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Head and Neck Cancer

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...

Head and Neck Cancer

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 ...

Head and Neck Cancer

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...

Head and Neck Cancer

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...

Head and Neck Cancer

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...

Head and Neck Cancer

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 ...

Head and Neck Cancer

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...

Head and Neck Cancer
Pain Management

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...

Solid Tumors
Head and Neck Cancer

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...

Head and Neck Cancer

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...

head and neck cancer
immunotherapy

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).

Head and Neck Cancer

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...

Head and Neck Cancer
Immunotherapy

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...

Head and Neck Cancer

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...

Head and Neck Cancer

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...

Head and Neck Cancer

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...

Head and Neck Cancer
Lung Cancer

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...

Head and Neck Cancer

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 ...

Head and Neck Cancer

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...

head and neck cancer

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).

Head and Neck Cancer

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....

Head and Neck Cancer
Immunotherapy

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...

Immunotherapy
Head and Neck Cancer
Lung Cancer

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...

Head and Neck Cancer

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...

Head and Neck Cancer

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...

head and neck cancer
survivorship

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).

Head and Neck Cancer
Supportive Care
Survivorship

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...

Head and Neck Cancer
Immunotherapy

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...

Head and Neck Cancer
Immunotherapy

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...

Head and Neck Cancer
Immunotherapy

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...

Head and Neck Cancer
Immunotherapy

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...

Head and Neck Cancer
Immunotherapy

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...

Head and Neck Cancer

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...

Head and Neck Cancer

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...

Head and Neck Cancer
Immunotherapy

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...

Head and Neck Cancer
Immunotherapy

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 ...

Head and Neck Cancer
Immunotherapy

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...

Head and Neck Cancer
Immunotherapy

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...

Head and Neck Cancer
Immunotherapy

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...

head and neck cancer

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.

head and neck cancer
immunotherapy

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).

head and neck cancer
immunotherapy

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).

head and neck cancer
pain management

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.

head and neck cancer

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.

head and neck cancer
issues in oncology

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.

head and neck cancer
immunotherapy

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).

head and neck cancer
immunotherapy

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.

head and neck cancer
symptom management

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).

head and neck cancer

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.

Lung Cancer
Head and Neck Cancer
Gynecologic Cancers
Breast 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...

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