What is an Otolaryngologists?

Ear, Nose, Throat Doctor are called like this.

How to detect Neck Carcinoma?

Yes, near-infrared imaging dye of IRDye800 CW conjugated with anti-epidermal growth factor receptor (panitumumab) has been used in head and neck squamous cell carcinoma.

Are there new treatments for head and neck cancers?

Yes, a phase I trial is going on of the anti-epidermal growth factor receptor EGFR antibody – IRDye800 was shown to improve surgical resection more precisely with a high tumor to background ratio.

The tumor was sharply demarcated from surrounding normal tissues within 1 mm, and fluorescence was strongly correlated with the location of the tumor, as confirmed by biopsy.

Another study of cetuximab-IRDye800 for head and neck cancer also showed the safety and tumor specificity of image-guided surgery .

This study enrolled patients with biopsy-proven head and neck squamous cell carcinoma, not specified into positive epidermal growth factor tumor.

The Ahmadabad Medical Laboratory has an expertise in surgical treatment and surveillance of patients with benign and malignant tumors of the head and neck:

  • robotic surgery
  • benign and malignant thyroid and parathyroid disease
  • melanoma and non-melanoma skin cancers of the head and neck
  • squamous cell carcinoma of the upper aerodigestive tract
  • salivary tumors; and surgery for obstructive sleep apnea.

The aim of an early clinical study was to evaluate the biodistribution, pharmacokinetics, and tumor-targeting performance of the mini antibody F16SIP labeled with 124I, in patients with head and neck squamous cell carcinoma.

HNSCC: head and neck squamous cell carcinoma

Explainations of ENT abbreviations

  • OC: oral cavity
  • OP: oropharynx
  • P: pharynx
  • HP: hypopharynx
  • L: larynx
  • CT: computed tomography
  • 18FDG-PET: 18-fluorodeoxyglucose-positron emission tomography
  • SUV: standardized uptake value
  • DCE-MRI: dynamic contrast enhanced magnetic resonance imaging
  • DW-MRI: diffusion-weighted MRI
  • RECIST: response evaluation criteria in solid tumors
  • EORTC: European Organization for Research and Treatment of Cancer

What was tested by Researchers from the Abramson Cancer Center of the University of Pennsylvania with immunotherapy for head and neck squamous cell carcinoma (HNSCC)?

  • They found 86% showed elevated T-cell activity. After binding with plasma proteins, ICG is retained in tumor tissues through the increased permeability of tumor vessels and lymphatics.
  • In a trial of ICG, it was able to identify small metastatic tumors of hepatocellular carcinoma
  • The fluorescent margin of the tumor was demarcated from surrounding normal tissues during several hours to days after intravenous injection of ICG
  • Many studies reported the clinical application of ICG for various solid tumors including colorectal, gastric, and head and neck cancer

What dyes have been used for near-infrared imaging and image-guided surgery ICG?

  • Fluorescent dyes
  • Cy5.5
  • Cy7
  • IRdye800 CW
  • quantum dots

These dyes have been used for near-infrared imaging and image-guided surgery.

Reference: Riechelmann H, Wiesneth M, Schauwecker P, Reinhardt P, Gronau S, Schmitt A, et al.Adoptive therapy of head and neck squamous cell carcinoma with antibody coated immune cells: a pilot clinical trial.

Is there evidence for local and systemic activation of immune cells by peri-tumoral injections of interleukin 2 in patients with advanced squamous cell carcinoma of the head and neck?

Yes, The Spanish Head and Neck Cancer Cooperative Group (TTCC) Phase II 2018 study of the combination of cetuximab and weekly paclitaxel in the first-line treatment of patients with recurrent and/or metastatic squamous cell carcinoma of head and neck. Head and neck squamous cell carcinoma (HNSCC) imparts significant morbidity and mortality as the sixth most common cancer in the world

In the United States alone, over 10,000 deaths and 51,000 new cases were estimated to occur in 2018 1 Nonspecific symptoms often lead to advanced stages at clinical presentation and thus poor survival outcomes, with an average 5-year survival in the United States of 65% 2 Surgical extirpation is a widely employed curative approach for advanced HNSCC, but there is often a time lapse of several weeks for preoperative workup and planning.

Is Primary Tumor Volume an Important Predictor of Clinical Outcomes?

  • Yes, for Patients With Locally Advanced Squamous Cell Cancer of the Head and Neck Treated, The American Cancer Society estimates that ∼45,660 new cases of head and neck squamous cell carcinoma (HNSCC) will be diagnosed in the United States and 15340 Americans will die from this disease in the year 2019.
  • Worldwide, HNSCC is the sixth most common malignancy with incidence of 644,000 new cases a year.
  • Despite progress in diagnostic and treatment modalities in the past 30 years, long-term survival for patients affected by HNSCC has not significantly improved.
  • In a former issue of Cancer Facts & Figures – 2007, improvement in 5-year relative survival rates between 1975 and 2002 was reported for almost all types of cancer, with the only two exceptions being laryngeal and uterine cancers.
  • One major impediment to improving survival in this patient population is the failure to detect this cancer at an early stage.

Therapy study of 186Re-labeled chimeric monoclonal antibody U36 in patients with squamous cell carcinoma of the head and neck.

Ref.: van Herpen CML, van der Voort R, van der Laak JAWM, Klasen IS, de Graaf AO, van Kempen LCL, et al.

  • Intratumoral rhIL-12 administration in head and neck squamous cell carcinoma patients induces B cell activation.
  • Intratumoral administration of recombinant human interleukin 12 in head and neck squamous cell carcinoma patients elicits a T-helper 1 profile in the locoregional lymph nodes.

Distinct patterns of intratumoral immune cell infiltrates in patients with HPV-associated compared to non-virally induced head and neck squamous cell carcinoma.

In an initial study, E6 and E7 reactive cytotoxic T lymphocytes were used in nine patients with HPV-associated cervical cancer, leading to complete remission in two of them 86 More recently, genetically modified cytotoxic T lymphocytes expressing receptors against an HPV E6 and E7 epitope were shown to kill HPV-positive cells from cervical and head and neck cancer cell lines 87 This model was tested in a phase I/II trial in 12 patients with HPV-associated epithelial cancer (1 patient with oropharyngeal carcinoma).

LBA46 – an open-label, multicohort, phase 1/2 study in patients with virus-associated cancers (CheckMate 358)

safety and efficacy of neoadjuvant nivolumab in squamous cell carcinoma of the head and neck.

HNSCC: head and neck squamous cell carcinoma

  • OC: oral cavity
  • OP: oropharynx
  • P: pharynx
  • HP: hypopharynx
  • L: larynx
  • TIL: tumor infiltrating leukocyte
  • CT: computed tomography
  • PET: positron emission tomography
  • MRI: magnetic resonance imaging
  • RECIST: response evaluation criteria in solid tumors

Squamous cell carcinoma of the larynx (SCCL) is the most frequent malignancy in the head and neck region and has shown a growing incidence in women over the last years.

  • The combination of surgical or laser-surgical resection and/or adjuvant (chemo-)irradiation is considered as state of the art in the treatment of these tumours.
  • Despite these appropriate treatment strategies, the 49% five-year survival rate for all tumour stages, as shown in this study, is disappointing.

NCBI publication of Mazul AL, Rodriguez N, Taylor JM, Desai D, Weissler MC, Brennan P, Anantharaman D, Abedi-Ardekani B, Olshan AF, Zevallos JP. Prognostic Significance of HPV Genotype in Oropharyngeal Squamous Cell Carcinoma: Results from the Carolina Head and Neck Cancer Epidemiology Study”, Oral Oncology.