Navigation Links
Researchers investigate a less toxic radiation treatment for HPV-Positive oropharynx cancer

CHICAGO, IL (May 29, 2013)Researchers from Fox Chase Cancer Center and other institutions have completed a phase II clinical trial that may help identify those patients with HPV-positive oropharyngeal cancer who do not require the full radiation dose given in a standard regimen of Intensity-Modulated Radiation Therapy (IMRT). Preliminary findings will be presented by Shanthi Marur, first author on the study and an oncologist at the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, at the 49th Annual Meeting of the American Society of Clinical Oncology on Sunday, June 2.

Patients enrolled in the trial received an initial regimen of chemotherapy followed by treatment with the targeted therapy cetuximab, a monoclonal antibody. In the study, a patient's response to those initial treatments determined the dose during radiation treatment.

"Those patients who had a really good response to chemotherapy might also be more responsive to radiation," says Barbara Burtness, senior author on the study and chief of head and neck medical oncology at Fox Chase. "Therefore, the use of a full dose of radiation for those patients might represent overtreatment."

Burtness is also chair of the Eastern Cooperative Oncology Group (ECOG), which sponsors this ongoing trial. ECOG is a a National Cancer Institute-funded team of researchers who organize and carry out clinical trials.

According to the National Cancer Institute, more than 40,000 people will be diagnosed with cancer of the oropharynxa swath of tissue at the back of the throatin 2013, and nearly 8,000 will die from the disease. Between 60 and 80 percent of cases are associated with infection by Human Papilloma Viruses, or HPVs.

"Patients with HPV-associated oropharyngeal cancer tend to be younger than other oropharyngeal cancer patients, and would be living with the aftereffects of treatment for more years," says Burtness. A patient who undergoes standard radiation to the back of the throatusually between 66 and 70 Gymay suffer serious side effects like dry mouth and disfunction in swallowing.

The investigators suspected a subset of HPV-associated oropharyngeal cancer patients, identified by their response to chemotherapy, may be suitable for trials of lower radiation.

Burtness and her co-investigators enrolled 90 patients in the trial, 80 of whom were analyzable. Of those patients, 95 percent were men, and the median age was 57. The researchers reported that most patients tolerated the induction chemotherapy and treatment with cetuximab, and 96 percent completed all three cycles. Forty-six patients had a complete clinical response, which meant all signs of the primary tumor had disappeared following treatment. These patients went on to receive a lower-than-standard dose of radiation, at 54 Gy.

The researchers report that most patients tolerated the treatment with low incidence of high-grade side effects, but other data are premature. The primary endpoint of the study is two-year progression-free survival, the fraction of patients whose diseases have not worsened after two years. The investigators say that if the two-year progression-free survival rate is at least 85 percent, further studies on lower-dose radiation are warranted.

"We do not expect that anyone would want to lower the dose of radiation based on this study, which is very much a developmental study," says Burtness. "We've never had a comparative trial of low dose versus standard dose IMRT."

Burtness notes among patients who received a lower dose of radiation, "what seemed to predict for a slightly worse outcome was either a heavy smoking history (more than 10 pack years), or those with larger tumors."

She says that although it's too early to draw definitive conclusions, the early results "may justify further study of deintensifying radiation among nonsmokers with HPV-associated oropharyngeal cancers."


Contact: Diana Quattrone
Fox Chase Cancer Center

Related medicine news :

1. Researchers discover new weapon in fight against cervical cancer
2. Researchers gain insight into key protein linked to cancers, neurodegenerative disorders
3. Researchers identify novel approach to create red blood cells, platelets in vitro
4. Researchers shed new light on egg freezing success rates
5. Junk DNA plays active role in cancer progression, researchers find
6. Researchers provide rationale for use of targeted immunotherapy in sarcomatoid lung carcinomas
7. Stanford researchers identify genetic suspects in sporadic Lou Gehrigs disease
8. Researchers identify first drug targets in childhood genetic tumor disorder
9. Researchers find common childhood asthma unconnected to allergens or inflammation
10. Researchers identify networks of neurons in the brain that are disrupted in psychiatric disease
11. Fish Oil Pills Might Cut Diabetes Risk, Researchers Say
Post Your Comments:
(Date:6/25/2016)... Oklahoma (PRWEB) , ... June 25, 2016 , ... ... both athletes and non-athletes recover from injury. Recently, he has implemented orthobiologic procedures ... Oklahoma City area —Johnson is one of the first doctors to perform the ...
(Date:6/24/2016)... ... June 24, 2016 , ... Those who have experienced traumatic ... many turn to unhealthy avenues, such as drug or alcohol abuse, as a coping ... released tools for healthy coping following a traumatic event. , Trauma sufferers tend to ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... Global law ... magazine’s 2016 Legal Elite. The attorneys chosen by their peers for this recognition are ... , Seven Greenberg Traurig Shareholders received special honors as members of this year’s Legal ...
(Date:6/24/2016)... ... June 24, 2016 , ... People across the U.S. are sharpening their pencils ... an essay contest in which patients and their families pay tribute to a genetic ... 2016 National Society of Genetic Counselors (NSGC) Annual Education Conference (AEC) this September. ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... feeding the Frederick area economy by obtaining investment capital for emerging technology companies. ... 2½ years that have already resulted in more than a million dollars of ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , June 24, 2016  Arkis BioSciences, a ... invasive and more durable cerebrospinal fluid treatments, today ... The Series-A funding is led by Innova Memphis, ... and other private investors.  Arkis, new financing will ... and the market release of its in-licensed Endexo® ...
(Date:6/23/2016)... BEVERLY HILLS, Calif. , June 23, 2016 ... faced the many challenges of the current process. Many of ... option because of the technical difficulties and high laboratory costs ... would have to offer it at such a high cost ... to afford it. Dr. Parsa Zadeh , ...
(Date:6/23/2016)... Roche (SIX: RO, ROG; OTCQX: RHHBY) announced ... BRAHMS PCT (procalcitonin) assay as a dedicated testing solution ... this clearance, Roche is the first IVD company in ... sepsis risk assessment and management. PCT is ... levels in blood can aid clinicians in assessing the ...
Breaking Medicine Technology: