Immunotherapy for Head and Neck Cancer: A Paradigm Shift From Induction Chemotherapy to Neoadjuvant Immunotherapy

Neoadjuvant immunotherapy has the potential to enhance clinical outcomes by increasing anti-tumor immune responses in the presence of abundant tumor-derived antigen in an immune microenvironment that has not been exposed to previous therapy. The current mainstay of advanced head and neck squamous cell carcinoma (HNSCC) treatment remains surgery and radiotherapy with/without conventional chemotherapy. Despite this multi-modality treatment, advanced human papillomavirus (HPV)-negative HNSCC shows poor prognosis. Treatment intensification with neoadjuvant (induction) chemotherapies with platinum drugs are insufficient to significantly prolong overall survival. Although only 15-20% of patients benefit, immunotherapies have been approved and widely used for recurrent and metastatic HNSCC. These successes have led to checkpoint blockade therapies being testing in earlier treatment settings. Recent clinical trials of neoadjuvant immunotherapy show promising results and this methodology has the potential to change the treatment algorithm of HNSCC. This overview examines the treatment history of neoadjuvant approaches for HNSCC, and especially focuses on the recent topics of neoadjuvant immunotherapy for HNSCC.

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Management of radiation-related supraglottic stenosis with serial in-office steroid injections

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20185311 ◽

2018 ◽

Vol 5 (1) ◽

pp. 184

Author(s):

Christine M. Kim ◽

Pratik B. Patel ◽

Aaron J. Feinstein ◽

Dinesh K. Chhetri

Keyword(s):

Head And Neck ◽

Paradigm Shift ◽

Surgical Intervention ◽

Outpatient Management ◽

Clinical Protocol ◽

Steroid Injections ◽

Clinical Challenge ◽

History Of ◽

Head And Neck Radiation

Management of supraglottic stenosis in patients with history of head and neck radiation presents a clinical challenge for otolaryngologists. The cornerstone of treatment has historically been surgical intervention, both endoscopic and open. However, recently described techniques related to outpatient management of subglottic and tracheal stenosis with routine in-office steroid injections may provide a translatable model for supraglottic stenosis management. We describe a clinical protocol for in-office steroid injections to the laryngopharynx for patients with supraglottic stenosis secondary to radiation fibrosis. Two patient cases are reported, including endoscopic examinations over a follow-up period of 12 to 16 months. Both patients experienced significant improvement in their supraglottic airways. In-office steroid injections may be beneficial to prevent or slow stenosis recurrence in patients treated with radiation for head and neck cancer. With continued refinement of this technique, a paradigm shift may occur in the management of supraglottic stenosis.

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The Beginnings of Islam in Afghanistan

10.1525/california/9780520294134.003.0002 ◽

2017 ◽

Cited By ~ 2

Author(s):

Arezou Azad

Keyword(s):

Paradigm Shift ◽

Political System ◽

Cultural Practices ◽

Eighth Century ◽

Religious Context ◽

Early Islam ◽

History Of ◽

Initial Conversion ◽

The Way

Covering the period from 709 to 871, this chapter traces the initial conversion of Afghanistan from Zoroastrianism and Buddhism to Islam. Highlighting the differential developments in four regions of Afghanistan, it discusses the very earliest history of Afghan Islam both as a religion and as a political system in the form of a caliphate. The chapter draws on under-utilized sources, such as fourth to eighth century Bactrian documents from Tukharistan and medieval Arabic and Persian histories of Balkh, Herat and Sistan. In so doing, it offers a paradigm shift in the way early Islam is understood by arguing that it did not arrive in Afghanistan as a finished product, but instead grew out of Afghanistan’s multi-religious context. Through fusions with Buddhism, Zoroastrianism, early Abrahamic traditions, and local cult practices, the Islam that resulted was less an Arab Islam that was imported wholesale than a patchwork of various cultural practices.

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Faculty Opinions recommendation of Late complications and long-term quality of life for survivors (>5 years) with history of head and neck cancer.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717952796.793457670 ◽

2012 ◽

Author(s):

Giulio Cantu ◽

Madia Pompilio ◽

Paolo Formillo

Keyword(s):

Quality Of Life ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Late Complications ◽

History Of

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Leiomyosarcoma of the Tracheostomy Site in a Patient with History of Laryngeal Squamous Cell Carcinoma

Case Reports in Oncology ◽

10.1159/000516797 ◽

2021 ◽

pp. 912-917

Author(s):

Zainub Ajmal ◽

Abdul Moiz Khan ◽

Lezah McCarthy ◽

Allison Lupinetti ◽

Syed Mehdi

Keyword(s):

Risk Factors ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

English Literature ◽

Neck Region ◽

Multiple Risk Factors ◽

History Of ◽

Rare Malignancy

Leiomyosarcoma (LMS) of the trachea is an extremely rare malignancy with only a few reported cases in English literature. As such the diagnosis can be frequently missed or delayed. We present a case of a 69-year-old male who underwent tracheostomy for airway obstruction secondary to glottic squamous cell carcinoma and treated definitely with radiation therapy. Subsequently, the patient developed LMS of the tracheostomy site. The case further details multiple risk factors that could contribute to development of LMS including radiation exposure, prior malignancy, and chronic inflammation. These risk factors have been well established for LMS in other sites but less so in the head and neck region, which is the subject of our discussion. We also review the current guidelines for head and neck as well as limb sarcomas and discussed role of surgery or radiation and their accompanying challenges in management of this rare malignancy.

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Vaccination strategy and anti - SARS-CoV-2 S titers in healthcare workers of the INT – IRCCS “Fondazione Pascale” Cancer Center (Naples, Italy)

Infectious Agents and Cancer ◽

10.1186/s13027-021-00375-2 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Ernesta Cavalcanti ◽

Maria Antonietta Isgrò ◽

Domenica Rea ◽

Lucia Di Capua ◽

Giusy Trillò ◽

...

Keyword(s):

Immune Response ◽

Immune Responses ◽

Healthcare Workers ◽

Geometric Mean ◽

Vaccination Strategy ◽

Antibody Responses ◽

Cancer Center ◽

Serum Samples ◽

Humoral Immune ◽

History Of

Abstract Background Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and the resulting disease, coronavirus disease 2019 (COVID-19), have spread to millions of people globally, requiring the development of billions of different vaccine doses. The SARS-CoV-2 spike mRNA vaccine (named BNT162b2/Pfizer), authorized by the FDA, has shown high efficacy in preventing SARS-CoV-2 infection after administration of two doses in individuals 16 years of age and older. In the present study, we retrospectively evaluated the differences in the SARS-CoV-2 humoral immune response after vaccine administration in the two different cohorts of workers at the INT - IRCCS “Fondazione Pascale” Cancer Center (Naples, Italy): previously infected to SARS-CoV-2 subjects and not infected to SARS-CoV-2 subjects. Methods We determined specific anti-RBD (receptor-binding domain) titers against trimeric spike glycoprotein (S) of SARS-CoV-2 by Roche Elecsys Anti-SARS-CoV-2 S immunoassay in serum samples of 35 healthcare workers with a previous documented history of SARS-CoV-2 infection and 158 healthcare workers without, after 1 and 2 doses of vaccine, respectively. Moreover, geometric mean titers and relative fold changes (FC) were calculated. Results Both previously infected and not infected to SARS-CoV-2 subjects developed significant immune responses to SARS-CoV-2 after the administration of 1 and 2 doses of vaccine, respectively. Anti-S antibody responses to the first dose of vaccine were significantly higher in previously SARS-CoV-2-infected subjects in comparison to titers of not infected subjects after the first as well as the second dose of vaccine. Fold changes for subjects previously infected to SARS-CoV-2 was very modest, given the high basal antibody titer, as well as the upper limit of 2500.0 BAU/mL imposed by the Roche methods. Conversely, for naïve subjects, mean fold change following the first dose was low ($$ \overline{x} $$ x ¯ =1.6), reaching 3.8 FC in 72 subjects (45.6%) following the second dose. Conclusions The results showed that, as early as the first dose, SARS-CoV-2-infected individuals developed a remarkable and statistically significant immune response in comparison to those who did not contract the virus previously, suggesting the possibility of administering only one dose in previously SARS-CoV-2-infected subjects. FC for previously infected subjects should not be taken into account for the generally high pre-vaccination values. Conversely, FC for not infected subjects, after the second dose, were = 3.8 in > 45.0% of vaccinees, and ≤ 3.1 in 19.0%, the latter showing a potential susceptibility to further SARS-CoV-2 infection.

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History of otorhinolaryngology in Germany before 1921

HNO ◽

10.1007/s00106-021-01046-9 ◽

2021 ◽

Vol 69 (5) ◽

pp. 338-365

Author(s):

Albert Mudry ◽

Robert Mlynski ◽

Burkhard Kramp

Keyword(s):

Head And Neck ◽

19Th Century ◽

Neck Surgery ◽

German Society ◽

100Th Anniversary ◽

Head And Neck Surgery ◽

History Of ◽

Academic Organization ◽

The 19Th Century ◽

Made In

AbstractIn 2021, the German Society of Otorhinolaryngology, Head and Neck Surgery is celebrating the 100th anniversary of its foundation. The aim of this article is to present the main inventions and progress made in Germany before 1921, the date the society was founded. Three chronological periods are discernible: the history of otorhinolaryngology (ORL) in Germany until the beginning of the 19th century, focusing mainly on the development of scattered knowledge; the birth of the sub-specialties otology, laryngology (pharyngo-laryngology and endoscopy), and rhinology in the 19th century, combining advances in knowledge and implementation of academic structures; and the creation of the ORL specialty at the turn of the 20th century, mainly concentrating on academic organization and expansion. This period was crucial and allowed for the foundation of the German Society of Otorhinolaryngology, Head and Neck Surgery on solid ground. Germany played an important role in the development and progress of ORL internationally in the 19th century with such great contributors as Anton von Tröltsch, Hermann Schwartze, Otto Körner, Rudolf Voltolini, and Gustav Killian to mention a few.

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Characteristics of 108 thyroid cancers detected by screening in a population with a history of head and neck irradiation

Cancer ◽

10.1002/1097-0142(19800901)46:5<1218::aid-cncr2820460523>3.0.co;2-h ◽

1980 ◽

Vol 46 (5) ◽

pp. 1218-1227 ◽

Cited By ~ 35

Author(s):

Arthur B. Schneider ◽

Steven Pinsky ◽

Carlos Bekerman ◽

U. Yun Ryo

Keyword(s):

Head And Neck ◽

Thyroid Cancers ◽

Neck Irradiation ◽

History Of ◽

Head And Neck Irradiation

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Preoperative predictors of dysphagia after transoral surgery

International Journal of Clinical Oncology ◽

10.1007/s10147-021-01860-9 ◽

2021 ◽

Author(s):

Kazunori Fujiwara ◽

Kenkichiro Taira ◽

Ryohei Donishi ◽

Satoshi Koyama ◽

Tsuyoshi Morisaki ◽

...

Keyword(s):

Head And Neck ◽

Forced Expiratory Volume ◽

Transoral Surgery ◽

Postoperative Dysphagia ◽

Swallowing Function ◽

History Of ◽

Group A ◽

Low Bmi ◽

Head And Neck Radiotherapy

Abstract Background Transoral surgery (TOS) has been used to remove pharyngeal and laryngeal cancers with the objective of improving functional without worsening survival. However, there is a risk of postoperative dysphagia, which can severely impair quality of life. The aim of this study was to evaluate the preoperative predictive factors for postoperative dysphagia in patients undergoing TOS. Methods One hundred and twenty patients who underwent TOS were evaluated in this study. The degree of dysphagia was evaluated using the Functional Outcome Swallowing Scale (FOSS) both preoperatively and 3 months postoperatively. Those whose FOSS stage was maintained postoperatively were classified into the FOSS-M group, while those with increased FOSS stage postopratively were classified into the FOSS-I group. The following parameters were assessed before surgery: age, weight, height, body mass index (BMI), forced expiratory volume in 1 s, and history of head and neck radiotherapy. Videofluoroscopy (VF) was performed preoperatively to evaluate swallowing function using the Penetration-Aspiration Scale (PAS). Results The BMI of the FOSS-M group was significantly higher than that of the FOSS-I group. A history of radiotherapy was significantly more common in the FOSS-I group than in the FOSS-M group. Finally, preoperative PAS in the FOSS-M group was lower than that in the FOSS-I group. Conclusion This study suggested that patients with preoperative aspiration detected using VF might develop postoperative dysphagia severely. In addition, preoperative low BMI and a history of previous radiotherapy for head and neck cancer were associated with postoperative dysphagia. Objective examinations such as VF should be performed preoperatively.

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Case-control study of oral disease indexes in individuals with head and neck cancer after antineoplastic therapy

Einstein (São Paulo) ◽

10.1590/s1679-45082018ao4245 ◽

2018 ◽

Vol 16 (3) ◽

Author(s):

Reyna Aguilar Quispe ◽

Adrielle Lindolpho Cremonesi ◽

Jeanne Kelly Gonçalves ◽

Cassia Maria Fischer Rubira ◽

Paulo Sérgio da Silva Santos

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Permanent Teeth ◽

Control Group ◽

Study Group ◽

Periodontal Index ◽

Community Periodontal Index ◽

History Of ◽

Antineoplastic Treatment

ABSTRACT Objective To evaluate the oral health of patients with head and neck cancer after antineoplastic treatment, and to compare them with patients with no history of cancer. Methods A total of 75 patients, divided into Study Group, composed of individuals after antineoplastic treatment (n=30), and Control Group, with individuals with no history of cancer (n=45), aged 37 to 79 years. The oral health status was evaluated through the index of decayed, missing or filled permanent teeth (DMFT), community periodontal index and evaluation of the use and need of prosthesis. All of these items were evaluated according to the criteria recommended by the World Health Organization. The statistical analysis was descriptive and used the Pearson’s χ2 test. Results The community periodontal index was higher in the Study Group when compared to the Control Group (p<0.0001). The need for an upper (p<0.001) and lower (p<0.0001) prostheses was higher in the Study Group. Also, the use of upper prosthesis was higher in the Study Group (p<0.002). The missing or filled permanent teeth index between the two groups (p>0.0506) and the use of lower prosthesis (p>0.214) did not present a relevant statistical difference. Conclusion Periodontal disease and edentulism are the most significant changes in individuals who received antineoplastic therapy for head and neck cancer as well as greater need for oral rehabilitation.

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