Head and Neck Cancer

Our Clinical Trials Continually updated list of our clinical trials for head and neck cancer more

Head and neck cancers encompass tumors that appear in the nasal passages, mouth, throat, larynx, salivary glands, and thyroid gland. Skin cancers that develop in the scalp, face, or neck are also considered to be head and neck cancers.

Surgery is the primary form of treatment for these cancers, and our surgeons have been at the forefront of developing techniques that preserve function and reconstruct critical organs. Our investigators have also developed more effective approaches using radiation therapy, better chemotherapy agents (including targeted drugs), and treatment protocols that combine chemotherapy and radiation therapy. These techniques often have a lower occurrence of side effects than more traditional approaches, in addition to being more effective.

Among our recent research accomplishments:

Detection, Diagnosis, and Prognosis

• Our investigators identified five chromosomal aberrations associated with patient outcome, validated the significance of 3q amplification, and identified SCCRO (Squamous Cell Carcinoma Related Oncogene) as a candidate gene driving selection for this amplification. We found that amplification and overexpression of SCCRO in these tumors and in bronchioloalveolar lung cancer correlate with poor clinical outcome. We are continuing functional analyses of SCCRO and collaborating to solve its crystal structure, with the intent of using structural and functional information to identify inhibitors. We have utilized expression profiling to identify factors associated with disease progression; the results appear to allow discrimination between new primary lung cancers and metastatic head and neck cancer. Cancer Res 2006;66:9437-9444. [PubMed Abstract]; Arch Otolaryngol Head Neck Surg 2005;131:10-18. [PubMed Abstract]; Cancer Res 2005;65:3063-3071. [PubMed Abstract]

• Our imaging researchers are evaluating the efficacy of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) and magnetic resonance spectroscopy as an a priori predictor or early marker of tumor response. They are also beginning clinical trials in patients with head and neck tumors using 1H spectroscopy studies of metabolism, DCE-MRI, and imaging 18F-fluoromisonidazole with positron emission tomography.

Therapeutics Approaches

• Our researchers have been leaders in expanding combined modality approaches for organ/larynx conservation to nonlaryngeal sites and in establishing the importance of quantifying both disease control and functional/quality of life outcomes. Building upon prior work, they defined a new combination of chemotherapy and altered fractionated radiation therapy integrated with cetuximab. A variation on the program developed here is currently being compared to the same locoregional treatment without cetuximab in a Radiation Therapy Oncology Group randomized controlled clinical trial. Also building upon our prior preclinical studies, we will attempt to define the optimal biological dose of 6-AN in combination with PALA and MMPR using ³¹P MRI. J Clin Oncol 2006;24:1072-1078. [PubMed Abstract]

• To optimize patient selection for organ preservation treatment that includes radiation therapy, we have developed the TALK score (T stage, Albumin, Liquor/Alcohol Use, Karnofsky Performance Status). In collaboration with investigators from the Veterans Affairs (VA) Larynx Preservation Study, this prognostic tool has been validated using VA data.