Researchers identify genetic markers for aggressive head and neck cancer

March 19, 2009

Scientists at Albert Einstein College of Medicine of Yeshiva University have identified genetic markers that signal poor outcomes for patients with head and neck cancer. These findings could one day lead to a genetic test that could help select or predict successful treatment options for patients with this type of cancer. The results were published in the American Journal of Pathology.

Head and neck cancer refers to tumors in the mouth, throat or larynx (voice box). Each year, about 40,000 men and women in the U.S. develop head and neck cancer, making it the sixth most common cancer in the U.S. Surgery, chemotherapy and/or radiation are the main treatment options but cause serious side effects: surgery may involve removing large areas of the tongue, throat, or neck and can affect appearance, and any type of therapy can cause swallowing or speech problems that can significantly affect quality of life. Despite curative treatment attempts, on average only about half of patients survive beyond five years after treatment. This is greatly affected by the size and location of the tumor.

The Einstein study focuses on microRNAs, a recently identified class of short RNA molecules that play key roles in regulating gene expression. Abnormal microRNA levels have been associated with all types of cancer yet examined.

In previous research, the Einstein scientists and other groups reported that approximately 50 specific microRNAs were expressed at higher or lower levels in head and neck tumor cell lines compared with normal cells. In this study, the Einstein researchers, for the first time, have linked levels of specific microRNAs with tumor recurrence and poorer survival in head and neck cancer.

The Einstein team analyzed samples from 104 head and neck cancer patients from Montefiore Medical Center, The University Hospital and Academic Medical Center for Einstein. The patients were treated and followed over five years. At the time of cancer diagnosis and before any therapy, researchers removed samples tumor tissue from patients, as well as normal tissue adjacent to their tumor, and measured microRNA levels in the two types of tissue.

Patients who fared worst had the lowest levels of two particular microRNAs─miR-205 and let-7d─in their tumor tissue. Specifically, these patients were four times more likely to have an earlier metastasis or local-regional recurrence of their cancer than patients with higher levels of miR-205 and let-7d in tumor tissue.

These findings may eventually be put to practical use, allowing physicians to identify potentially aggressive head and neck cancers and choose the most appropriate treatment. "A biologic marker identifying aggressive tumors would allow us to direct therapy more appropriately, minimizing over or under-treatment," explained Richard Smith, M.D., the lead clinician on the paper. Dr. Smith is associate professor of clinical otorhinolaryngology-head & neck surgery and associate professor of surgery at Einstein, and vice-chair of otorhinolaryngology-head & neck surgery at Einstein and Montefiore.

"In addition, these molecules, or modified forms of these molecules, can potentially be used in treatment because their small size allows them to be reintroduced into cells with the possibility of altering the behavior of a tumor," says Geoffrey Childs, Ph.D., professor of pathology at Einstein and corresponding author of the article.

"Our next steps are to confirm these results in a new patient population and to find additional markers that would allow us to develop a reproducible and accurate prognostic test," explained Nicolas Schlecht, Ph.D., assistant professor of epidemiology and population health, and of medicine at Einstein. Dr. Schlecht is also the Miriam Mandel faculty scholar in cancer research and a senior author of the paper.

Albert Einstein College of Medicine

---

---

	Meeting the Challenges of Oral and Head and Neck Cancer: A Guide for Survivors and Caregivers, Second Edition by Nancy E. Leupold (Author), James Sciubba (Author) This volume has been expanded, updated, and polished and thus constitutes an even more comprehensive resource of valuable scientific, psychological, sociological, therapeutic, financial, and practical information for the patient afflicted with head and neck cancer and his or her family. Appreciation of these principles [in this book] and others too numerous to mention will soften the impact of the cancer and facilitate the care of, as well as the caring for, the patient afflicted with head and neck cancer. From the foreword by Elliot W. Strong, M.D., F.A.C.S, Emeritus, Memorial Hospital for Cancer and Allied Disease, Emeritus, Memorial Sloan Kettering Cancer Center, Former Attending Surgeon and Chief, Head and Neck Service, Former Professor of Surgery, Cornell University, Medical College....
	Radiotherapy for Head and Neck Cancers: Indications and Techniques by K. Kian Ang (Author), Adam Garden (Author) Long established as a staple reference for all radiation oncologists, Radiotherapy for Head and Neck Cancers: Indications and Techniques is now in its Fourth Edition. This completely updated edition presents the state-of-the-art protocols currently used at the MD Anderson Cancer Center and thoroughly explains the principles, nomenclature, and clinical use of intensity-modulated radiotherapy (IMRT). The first section discusses the practical aspects of external beam therapy, brachytherapy, and endocavitary beam therapy and offers guidelines on patient care before and during radiotherapy. The second section provides detailed coverage of site-specific indications and techniques.
	100 Q&A About Head and Neck Cancer (100 Questions & Answers about . . .) by Elise Carper (Author), Kenneth S. Hu (Author), Elena Kuzin (Author) Tumors of the head and neck afflict nearly forty thousand people annually and account for approximately five percent of all cancers. Whether you're a newly diagnosed head and neck cancer patient, a survivor, or friend or relative of either, this book offers help. The only text to provide the doctor's and patient's views, 100 Questions & Answers About Head and Neck Cancer gives you authoritative, practical answers to your questions about treatment options, post-treatment quality of life, sources of support, and much more. This is an invaluable resource for anyone coping with the physical and emotional turmoil of head and neck cancer.
	Tongue Cancer and My Organic Cotton Socks Tongue Cancer and My Organic Cotton Socks Is anyone safe? For years, for decades, I searched for organic foods, put aside my two cigarettes a day forever twenty seven years ago, followed in my Father’s Mother’s footsteps sipping a glass of red wine now and then before bedtime, only now and then mind you. Glass jars and glass glasses, stainless pots and pans, filtered water, my chicken and beef were free of antibiotics, my fruit and veggies cost sometimes twice as much, but I figured pay now or pay later. The paint in my house is safe, there are no harsh cleaning chemicals in my cabinets, no pesticides on my lawn so what gives? Oh, there's more? The dogs dine on organic food, sleep on organic cotton beds, enjoy the safest shampoos and treats, love soothing music, have a safe...
	Head and Neck Cancer Imaging (Medical Radiology / Diagnostic Imaging) by Robert Hermans (Editor), Albert L. Baert (Editor) This book provides a comprehensive review of state-of-the-art imaging in head and neck cancer. Precise determination of tumor extent is of the utmost importance in these neoplasms, as it has important consequences for staging of disease, prediction of outcome and choice of treatment. Only the radiologist can fully appreciate submucosal, perineural, and perivascular tumor spread and detect metastatic disease at an early stage. Imaging is also of considerable benefit for patient surveillance after treatment. All imaging modalities currently used in the management of head and neck neoplasms are considered in depth, and in addition newer techniques such as PET-CT and diffusion-weighted MRI are discussed. This book will help the reader to recommend, execute and report head and neck imaging...
	Head and Neck Cancer: Multimodality Management by Jacques Bernier (Editor) In recent years, great advances in translational research have led to new paradigms in the treatment of cancers of the head and neck.  Written by leading international physicians and investigators, this innovative multi-disciplinary book presents the most up-to-date research and clinical approaches.  Coverage is given to progress in a variety of clinical settings, including programs of organ and function preservation, curative treatments, unresectable disease, adjuvant treatments in high-risk patients, and recurrent/metastatic disease.  Complementary to the techniques of surgery, radiotherapy, and systemic treatments, the authors present data on epidemiology, molecular pathology, normal tissue complications, rehabilitation, palliative care, and treatment in the elderly. ...
	Clinical Manual for Laryngectomy and Head/Neck Cancer Rehabilitation (Clinical Competence Series) by Janina K. Casper (Author), Raymond H. Colton (Author) Following a highly successful first edition, Clinical Manual For Laryngectomy And Head/Neck Cancer Rehabilitation, 2E continues the tradition of its predecessor as being an indispensable aid and sought-after reference for all voice professionals in clinical settings.
	Multidisciplinary Management of Head and Neck Cancer by Robert Haddad MD (Author) Head and neck cancer is a very common cancer worldwide with an estimated 500,000 individuals diagnosed each year. In the United States an average of 39,000 new cases are reported each year representing between 3 to 5% of all new cancer cases diagnosed annually. Head and neck cancers are more common in men and in individuals over the age of 50. The treatment of head and neck cancer is extremely challenging and involves insight and expertise from multiple disciplines. Multidisciplinary Management of Head and Neck Cancer is a comprehensive textbook looking at different aspects of head and neck cancer, including the diagnosis, treatment and outcomes for patients with this disease. The chapters written by world-renowned experts cover the entire discipline of head and neck oncology and include...
	Head and Neck Cancer: Treatment, Rehabilitation, and Outcomes by Elizabeth C. Ward and Corina J. van As Brooks (Author), Ph.d. Ward Elizabeth C. (Editor), Ph.d. Van As Brooks Corina J. (Editor) Univ. of Queensland, UK. Presents information for the head and neck cancer team. Topics include evaluating impact of cancer of the head and neck, radiation and chemotherapy, laryngeal and hypopharyngeal cancer, nonsurgical voice restoration following total laryngectomy, and more. DNLM: Head and Neck Neoplasms-therapy.
	An assessment of risk factors for the development of a second primary malignancy in the head and neck.: An article from: Ear, Nose and Throat Journal by Neil Bhattacharyya (Author) This digital document is an article from Ear, Nose and Throat Journal, published by Thomson Gale on February 1, 2006. The length of the article is 3540 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser. Citation Details Title: An assessment of risk factors for the development of a second primary malignancy in the head and neck. Author: Neil Bhattacharyya Publication: Ear, Nose and Throat Journal (Magazine/Journal) Date: February 1, 2006 Publisher: Thomson Gale Volume: 85 Issue: 2 Page: 121(5) Distributed by Thomson...