Weekly News - Wednesday 26 September 2018

 Immunotherapy News
 Missak Haigentz, MD, chief of Hematology and Oncology at Morristown Medical Center, medical director of Atlantic Hematology and Oncology for Atlantic Medical Group at the Carol G. Simon Cancer Center, discusses the impact that immunotherapy has had on the treatment of patients with head and neck cancer.

Immunotherapy has revolutionized the way that cancer is approached, says Haigentz. Five years ago, the only treatments available for patients with head and neck cancer were traditional chemotherapy and targeted therapies like cetuximab (Erbitux). Success with immunotherapy has been experienced across tumor types including melanoma and lung cancer, as well as head and neck cancer.

Haigentz says that immunotherapy has provided an opportunity to improve survival, particularly in those with incurable disease. Immunotherapy is impacting both the curative and non-curative setting, improving patient outcomes across the board. Viewing cancer as a genetic- and immune-based disease is the future of therapy, concludes Haigentz.
Farah Succaria, MD, postdoctoral fellow, Johns Hopkins Medicine, discusses targetable immune checkpoints in head and neck squamous cell carcinoma (SCCHN).

Investigators are currently trying to identify potential targetable immune checkpoints in the tumor microenvironment of SCCHN. This is in an effort to inform rational combination therapy development, according to Succaria. While PD-1 is the only established immune checkpoint in SCCHN, targets under investigation include TIM-3, LAG-3, FoxP3, GITR, IDO, and PD-L2. Immunohistochemistry for these markers, as well as CD3, CD4, CD8, CD20, and CD68, was quantified using HALO image analysis for density of positive cells.

In 27 specimens, 14 were found to be HPV-negative and 13 were HPV-positive. After the density of each of the markers was assessed and exported into the HALO server, Succaria could then tell which cells were tumor cells, and which were immune cells. Succaria says that she was then able to determine the density of a given marker in the tumor. This allowed investigators to test for multiple markers, not just PD-L1. Findings showed that tumors that were HPV-positive had more T cells, CD3, CD4, CD8, CD20, and PD-1, which was statistically significant. Additionally, there was a trend toward increased density of FoxP3-positive cells in these patients.Read more...

HPV Vaccine May Reduce Risk Of Transmitting Devastating Throat Disease To Children


Child undergoing anesthesia. Photo Credit, Getty Images.

The human papillomavirus, or HPV, has been a well-recognized risk factor for developing several types of cancers. Initially, it was a known precursor to cancers of the cervix, with certain sub-types of the virus predisposing women to HPV lesions (genital warts) and formation of cancerous growths.

In more recent years, the association of HPV and head and neck cancers, specifically those of the tonsil, larynx (voice box), tongue, and sinus in otherwise healthy under 65-year-old non-smokers and non-drinkers has led to HPV-related head and neck cancers becoming known as 'baby-boomer' cancers.

A much lesser known consequence of HPV disease is that the transmission from a pregnant mother who has HPV in the genital tract can lead to HPV disease in her unborn child.  Transmission of the virus, even in the absence of visible genital warts, can lead to a rare, yet devastating, condition in children, known as recurrent respiratory papillomatosis, or RRP.  These children typically develop symptoms of hoarseness, raspy voice, chronic cough, and severe breathing problems during the toddler years.  As the disease is quite rare and not readily identified, duration between symptoms and diagnosis can be several months to over a year. Often by the time the child is diagnosed, he or she is in respiratory distress due to lesions blocking the air passages. Read more...

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