scholarly journals Dermatologic Toxicities of Targeted Therapy and Immunotherapy in Head and Neck Cancers

2021 ◽  
Vol 11 ◽  
Author(s):  
Maria L. Espinosa ◽  
Chelsea Abad ◽  
Yaira Kurtzman ◽  
Farah R. Abdulla
Keyword(s):  
Targeted Therapy ◽  
Adverse Events ◽  
Head And Neck ◽  
Targeted Therapies ◽  
Tumor Burden ◽  
Head And Neck Cancers ◽  
Stevens Johnson Syndrome ◽  
Preventative Measures ◽  
Johnson Syndrome ◽  
Preserve Function

Treatment of head and neck cancers requires multidisciplinary collaboration to reduce morbidity and mortality associated with the tumor burden, as well as to preserve function of organs and structures. With the use of various new targeted therapies come new adverse events including dermatologic toxicities, which may consist of xerosis, nail and hair changes, morbilliform or papulopustular rashes, to more severe eruptions such as Stevens–Johnson syndrome. We describe the dermatologic toxicities and corresponding grades of severity and associated pathophysiology resulting from seven therapeutics used to treat head and neck cancers: cetuximab, trastuzumab, pembrolizumab, nivolumab, lentatinib, larotrectinib, and entrectinib. Being familiar with these dermatologic toxicities allows clinicians to provide comprehensive counseling for patients, encourage preventative measures, and to know when it is appropriate to hold therapy or permanently stop treatment.

scholarly journals Phytodentistry in Africa: prospects for head and neck cancers

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Henry A. Adeola ◽  
Saheed Sabiu ◽  
Raphael T. Aruleba ◽  
Tayo A. Adekiya ◽  
Anthonio O. Adefuye ◽  
...  
Keyword(s):  
Head And Neck ◽  
Targeted Therapies ◽  
Head And Neck Cancers ◽  
Molecular Evidence ◽  
Main Body ◽  
Clinical Implementation ◽  
Medical Problems ◽  
Resource Limited ◽  
Impression Materials ◽  
Dental Diseases

Abstract Background Orthodox dentistry has undergone significant changes in recent times with the introduction of various omics and molecular targeted therapies both at the experimental/trial and clinical implementation level. Although, significant milestones have been achieved in the molecular dentistry field in the past decade, there remains a dearth of application of phytopharmacological innovation in personalized and targeted therapies for dental diseases. Main body From time immemorial, plant products have long been an integral aspect of dental practice ranging from chewing sticks/herbal kinds of toothpaste to dental/impression materials. The current era of precision medicine seeks to apply a multipronged molecular and bio-computational approaches to solve fundamental medical problems that have hitherto remained difficult. Remarkable changes in the molecular/omics era, have transformed empirical therapies into personalized/individualized ones. Furthermore, the combinatorial application and the widespread introduction of high-throughput molecular tools such as pharmacogenomics, phytopharmacology, metabolomics, mathematical modelling, and genetic engineering inter alia, has tremendously improved the diagnostic and therapeutic landscape of medicine. Additionally, the variable molecular epidemiology of diseases among different population and emerging molecular evidence warrants the use of customized novel theranostic techniques. Unfortunately, the footprint of such emerging application is sparse in dental diseases such as maxillofacial cancers. Conclusion Hence, this review seeks to evaluate the potential application of phytopharmacological approaches to head and neck cancers in a resource-limited environment, such as Africa.

scholarly journals Postoperative Radiotherapy in Head and Neck Cancer

2010 ◽  
Vol 2 (1) ◽  
pp. 43-51
Author(s):  
Vedang Murthy ◽  
Sayan Kundu ◽  
Tanweer Shahid ◽  
Ashwini Budrukkar ◽  
Tejpal Gupta ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Targeted Therapy ◽  
Head And Neck ◽  
Neck Cancer ◽  
Early Stage ◽  
Postoperative Radiotherapy ◽  
Locally Advanced ◽  
Head And Neck Cancers ◽  
Advanced Head ◽  
Locoregional Failure

Abstract Though early stage head and neck cancers can be cured either by surgery or radiation, patients with locally advanced disease continues to pose a therapeutic challenge. Locoregional failure is the major cause of death in head and neck cancers. As the outcome of locally advanced head and neck cancer is less than promising, a combined modality approach is generally undertaken in this group of patients. The combination of surgery, radiation and more recently, chemotherapy and targeted therapy can improve outcomes in locally advanced head and neck cancer patients. This overview discusses the rationale and role of postoperative radiotherapy (PORT) in advanced head and neck cancers, the radiotherapy technique in brief and methods of enhancing the efficacy of postoperative RT by altering the fractionation schedules and adding chemotherapy and targeted therapy.

Head and Neck Manifestations of Erythema Multiforme in Children

1994 ◽  
Vol 111 (3P1) ◽  
pp. 236-242 ◽  
Author(s):  
Michael G. Stewart ◽  
Newton O. Duncan ◽  
Daniel J. Franklin ◽  
Ellen M. Friedman ◽  
Marcelle Sulek
Keyword(s):  
Oral Cavity ◽  
Toxic Epidermal Necrolysis ◽  
Head And Neck ◽  
Erythema Multiforme ◽  
Medication Use ◽  
Stevens Johnson Syndrome ◽  
Striking Increase ◽  
Johnson Syndrome ◽  
Mucosal Involvement ◽  
Mucous Membranes

Erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis are related disorders of skin and mucous membranes, which are typically associated with antecedent medication use or infection. We review 108 cases of erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis from Texas Children's Hospital, Houston, Texas, from 1981 to 1991, and illustrate the characteristic skin and mucosal lesions. In addition, we describe in detail two unusual cases requiring intensive airway management. Head and neck manifestations were present in 4 of 79 patients (5%) with erythema multiforme and 26 of 28 patients (93%) with Stevens-Johnson syndrome. In Stevens-Johnson syndrome, mucosal involvement of the lip (93%), conjunctiva (82%), oral cavity (79%), and nose (36%) were most common. Antecedent medication use was identified in 59% of erythema multiforme patients and 68% of Stevens-Johnson syndrome patients. We note a striking increase in the number of cases in our series caused by cephalosporins. Fifty percent of Stevens-Johnson syndrome patients required supplemental hydration or alimentation because of the severity of the oral cavity involvement. The head and neck mucosal manifestations largely respond to local care, and the routine use of prophylactic antibiotics or systemic steroids is not recommended.

Economic burden of adverse events in patients with metastatic renal cell carcinoma (mRCC).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e16573-e16573
Author(s):  
May Hagiwara ◽  
Rohit Borker ◽  
Gerry Oster
Keyword(s):  
Abdominal Pain ◽  
Back Pain ◽  
Targeted Therapy ◽  
Adverse Events ◽  
Targeted Therapies ◽  
Index Date ◽  
Line Treatment ◽  
First Line ◽  
Baseline Characteristics ◽  
First Line Treatment

e16573 Background: To estimate costs associated with adverse events (AEs) in patients receiving targeted therapies indicated for first-line treatment of mRCC. Methods: A retrospective study using a large US healthcare claims database (PharMetrics) from 1/2000 to 12/2009 was conducted. Study subjects were aged ≥18 years, had mRCC, and received first-line treatment with targeted therapies. AEs of interest comprised abdominal pain, back pain, diarrhea, dyspnea, extremity pain, fatigue/asthenia, hand-foot syndrome, hypertension, lymphopenia, nausea/vomiting, neutropenia, and proteinuria. Patients receiving care for these AEs were identified using ICD-9-CM diagnosis/procedure codes on healthcare claims. Costs were examined over a 30-day period, beginning with date of first mention of each AE; non-evented patients were assigned a “shadow” index date for comparison purposes. We estimated total costs over 30 days following the index date for patients with and without AEs, on both unadjusted basis and following adjustment for differences in baseline characteristics using a generalized linear model (GLM). Direct costs of targeted therapy were not considered. Results: Among patients receiving targeted therapy for mRCC, 64% had healthcare encounters for one or more AEs. AEs occurring with frequency >20% included severe abdominal pain, back pain, fatigue/asthenia, and nausea/vomiting, respectively; 10-20% of patients had encounters for diarrhea, dyspnea, and extremity pain, respectively. Mean [SD] total costs of care during the 30-day, post-index period were substantially higher among patients with AEs ($12,177 [$19,621] vs $4070 [$8142] for those without AEs). Adjusting for differences in baseline characteristics, the estimated cost difference (95% CI) was $11,373 ($5286 - $21,419). Conclusions: Costs associated with AEs of first-line targeted therapies are substantial in patients with mRCC. Efforts to prevent and/or better manage these events may reduce healthcare costs.

scholarly journals Management of Chemoradiation-Induced Mucositis in Head and Neck Cancers With Oral Glutamine

2016 ◽  
Vol 2 (4) ◽  
pp. 200-206 ◽  
Author(s):  
Lucy Pattanayak ◽  
Niharika Panda ◽  
Manoj Kumar Dash ◽  
Sumita Mohanty ◽  
Sagarika Samantaray
Keyword(s):  
Squamous Cell Carcinoma ◽  
Head And Neck Cancer ◽  
Adverse Events ◽  
Head And Neck ◽  
Tube Feeding ◽  
Negative Control ◽  
Head And Neck Cancers ◽  
Glutamine Supplementation ◽  
Efficacy And Safety ◽  
The Third

Purpose Head and neck cancers are the third most common cancers worldwide. Oral mucositis is the most common toxicity seen in patients who receive chemoradiation to treat head and neck cancer. The aim of this study was to evaluate the efficacy and safety of oral glutamine supplementation in these patients. Materials and Methods From December 2013 to December 2014, we randomly assigned to two arms 162 patients who had squamous cell carcinoma of the head and neck. Patients in arm A were given oral glutamine once per day, whereas those in arm B served as negative control subjects. All patients received radiotherapy given as 70 Gy in 35 fractions over 7 weeks with an injection of cisplatin once per week. Patients were assessed once per week to evaluate for the onset and severity of mucositis, pain, use of analgesics, and for Ryle tube feeding. Results We observed that 53.1% of patients developed mucositis toward the fifth week in the glutamine arm compared with 55.5% of patients in the control arm at the third week. None in the glutamine arm compared with 92.35% of patients in the control arm developed G3 mucositis. Rates of adverse events like pain, dysphagia, nausea, edema, and cough, as well as use of analgesics and Ryle tube feeding, were significantly lower in the glutamine arm than in the control arm. Conclusion This study highlights that the onset as well as the severity of mucositis in patients receiving glutamine was significantly delayed. None of the patients receiving glutamine developed G3 mucositis. Hence, the findings emphasize the use of oral glutamine supplementation as a feasible and affordable treatment option for mucositis in patients with head and neck cancers who are receiving chemoradiation.

scholarly journals Outcome of Targeted Therapy Recommendations for Metastatic and Recurrent Head and Neck Cancers

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3381
Author(s):  
Hossein Taghizadeh ◽  
Robert M. Mader ◽  
Leonhard Müllauer ◽  
Thorsten Fuereder ◽  
Alexandra Kautzky-Willer ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Head And Neck ◽  
Precision Medicine ◽  
Head And Neck Cancers ◽  
Molecular Profile ◽  
Therapy Recommendations ◽  
Advanced Therapy ◽  
Cancer Tumor ◽  
Generation Sequencing ◽  
Recurrent Head

Recurrent/metastatic (R/M) head and neck cancers bear a poor prognosis. In this analysis, we examined the efficacy and the outcome of targeted therapy recommendations based on the patients’ molecular tumor portrait after failure of all standard therapy options. In this single-center, real-world retrospective analysis of our platform for precision medicine, we analyzed the molecular profile of 50 patients diagnosed with R/M head and neck cancer. Tumor samples of the patients were examined using next-generation sequencing panels of mutation hotspots, microsatellite instability (MSI) testing, and immunohistochemistry (IHC). In 31 cases (62.0% of all patients), a molecular-driven targeted therapy approach was recommended. Eventually, 14 patients (28%) received the suggested targeted therapy. Six of fourteen patients (43%) achieved stable disease conditions and four patients (29%) experienced a progressive disease. The median time to treatment failure was 2.8 months. Therapy recommendations were significantly more often issued for men (p = 0.037) than for women. This analysis demonstrated that precision medicine provided the basis for molecular-driven therapy recommendations in over half of the patients with advanced therapy refractory head and neck cancers, with significantly more therapy recommendations for men. Our analysis showed that although precision medicine approaches are implementable and feasible for the management of recurrent/metastatic head and neck cancers in daily clinical routine, there are major limitations and challenges that have to be overcome.

Stevens–Johnson syndrome and toxic epidermal necrolysis induced by amifostine during head and neck radiotherapy

2008 ◽  
Vol 87 (2) ◽  
pp. 300-303 ◽  
Author(s):  
Laurence Valeyrie-Allanore ◽  
Nicolas Poulalhon ◽  
Jean-Paul Fagot ◽  
Peggy Sekula ◽  
Batya Davidovici ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Head And Neck ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome ◽  
Head And Neck Radiotherapy

scholarly journals Is there a Role for Adjuvant Targeted and Immunotherapies in Patients with Locoregionally-Advanced Head and Neck Cancer?

2021 ◽  
pp. 205-219
Author(s):  
Kevin J. Harrington
Keyword(s):  
Head And Neck ◽  
Targeted Therapies ◽  
Cytotoxic Chemotherapy ◽  
Head And Neck Cancers ◽  
Advanced Head ◽  
Her Family ◽  
Adjuvant Therapies ◽  
Metastatic Relapse ◽  
Risk Of Disease ◽  
First Time

AbstractDespite significant technical improvements in the management of patients with locoregionally-advanced head and neck cancers, too many patients fail to achieve durable remissions that ultimately translate into cures. Loco-regional recurrence and/or metastatic relapse after intensive local therapies remain the scourge of those who suffer from this disease, and the surgeons and physicians who treat them. Regrettably, until now, we have failed to develop effective adjuvant therapies that can be delivered after the completion of definitive loco-regional treatment in order to reduce the risk of disease relapse. In this chapter, approaches based on cytotoxic chemotherapy, targeted therapies directed against c-erbB/HER receptors and immune checkpoint inhibition will be discussed. Neither cytotoxic chemotherapy nor anti-HER-family targeted therapies have proven to be successful as adjuvant therapies for locoregionally-advanced head and neck cancers, but there is significant hope that anti-PD1/anti-PD-L1-targeted antibody therapies may deliver progress in this area for the first time.

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