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PMH finding may help some tonsil cancer patients avoid chemotherapy
November 04, 2009Clinical researchers at Princess Margaret Hospital (PMH) have confirmed that patients with oropharyngeal squamous cell cancer ("tonsil cancer") harbour a common type of human papilloma virus (HPV16), but also that such cancers are very sensitive to radiation. For some patients, this may mean successful treatment with radiation alone and avoiding the side effects of chemotherapy.
"This represents the power of personalized medicine. By using a relatively simple molecular test to evaluate the tumour, we can customize the treatment plan, produce an excellent outcome, and maintain the patient's quality of life," says principal investigator Dr. Fei-Fei Liu, PMH radiation oncologist, Head of the Division of Applied Molecular Oncology, Ontario Cancer Institute, and Dr. Mariano Elia Chair in Head & Neck Cancer Research, University Health Network.
The findings were published on November 2 in the Journal of Clinical Oncology (JCO 231670).
Dr. Liu's team discovered that patients whose tumours tested positive for HPV16 had a much better survival, compared to patients whose tumours did not harbour HPV16. This HPV effect was independent of treatment (radiation alone, or radiation plus chemotherapy), suggesting that some HPV16 patients could be treated with radiation only. As a result, PMH now routinely tests tonsil-area tumours for HPV16 -- one of the first cancer programs to do so.
The study's finding is important because this particular type of cancer is increasing - up more than 10% in the past 20 years. The jump is likely attributed to the spread of HPV16 through sexual activity, compared with a 20% decline in other similar head-and-neck cancers over the same period because fewer people are now smoking.
Dr. Liu says the HPV vaccine currently available for teenagers targets the HPV16 strain. "Of course the goal is to prevent HPV infection in the first place, but for individuals who need treatment now, it's a major step to know that we could provide options so that some of our patients could be spared the often-difficult side effects of chemotherapy."
The research team analyzed tumour biopsies of 111 patients treated at PMH from 2003-2006, comparing clinical diagnosis, treatment plans, and outcomes. They found HPV16 in 60% of the samples, and determined that these patients experienced a much better survival, compared to the HPV-negative patients.
"We hope these findings will help other cancer programs manage their patients," says Dr. Brian O'Sullivan, Leader of the Head and Neck Program at Princess Margaret Hospital, Associate Director of the Radiation Medicine Program at PMH, and Bartley-Smith/Wharton Chair in Radiation Oncology.
University Health Network
Dr. Liu's team discovered that patients whose tumours tested positive for HPV16 had a much better survival, compared to patients whose tumours did not harbour HPV16. This HPV effect was independent of treatment (radiation alone, or radiation plus chemotherapy), suggesting that some HPV16 patients could be treated with radiation only. As a result, PMH now routinely tests tonsil-area tumours for HPV16 -- one of the first cancer programs to do so.
The study's finding is important because this particular type of cancer is increasing - up more than 10% in the past 20 years. The jump is likely attributed to the spread of HPV16 through sexual activity, compared with a 20% decline in other similar head-and-neck cancers over the same period because fewer people are now smoking.
Dr. Liu says the HPV vaccine currently available for teenagers targets the HPV16 strain. "Of course the goal is to prevent HPV infection in the first place, but for individuals who need treatment now, it's a major step to know that we could provide options so that some of our patients could be spared the often-difficult side effects of chemotherapy."
The research team analyzed tumour biopsies of 111 patients treated at PMH from 2003-2006, comparing clinical diagnosis, treatment plans, and outcomes. They found HPV16 in 60% of the samples, and determined that these patients experienced a much better survival, compared to the HPV-negative patients.
"We hope these findings will help other cancer programs manage their patients," says Dr. Brian O'Sullivan, Leader of the Head and Neck Program at Princess Margaret Hospital, Associate Director of the Radiation Medicine Program at PMH, and Bartley-Smith/Wharton Chair in Radiation Oncology.
University Health Network
Chemotherapy Current Events and Chemotherapy News RSSFertility procedures need not delay breast cancer treatment for younger women
A new study published in the November issue of the Journal of the American College of Surgeons shows that breast cancer patients under 40 years old who undergo fertility preservation do not face a significant delay in the treatment of their disease when their care is coordinated in a timely fashion.
Drugs to treat anemia in cancer patients linked to thromboembolism
Medications frequently given to cancer patients to reduce their risk of anemia are associated with an increased risk of deep vein thrombosis or pulmonary embolism, according to new research led by Dawn Hershman, M.D, M.S., co-director of the breast cancer program at the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian Hospital/Columbia University Medical Center.
For young boys with cancer, testicular tissue banking may be option to preserve fertility
For parents of children with cancer, the hopeful news is that pediatric survival rates have steadily improved for decades. Among the bad news-treatments that enable survival often cause infertility.
FDA approved leukemia drugs shows promise in ovarian cancer cells
The drug Sprycel, approved for use by the U.S. Food and Drug Administration in patients with chronic myeloid leukemia, significantly inhibited the growth and invasiveness of ovarian cancer cells and also promoted their death, a study by researchers with UCLA's Jonsson Comprehensive Cancer Center found.
1930s drug slows tumor growth
Drugs sometimes have beneficial side effects. A glaucoma treatment causes luscious eyelashes. A blood pressure drug also aids those with a rare genetic disease.
First use of antibody and stem cell transplantation to successfully treat advanced leukemia
For the first time, researchers at Fred Hutchinson Cancer Research Center have reported the use of a radiolabeled antibody to deliver targeted doses of radiation, followed by a stem cell transplant, to successfully treat a group of leukemia and pre-leukemia patients for whom there previously had been no other curative treatment options.
New Synthetic Molecules Trigger Immune Response to HIV and Prostate Cancer
Researchers at Yale University have developed synthetic molecules capable of enhancing the body's immune response to HIV and HIV-infected cells, as well as to prostate cancer cells. Their findings, published online in the Journal of the American Chemical Society, could lead to novel therapeutic approaches for these diseases.
Chemo-radiation before prostate removal may prevent cancer recurrence
Researchers in the Oregon Health & Science University Knight Cancer Institute and the Portland Veterans Affairs Medical Center have found a combination of radiation therapy and chemotherapy given before prostate removal is safe and may have the potential to reduce cancer recurrence and improve patient survival.
Study of concurrent radiotherapy, chemotherapy shows promise in small cell lung cancer
Treating limited stage small cell lung cancer(LSCL) with a combination of accelerated high-dose radiotherapy and chemotherapy has shown encouraging results.
Blood vessels might predict prostate cancer behavior
A diagnosis of prostate cancer raises the question for patients and their physicians as to how the tumor will behave. Will it grow quickly and aggressively and require continuous treatment, or slowly, allowing therapy and its risks to be safely delayed?
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