Head & Neck Cancer -- Clinical Research Program

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:

Molecular Pathology

  • In a genomewide analysis of laryngopharyngeal cancer, our investigators have identified two genes, MDM2 and erbB2, that are indicative of locoregional failure in patients who are treated with chemoradiotherapy. These genes could be monitored as molecular markers to identify those patients who are likely to benefit most from chemoradiotherapy versus primary surgery. J Clin Oncol. 2007 Apr 10;25(11):1369-76. [PubMed Abstract]

Imaging

  • Our investigators are evaluating the use of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in patients with squamous cell head and neck cancer. Our findings indicate that the method can be used to predict treatment responses during initial analyses and to differentiate between hypoxic and nonhypoxic nodes.
  • In characterizing the histology of metastatic tumor tissue from patients with thyroid cancer whose disease is radioactive iodine-refractory (RAIR) and can be monitored using positron emission tomography (PET), we have found that such tumors form a clinically aggressive subset. Our findings could improve our understanding of thyroid cancer progression and could also spur the development of novel targeted therapies for RAIR disease. Cancer. 2008 Jul 1;113(1):48-56. [PubMed Abstract]
  • We have also developed a new quantitative tomography imaging method for assessing the absorbed radioiodine dose to normal organs in thyroid cancer patients who have been treated with iodine therapy. J Nucl Med. 2007 Jan;48(1):143-9. [PubMed Abstract]
  • We have found that PET imaging using radiolabeled fluorodeoxyglucose can be used to exclude locoregional disease with high accuracy in patients with squamous cell head and neck cancer who have had chemoradiation. Our results provide a basis to avoid neck dissection in these patients. J Nucl Med. 2008 Apr;49(4):532-40. [PubMed Abstract]

Radiation Therapy

  • After thyroid cancer patients are treated with surgery, radioiodine therapy may be used. Physicians have found that administration of recombinant TSH protein is as effective as, and much better tolerated than, traditional thyroid hormone withdrawal in preparing patients for radioiodine therapy. Cancer. 2008 Jul 1;113(1):48-56. [PubMed Abstract]
  • Our investigators are evaluating the use of intensity-modulated radiation therapy (IMRT) for treatment of head and neck cancers. Our preliminary analysis of IMRT in patients whose primary cancer is in an unknown primary site suggests that this method has acceptable toxicity and encouraging efficacy. Int J Radiat Oncol Biol Phys. 2008 Mar 15;70(4):1100-7. [PubMed Abstract]
  • In reviewing our experience in treating patients with recurrent head and neck cancer, we have observed that IMRT predicted better locoregional tumor control when compared to conventional radiotherapy. Int J Radiat Oncol Biol Phys. 2007 Jul 1;68(3):731-40. [PubMed Abstract]
  • IMRT also achieved encouraging locoregional tumor control in patients with advanced laryngeal and hypopharyngeal cancer. Int J Radiat Oncol Biol Phys. 2007 Oct 1;69(2):459-68. [PubMed Abstract]

Targeted Therapies

  • Our researchers are exploring the therapeutic potential of novel targeted therapies using in vitro and in vivo models of head and neck cancers.
  • We have discovered that the protein nectin-1 can be used as a marker to predict the sensitivity of a squamous cell head and neck cancer to oncolytic therapy with herpes simplex virus. Mol Ther. 2007 Jan;15(1):103-13. [PubMed Abstract]
  • Using studies in mice bearing human medullary thyroid cancer, we have shown that the targeted drug NVP-AST487 blocks tumor growth while independently inhibiting the expression of calcitonin, a protein that serves as a biomarker of tumor burden in medullary thyroid cancer patients. Our findings indicate that the role of traditional tumor biomarkers may need to be reassessed as new targeted therapies are implemented. Cancer Res. 2007 Jul 15;67(14):6956-64. [PubMed Abstract]
  • In exploring the interaction between RET and EGFR, two genes that are commonly altered in thyroid cancer, we have found that drugs targeting both gene products may have enhanced activity in patients whose tumors have RET mutations. Cancer Res. 2008 Jun 1;68(11):4183-91. [PubMed Abstract]
  • Our findings also suggest that papillary thyroid cancers harboring BRAF mutations are responsive to drugs that inhibit the protein MEK. J Clin Endocrinol Metab. 2008 Jun; 93(6):2194-201. [PubMed Abstract]

Integrative and Complementary Approaches

  • Our results from a randomized, controlled trial show that acupuncture provides significant reductions in pain, dysfunction, and dry mouth in head and neck cancer patients after neck dissection and radiation therapy