Wiring multiple microenvironment proteomes uncovers the biology in head and neck cancer

The poor prognosis of head and neck cancer (HNC) is associated with the presence of metastasis within the lymph nodes (LNs). Herein, the proteome of 140 multisite samples from a 59-HNC patient cohort, including primary and matched LN-negative or -positive tissues, saliva, and blood cells, reveals insights into the biology and potential metastasis biomarkers that may assist in clinical decision making. Protein profiles are strictly associated with immune modulation across datasets, and this provides the basis for investigating immune markers associated with metastasis. The proteome of LN metastatic cells recapitulates the proteome of the primary tumor sites. Conversely, the LN microenvironment proteome highlights the candidate prognostic markers. By integrating prioritized peptide, protein, and transcript levels with machine learning models, we identified a nodal metastasis signature in the blood and saliva. In summary, we present the deepest proteome characterization wiring multiple sampling sites in HNC, thus providing a promising basis for understanding tumoral biology and identifying metastasis-associated signatures.

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Deliberações clínicas na atuação em pacientes com câncer de cabeça e pescoço: atualidades e desafios na disfagia

Distúrbios da Comunicação ◽

10.23925/2176-2724.2019v31i4p693-697 ◽

2020 ◽

Vol 31 (4) ◽

pp. 693-697

Author(s):

Guilherme Maia Zica ◽

Andressa Silva de Freitas

Keyword(s):

Decision Making ◽

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Clinical Decision Making ◽

Clinical Decision

Starmer H, Edwards J. Clinical Decision Making with Head and Neck Cancer Patients with Dysphagia. Semin Speech Lang. 2019 Jun;40(3):213-226.

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Anticipation of the Impact of Human Papillomavirus on Clinical Decision Making for the Head and Neck Cancer Patient

Hematology/Oncology Clinics of North America ◽

10.1016/j.hoc.2015.08.003 ◽

2015 ◽

Vol 29 (6) ◽

pp. 1045-1060 ◽

Cited By ~ 15

Author(s):

Maura L. Gillison ◽

Carlo Restighini

Keyword(s):

Decision Making ◽

Head And Neck Cancer ◽

Human Papillomavirus ◽

Cancer Patient ◽

Head And Neck ◽

Neck Cancer ◽

Clinical Decision Making ◽

Clinical Decision ◽

Neck Cancer Patient ◽

The Impact

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Clinical Practices in Head and Neck Cancer: A Speech-Language Pathologist Practice Pattern Survey

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894211001065 ◽

2021 ◽

pp. 000348942110010

Author(s):

Ashley M. Logan ◽

Mario A. Landera

Keyword(s):

Decision Making ◽

Head And Neck Cancer ◽

Best Practices ◽

Head And Neck ◽

Neck Cancer ◽

Clinical Decision Making ◽

Clinical Decision ◽

Years Of Experience ◽

Group Consensus ◽

Clinical Practices

Objective: Clinical practices of speech-language pathologists (SLP) treating head and neck cancer (HNC) patients range widely despite literature trending toward best practices. This survey study was designed to identify current patterns and assess for gaps in clinical implementation of research evidence. Method: A web-based survey was distributed to SLPs via listserv and social media outlets. Descriptive statistics and group calculations were completed to identify trends and associations in responses. Results: Of 152 received surveys, the majority of respondents were hospital-based (86%) and had greater than 5 years of experience (65%). There was group consensus for the use of prophylactic exercise programs (95%), recommendations for SLP intervention during HNC treatment (75%), and use of maintenance programs post-treatment (97%). Conversely, no group consensus was observed for use of pre-treatment swallow evaluations, frequency of service provision, and content of therapy sessions. Variation in clinical decision making was noted in use of prophylactic feeding tubes and number of patients taking nothing by mouth during treatment. No associations were found between years of experience and decision-making practices, nor were any associations found between practice setting and clinical decision making. Conclusion: Despite the growing body of literature outlining evidence-based treatment practices for HNC patients, clinical practice patterns among SLPs continue to vary widely resulting in inconsistent patient care across practice settings. As compared to prior similar data, increased alignment with best practices was observed relative to early referrals, implementation of prophylactic intervention programs, and intervention with the SLP during the period of HNC treatment.

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Leveraging patient‐reported outcomes data to inform oncology clinical decision making: Introducing the FACE‐Q Head and Neck Cancer Module

Cancer ◽

10.1002/cncr.31900 ◽

2018 ◽

Vol 125 (6) ◽

pp. 863-872 ◽

Cited By ~ 5

Author(s):

Jennifer R. Cracchiolo ◽

Anne F. Klassen ◽

Danny A. Young‐Afat ◽

Claudia R. Albornoz ◽

Stefan J. Cano ◽

...

Keyword(s):

Decision Making ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Patient Reported Outcomes ◽

Clinical Decision Making ◽

Clinical Decision ◽

Cancer Module ◽

Patient Reported ◽

The Face

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Circulating Non-Coding RNAs in Head and Neck Cancer: Roles in Diagnosis, Prognosis, and Therapy Monitoring

Cells ◽

10.3390/cells10010048 ◽

2020 ◽

Vol 10 (1) ◽

pp. 48

Author(s):

Araceli Diez-Fraile ◽

Joke De Ceulaer ◽

Charlotte Derpoorter ◽

Christophe Spaas ◽

Tom De Backer ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Clinical Decision Making ◽

Therapy Monitoring ◽

Clinical Decision ◽

Upper Aerodigestive Tract ◽

Non Coding Rna ◽

Non Coding Rnas ◽

Trna Halves

Head and neck cancer (HNC), the seventh most common form of cancer worldwide, is a group of epithelial malignancies affecting sites in the upper aerodigestive tract. The 5-year overall survival for patients with HNC has stayed around 40–50% for decades, with mortality being attributable mainly to late diagnosis and recurrence. Recently, non-coding RNAs, including tRNA halves, YRNA fragments, microRNAs (miRNAs), and long non-coding RNAs (lncRNAs), have been identified in the blood and saliva of patients diagnosed with HNC. These observations have recently fueled the study of their potential use in early detection, diagnosis, and risk assessment. The present review focuses on recent insights and the potential impact that circulating non-coding RNA evaluation may have on clinical decision-making in the management of HNC.

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Clinical Decision Making with Head and Neck Cancer Patients with Dysphagia

Seminars in Speech and Language ◽

10.1055/s-0039-1688979 ◽

2019 ◽

Vol 40 (03) ◽

pp. 213-226

Author(s):

Heather Starmer ◽

Jeffrey Edwards

Keyword(s):

Decision Making ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Clinical Decision Making ◽

Clinical Decision ◽

Surgical Removal ◽

Epidemiologic Factors ◽

Cancer Management ◽

Nonsurgical Patient

AbstractDysphagia is a common challenge faced by patients with head and neck cancer. Management of these patients is quite distinct from many other dysphagia etiologies due to the nature of surgical removal of organs critical to swallowing, the ability to provide preventative therapies, and the variable risk for complications related to dysphagia. Thus, clinicians providing care to the head and neck cancer population need to understand these differences when employing clinical decision making. In addition, changes in the demographics of head and neck cancer, related predominantly to the epidemic of oropharyngeal cancer associated with the human papillomavirus, have further transformed both the types of patients and the types of treatments offered. These epidemiologic factors further complicate the decision-making process for clinicians. This article provides a framework for decision making in the surgical and nonsurgical patient with head and neck cancer.

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The Importance of Verification CT-QA Scans in Patients Treated with IMPT for Head and Neck Cancers

International Journal of Particle Therapy ◽

10.14338/ijpt-20-00006.1 ◽

2020 ◽

Vol 7 (1) ◽

pp. 41-53

Author(s):

Jaden D. Evans ◽

Riley H. Harper ◽

Molly Petersen ◽

William S. Harmsen ◽

Aman Anand ◽

...

Keyword(s):

Decision Making ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Clinical Decision Making ◽

Cox Model ◽

Clinical Decision ◽

Concurrent Chemotherapy ◽

Cumulative Probability ◽

Kaplan Meier

Abstract Purpose To understand how verification computed tomography-quality assurance (CT-QA) scans influenced clinical decision-making to replan patients with head and neck cancer and identify predictors for replanning to guide intensity-modulated proton therapy (IMPT) clinical practice. Patients and Methods We performed a quality-improvement study by prospectively collecting data on 160 consecutive patients with head and neck cancer treated using spot-scanning IMPT who underwent weekly verification CT-QA scans. Kaplan-Meier estimates were used to determine the cumulative probability of a replan by week. Predictors for replanning were determined with univariate (UVA) and multivariate (MVA) Cox model hazard ratios (HRs). Logistic regression was used to determine odds ratios (ORs). P < .05 was considered statistically significant. Results Of the 160 patients, 79 (49.4%) had verification CT-QA scans, which prompted a replan. The cumulative probability of a replan by week 1 was 13.7% (95% confidence interval [CI], 8.82-18.9), week 2, 25.0% (95% CI, 18.0-31.4), week 3, 33.1% (95% CI, 25.4-40.0), week 4, 45.6% (95% CI, 37.3-52.8), and week 5 and 6, 49.4% (95% CI, 41.0-56.6). Predictors for replanning were sinonasal disease site (UVA: HR, 1.82, P = .04; MVA: HR, 3.64, P = .03), advanced stage disease (UVA: HR, 4.68, P < .01; MVA: HR, 3.10, P < .05), dose > 60 Gy equivalent (GyE; relative biologic effectiveness, 1.1) (UVA: HR, 1.99, P < .01; MVA: HR, 2.20, P < .01), primary disease (UVA: HR, 2.00 versus recurrent, P = .01; MVA: HR, 2.46, P = .01), concurrent chemotherapy (UVA: HR, 2.05, P < .01; MVA: not statistically significant [NS]), definitive intent treatment (UVA: HR, 1.70 versus adjuvant, P < .02; MVA: NS), bilateral neck treatment (UVA: HR, 2.07, P = .03; MVA: NS), and greater number of beams (5 beam UVA: HR, 5.55 versus 1 or 2 beams, P < .02; MVA: NS). Maximal weight change from baseline was associated with higher odds of a replan (≥3 kg: OR, 1.97, P = .04; ≥ 5 kg: OR, 2.13, P = .02). Conclusions Weekly verification CT-QA scans frequently influenced clinical decision-making to replan. Additional studies that evaluate the practice of monitoring IMPT-treated patients with weekly CT-QA scans and whether that improves clinical outcomes are warranted.

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