAs) may be able to provide the decisive data. Squamous cell carcinomas of the head ...
HPV Vaccine Completion Up 5% From 2016 to 2017
The number of adolescents who are up to date on human papillomavirus (HPV) vaccination—meaning they started and completed the HPV vaccine series—increased 5 percentage points from 2016 to 2017, according to results from a national survey published by Walker et al in Morbidity and...
Induction Chemotherapy Followed by Cetuximab and Radiotherapy vs Concurrent Chemoradiotherapy in Head and Neck Cancer
As reported in the Journal of Clinical Oncology by Geoffrois et al, the European phase III GORTEC (Groupe Oncologie Radiothèrapie Tête et Cou) 2007-02 trial has shown no improvement in progression-free survival with induction chemotherapy followed by cetuximab and radiotherapy (RT) vs...
Cetuximab With Radiotherapy Found to Be Inferior to Standard Treatment in HPV-Positive Oropharyngeal Cancer
An interim analysis of data from a randomized clinical trial of patients with human papillomavirus (HPV)-positive oropharyngeal cancer found that treatment with radiation therapy and cetuximab (Erbitux) is associated with worse overall and progression-free survival compared to the current standard...
Expert Point of View: Rajesh Lalla, DDS, PhD
COMMENTING ON the results of this trial of GC4419, Rajesh V. Lalla, DDS, PhD, President of the Multinational Association of Supportive Care in Cancer, said, “This study demonstrated this agent’s strong potential for the management of oral mucositis in patients receiving head and neck radiation...
Novel Therapy Reduces Duration of Chemoradiotherapy-Induced Mucositis in Patients With Head and Neck Cancer
GC4419, A SMALL molecule superoxide dismutase mimetic, reduced the duration, incidence, and severity of chemoradiotherapy-induced mucositis in patients with locally advanced head and neck cancer, with a safety profile comparable to that of placebo. This finding comes from a randomized phase IIb...
KEYNOTE-048: Pembrolizumab Monotherapy in Head and Neck Squamous Cell Carcinoma
The phase III KEYNOTE-048 trial, which is investigating pembrolizumab (Keytruda) for first-line treatment of recurrent or metastatic head and neck squamous cell carcinoma (HNSCC), met a primary endpoint of overall survival (OS) as monotherapy in patients whose tumors expressed programmed cell death ...
Study Finds Gender Disparities in Head and Neck Cancer Treatment and Outcomes
An analysis of cancer registry data from a California hospital system showed that women with head and neck cancer were less likely to receive intensive chemotherapy (35% vs 46%) and radiation (60% vs 70%) compared to men. Controlling for factors such as age and serious medical conditions, a...
Pazopanib Plus Cetuximab in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma
As reported in The Lancet Oncology by Adkins et al, the addition of the angiogenesis inhibitor pazopanib (Votrient) to cetuximab (Erbitux) in a phase Ib and expansion cohort study showed activity in patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC). In the...
Adding Motolimod to Standard Chemotherapy and Cetuximab in Squamous Cell Carcinoma of the Head and Neck
In a phase II trial (Active8) reported in JAMA Oncology, Ferris et al found that the addition of the toll-like receptor 8 (TLR8) agonist motolimod to platinum-fluorouracil plus cetuximab (Erbitux) did not improve progression-free survival among all patients with recurrent or metastatic squamous...
Socioeconomic and Racial Disparities in Management of Brain Metastases
Increasing use of a potentially life-saving treatment for metastatic cancer is leaving many vulnerable patients behind, according to a new study from Yale Cancer Center/Smilow Cancer Hospital published by Benjamin H. Kann, MD, of Yale University School of Medicine, and colleagues in the Journal of ...
Addition of Concurrent Chemotherapy to EGFR Inhibitor and Radiotherapy in Locally Advanced Head and Neck Carcinoma
As reported in the Journal of Clinical Oncology by Tao et al, the phase III GORTEC (Groupe Oncologie Radiothèrapie Tête et Cou) 2007-01 trial has shown improved progression-free survival with the addition of concurrent chemotherapy to cetuximab (Erbitux) and radiotherapy (RT) in...
Esomeprazole With Aspirin in Patients With Barrett’s Esophagus
An updated analysis of a randomized phase III trial showed that taking a high dose of esomeprazole with low-dose aspirin for at least 7 years may moderately reduce the risk of developing high-grade dysplasia or esophageal cancer and may delay death from any cause in people with Barrett’s esophagus. ...
Male Thyroid Cancer Survivors Face 50% Higher Risk of Cardiovascular Disease Than Women
Male thyroid cancer survivors have a nearly 50% higher risk of developing cardiovascular disease than women within 5 years of cancer diagnosis, according to a new study published by Park et al in the Journal of Clinical Endocrinology & Metabolism. More than 62,000 new cases of thyroid cancer...
Expert Point of View: Bruce Johnson, MD, FASCO
ASCO PRESIDENT Bruce E. Johnson, MD, FASCO, commented on these study findings during the press briefing. “This study adds to a growing body of knowledge showing the value of integrating patient-reported outcomes into routine oncology practice for symptom monitoring that a wide variety of our...
Mobile and Sensor Technology May Lead to Reduced Symptoms of Head and Neck Cancer and Its Treatment
A RANDOMIZED clinical trial evaluating the use of mobile and sensor technology to remotely monitor symptoms in patients receiving radiation therapy for head and neck cancer found that use of this technology reduced the severity of symptoms related to cancer and its treatment compared with usual...
Dabrafenib Plus Trametinib for Thyroid Cancer, Melanoma With BRAF Mutations
On May 4, 2018, dabrafenib (Tafinlar) and trametinib (Mekinist) in combination was granted approval for treatment of patients with locally advanced or metastatic anaplastic thyroid cancer with BRAF V600E mutation and no satisfactory locoregional treatment options.1-3 Dabrafenib is not indicated for ...
Manisha H. Shah, MD, on Thyroid Cancer: Advances in Precision Medicine
Manisha H. Shah, MD, of The Ohio State University Comprehensive Cancer Center, summarizes a session she chaired on progress in tailored treatments for medullary and anaplastic thyroid cancers as well as salivary gland cancer.
Jed A. Katzel, MD, on Head and Neck Cancer: Findings on Treatment of Female Patients
Jed A. Katzel, MD, of Kaiser Permanente, discusses his team’s findings on the disparities in head and neck cancer treatment for women and the possible missed opportunities to take a more aggressive and beneficial approach (Abstract LBA6002).
2018 ASCO: Gender Disparities in Head and Neck Cancer Treatment and Outcomes
An analysis of cancer registry data from a California hospital system showed that women with head and neck cancer were less likely to receive intensive chemotherapy (35% vs 46%) and radiation (60% vs 70%) compared to men. Controlling for factors such as age and serious medical conditions, a...
Number of Metastatic Lymph Nodes and Survival in Hypopharyngeal/Laryngeal Cancer
A study using National Cancer Database data has shown that the number of metastatic nodes is a primary independent factor associated with an increased mortality risk in patients with hypopharyngeal and laryngeal cancers. The study was reported in JAMA Oncology by Allen S. Ho, MD, of the Samuel...
Once-Weekly vs Every-3-Week Cisplatin Chemoradiation in Locally Advanced Head and Neck Cancer
In an Indian phase III trial reported in the Journal of Clinical Oncology, Vanita Noronha, MD, of Tata Memorial Hospital, Mumbai, and colleagues found that curative-intent adjuvant chemoradiation with cisplatin at 100 mg/m2 every 3 weeks produced better locoregional control vs cisplatin at 30...
Circulating Tumor DNA May Guide Treatment Intensity in Advanced HPV-Associated Head and Neck Cancers
A MULTI-INSTITUTIONAL analysis of circulating tumor DNA extracted from the plasma of patients has shown that human papillomavirus type 16 (HPV16) DNA is detectable in the majority of cases of favorable-risk HPV-associated oropharyngeal squamous cell carcinoma and may be a clinically useful...
