Advances in biomarkers and treatment strategies for HPV-associated head and neck cancer

Background. In this study, we investigated the prognostic role of homotypic tumor cell cannibalism in different cancer types.Methods. The phenomenon of one cell being internalized into another, which we refer to as “cell-in-cell event,” was assessed in 416 cases from five head and neck cancer cohorts, as well as one anal and one rectal cancer cohort. The samples were processed into tissue microarrays and immunohistochemically stained for E-cadherin and cleaved caspase-3 to visualize cell membranes and apoptotic cell death.Results. Cell-in-cell events were found in all of the cohorts. The frequency ranged from 0.7 to 17.3 cell-in-cell events per mm2. Hardly any apoptotic cells were found within the cell-in-cell structures, although apoptotic cell rates were about 1.6 to two times as high as cell-in-cell rates of the same tissue sample. High numbers of cell-in-cell events showed adverse effects on patients’ survival in the head and neck and in the rectal cancer cohorts. In multivariate analysis, high frequency was an adverse prognostic factor for overall survival in patients with head and neck cancer (p=0.008).Conclusion. Cell-in-cell events were found to predict patient outcomes in various types of cancer better than apoptosis and proliferation and might therefore be used to guide treatment strategies.

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How Do Head and Neck Cancer Patients Prioritize Treatment Outcomes Before Initiating Treatment?

Journal of Clinical Oncology ◽

10.1200/jco.2000.18.4.877 ◽

2000 ◽

Vol 18 (4) ◽

pp. 877-877 ◽

Cited By ~ 126

Author(s):

Marcy A. List ◽

John Stracks ◽

Laura Colangelo ◽

Pamela Butler ◽

Natasha Ganzenko ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Treatment Effects ◽

Performance Status ◽

Treatment Strategies ◽

Individual Variability ◽

Lower Priority ◽

Disease Characteristics

PURPOSE: To determine, pretreatment, how head and neck cancer (HNC) patients prioritize potential treatment effects in relationship to each other and to survival and to ascertain whether patients’ preferences are related to demographic or disease characteristics, performance status, or quality of life (QOL). PATIENTS AND METHODS: One hundred thirty-one patients were assessed pretreatment using standardized measures of QOL (Functional Assessment of Cancer Therapy-Head and Neck) and performance (Performance Status Scale for Head and Neck Cancer). Patients were also asked to rank a series of 12 potential HNC treatment effects. RESULTS: Being cured was ranked top priority by 75% of patients; another 18% ranked it second or third. Living as long as possible and having no pain were placed in the top three by 56% and 35% of patients, respectively. Items that were ranked in the top three by 10% to 24% of patients included those related to energy, swallowing, voice, and appearance. Items related to chewing, being understood, tasting, and dry mouth were placed in the top three by less than 10% of patients. Excluding the top three rankings, there was considerable variability in ratings. Rankings were generally unrelated to patient or disease characteristics, with the exception that cure and living were of slightly lower priority and pain of higher priority to older patients compared with younger patients. CONCLUSION: The data suggest that, at least pretreatment, survival is of primary importance to patients, supporting the development of aggressive treatment strategies. In addition, results highlight individual variability and warn against making assumptions about patients’ attitudes vis-à-vis potential outcomes. Whether patients’ priorities will change as they experience late effects is currently under investigation.

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An Evaluation of Treatment Strategies for Head and Neck Cancer in an African American Population

West Indian Medical Journal ◽

10.7727/wimj.2013.046 ◽

2017 ◽

Author(s):

DN Ignacio ◽

JJ Griffin ◽

MG Daniel ◽

MT Serlemitsos-Day ◽

FA Lombardo ◽

...

Keyword(s):

African American ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Treatment Strategies ◽

American Population ◽

African American Population

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A History of Innovations in the Diagnosis and Treatment of Oral and Head and Neck Cancer

Journal of Dental Research ◽

10.1177/0022034519833645 ◽

2019 ◽

Vol 98 (5) ◽

pp. 489-497 ◽

Cited By ~ 1

Author(s):

P.J. Polverini ◽

M.W. Lingen

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Progression ◽

Neck Cancer ◽

New Technologies ◽

Treatment Strategies ◽

Disease Process ◽

Treatment Protocols ◽

Multistep Process ◽

Etiological Agents

Historical records as far back as 3000 BCE show that oral and head and neck cancer was a disease process well known to Egyptian physicians. Luminaries such as Hippocrates, Galen, Pott, and Virchow were instrumental in shaping our understanding of the etiology and pathogenesis of cancer. During the 20th century, evidence-based medicine catalyzed the development of rigorous science-based diagnostic and treatment protocols. The use of surgery, therapeutic radiation, and chemotherapy as single-treatment agents or in combination with one another gradually emerged as the preferred approach to cancer therapy. The recognition of tobacco, alcohol, and human papillomavirus as etiological agents in oral and head and neck cancer prompted the development of new diagnostic aids and treatment strategies to mitigate cancer progression. More in-depth mechanistic insights into the multistep process of oral and head and neck cancer were made possible by the use of the hamster buccal pouch and mouse models. New technologies, such as the sequencing of the human genome, metabolomics, and proteomics, have provided the foundation for what we today call precision medicine. The future success of tailored medical treatment for cancer patients will depend on the discovery of new druggable targets with improved therapeutic efficacy. As the precision and sensitivity of existing tools for prevention and risk assessment improve, greater accuracy will be achieved in predicting health outcomes.

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Role of neoadjuvant chemotherapy in head and neck cancer management: A case for exploring diverse treatment strategies for evaluating long-term efficacy

Oral Oncology ◽

10.1016/j.oraloncology.2021.105594 ◽

2021 ◽

Vol 123 ◽

pp. 105594

Author(s):

Shameekcha Mishra ◽

Anand Subash ◽

Vishal U.S. Rao ◽

Shalini Thakur

Keyword(s):

Head And Neck Cancer ◽

Neoadjuvant Chemotherapy ◽

Head And Neck ◽

Neck Cancer ◽

Treatment Strategies ◽

Cancer Management ◽

Term Efficacy

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Evaluation and Management of the Unknown Primary Carcinoma of the Head and Neck

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2008.0080 ◽

2008 ◽

Vol 6 (10) ◽

pp. 1068-1075 ◽

Cited By ~ 15

Author(s):

Chad E. Galer ◽

Merrill S. Kies

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Clinical Presentation ◽

Treatment Strategies ◽

Clinical Problem ◽

Unknown Primary ◽

Multidisciplinary Teams ◽

Primary Origin ◽

Unknown Primary Carcinoma

Squamous cell carcinoma of unknown primary origin in the head and neck is encountered as a recurring clinical problem in head and neck cancer clinics, affecting 3% to 25% of patients. This article describes the clinical presentation, appropriate evaluation, and treatment strategies for this important subgroup. Treatment—best carried out with multidisciplinary teams of specialists experienced in the care of head and neck cancer patients—is curative for most of these patients.

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Evaluation and Management of Oropharyngeal Dysphagia in Head and Neck Cancer

Cancer Control ◽

10.1177/107327480200900505 ◽

2002 ◽

Vol 9 (5) ◽

pp. 400-409 ◽

Cited By ~ 48

Author(s):

Joy E. Gaziano

Keyword(s):

Quality Of Life ◽

Head And Neck Cancer ◽

Nutritional Status ◽

Head And Neck ◽

Neck Cancer ◽

Treatment Strategies ◽

Oral Intake ◽

Swallowing Disorders ◽

Accurate Identification

Background Dysphagia is a common symptom of head and neck cancer or sequelae of its management. Swallowing disorders related to head and neck cancer are often predictable, depending on the structures or treatment modality involved. Dysphagia can profoundly affect posttreatment recovery as it may contribute to aspiration pneumonia, dehydration, malnutrition, poor wound healing, and reduced tolerance to medical treatments. Methods The author reviewed the normal anatomy and physiology of swallowing and contrasted it with the commonly identified swallowing deficits related to head and neck cancer management. Evaluation methods and treatment strategies that can be used to successfully manage the physical and psychosocial effects of dysphagia are also reviewed. Results Evaluation of dysphagia by the speech pathologist can be achieved with instrumental and non-instrumental methods. Once accurate identification of the deficits is completed, a range of treatment strategies can be applied that may return patients to safe oral intake, improve nutritional status, and enhance quality of life. Conclusions To improve safety of oral intake, normalize nutritional status, reduce complications of cancer treatment and enhance quality of life, accurate identification of swallowing disorders and efficient management of dysphagia symptoms must be achieved in an interdisciplinary team environment.

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Persistent Postoperative Opioid Use in Older Head and Neck Cancer Patients

Otolaryngology ◽

10.1177/0194599818778276 ◽

2018 ◽

Vol 160 (3) ◽

pp. 380-387 ◽

Cited By ~ 18

Author(s):

Anirudh Saraswathula ◽

Michelle M. Chen ◽

Seshadri C. Mudumbai ◽

Alice S. Whittemore ◽

Vasu Divi

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Postoperative Radiotherapy ◽

Treatment Strategies ◽

Postoperative Treatment ◽

Opioid Use ◽

Substantial Problem ◽

Comorbidity Index ◽

Discharge Criteria

Objectives Despite the epidemic of opioid overuse among American patients, there are limited data regarding the prevalence of such use among patients with head and neck cancer (HNC). Here, we report on the prevalence of persistent postoperative opioid (PPO) use and its risk factors among older patients with HNC undergoing surgery. Study Design Retrospective cohort study. Setting Surveillance, Epidemiology, and End Results (SEER)–Medicare linked cancer registry-claims database. Subjects and Methods We identified patients aged 66 years or older who were diagnosed with HNC from 2008 to 2013, underwent primary surgical resection for their cancers, and met certain insurance and discharge criteria. The primary outcome was PPO use, defined as new opioid prescriptions 90 to 180 days postoperatively. We used multivariable logistic regression to evaluate associations between PPO use and factors such as demographics and postoperative treatment. Results Of the 1190 eligible patients with HNC, 866 (72.8%) received opioid prescriptions attributable to their surgery. Among these 866 patients, the prevalence of PPO use was 33.3% overall; it was 48.3% among the 428 patients with preoperative opioid use compared to 18.5% among the 438 opioid-naive patients (adjusted odds ratio [OR], 3.96; 95% confidence interval [CI], 2.80-5.59). Other factors associated with PPO use include postoperative radiotherapy (OR, 1.99; 95%, CI 1.33-2.98) and Charlson comorbidity index (OR, 1.20; 95% CI, 1.03-1.41). Postoperative chemotherapy (OR, 1.19; 95% CI, 0.73-1.95) was not significantly associated with PPO use. Conclusions PPO use is a substantial problem in older surgical patients with HNC, one that warrants consideration of alternative treatment strategies and continued examination of prescription guidelines for patients with HNC.

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