Tag Archive for: head and neck cancer research

Head and Neck Cancer Research | How Innovation Leads to Advances in Care

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Head and Neck Cancer Research | How Innovation Leads to Advances in Care from Patient Empowerment Network on Vimeo.

How can innovation lead to head and neck cancer research advances? Expert Dr. Ezra Cohen discusses how improvements in technology have led to changes in diagnostics, therapeutics, surgery, and radiation. 

Dr. Ezra Cohen is a medical oncologist, head and neck cancer researcher and Chief Medical Officer of Oncology at Tempus Labs.

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See More from Evolve Head & Neck Cancer

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Transcript:

Katherine:

How are innovations in technologies accelerating head and neck cancer research? 

Dr. Cohen:

I think, in many ways. First there’s – we mentioned the multidisciplinary approach of head and neck cancer and each of the disciplines, the major therapeutic disciplines, being medical oncology, radiation and surgery, really have had dramatic technological advances in the last, certainly in the last decade, maybe a little bit longer.  

For the surgery, it’s been the ability to do minimally invasive surgery, usually through a robot called transoral resection. And this is, as the name implies, literally a robot that’s controlled at the side of the operating room or even sometimes controlled remotely. But the advantage is that the instrument is much smaller than the human hand, and it can articulate in every degree possible. Which, obviously, the human hand has restrictions.

So, in other words, that robot can get into places and get into areas that would be very difficult without a much bigger surgery if done without the robot. And now, that surgery called TORS, transoral robotic surgery, has become pretty well, pretty standard for cancers of the base of the tongue and the oral pharynx.  

That is really the back of the throat. Whereas in the past, in order to access those areas, the patient’s jaw would have to have been split, and the area had been opened. Now, that’s not necessary at all, and the surgery has turned into a much, much faster recovery with equivalent oncologic outcomes. And, of course, there’s more advancements going on in that regard.

For radiation, I think the most relevant technological advances have been the ability to focus radiation through different means on the tumor and spare normal tissue. Whether that’s with something called IMRT, which is essentially a much more sophisticated way to deliver radiation that is controlled by a computer that allows the radiation fields to be contoured around structures in a 3D fashion, much more than we were able to do prior to that.  

And, of course, the other way is to use a different type of energy. Whereas conventional radiation, when we talk about radiation, we’re talking about photons. Protons, now, are becoming more widely available. And that particle has a different way to deliver energy and can actually spare normal tissue but still deliver the energy desired to the tumor. So, tremendous advances in radiation.

And then, of course, for medical oncologists, we’ve had advancements in both diagnostics and in therapeutics. 10 years ago, sequencing a cancer, deciphering the genes that drive it, the mutations that drive it, was uncommon. And, in fact, even I dare say, frowned upon by the community.  

But now, there isn’t a patient that I see who has recurrent or metastatic disease that I don’t sequence. I sequence them all. 

Katherine:

Wow.  

Dr. Cohen:

Because the technology is readily available and quite honestly, it gives us more information that we might be able to apply to the treatment of that patient. So, that’s been a very large, a very big advancement. And then, of course, therapeutically we’ve had different agents that we’ve been able to look at. I mentioned immunotherapy. There are many new drugs that are being tested and hopefully very soon even approved for patients with head and neck cancer.  

Head and Neck Cancer Clinical Trials | What Are the Benefits?

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Head and Neck Cancer Clinical Trials | What Are the Benefits? from Patient Empowerment Network on Vimeo.

What benefits can head and neck cancer clinical trials bring to patients? Expert Dr. Ezra Cohen discusses clinical trial participation rates, explains how trials move research forward, and details questions to ask your doctor when considering joining a clinical trial. 

Dr. Ezra Cohen is a medical oncologist, head and neck cancer researcher and Chief Medical Officer of Oncology at Tempus Labs.

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See More from Evolve Head & Neck Cancer

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Head and Neck Cancer Treatment and Research Updates

Head and Neck Cancer Treatment and Research Updates

 Head and Neck Cancer Research | How Innovation Leads to Advances in Care

Head and Neck Cancer Research | How Innovation Leads to Advances in Care

 How Is Head & Neck Cancer Treatment Approached?

How Is Head & Neck Cancer Treatment Approached?

Transcript:

 Katherine:

A key part of research moving forward is the clinical trial process. Can you talk about the benefits of patient participation?  

Dr. Cohen:

Of course. And I’m certainly a firm believer. It’s been part of what I’ve been doing for, again, over 20 years. And, so, certainly I think clinical trials are a critical component of our ability to produce better outcomes and move forward. The sobering reality is that only 3  percent of adult patients actually participate in clinical trials.  

Katherine:

Wow. 

Dr. Cohen:

And if we’re really going to move the field forward and be where we want to be with cancer, and that is to either cure as many people as we can or turn cancer into a chronic disease, better yet in many individuals, detect it early and prevent it. We need much greater participation in clinical trials. So, that being said, nothing is going to happen, we are not going to make strides forward in therapeutics and diagnostics, whatever in prevention, without clinical trials. Even the basic standards of care that we engage in now, and I mentioned that drug pembrolizumab (Keytruda), that was approved on the basis of a large randomized clinical trial.  

Now, having said that, I think patients – part of the responsibility is on patients to ask their provider, “Well, what about clinical trials?” There is almost always a clinical trial that is available given a specific setting. The challenge is that it may not be available where the patient is seeking care. And there is a large disconnect in that regard. Now, there are different organizations that are trying to improve that, improve the diversity of participation in clinical trials and the equality of availability of clinical trials to the entire population, not just people going to large academic medical centers. But, that’s the first thing I would tell patients, is part of the list of questions that you have for your provider, especially at the beginning and throughout the entire process, is there a clinical trial that would be applicable to my situation?  

And if the answer is, “Well, no.” The follow-up should be, “Well, what about in the area?” Or, “What about something that may not necessarily be available in this practice but what about somewhere else in town or somewhere I could access?” Of course, that may not be possible for all patients. But if it is, I would encourage all people to ask that question. And then there is a large responsibility, I think, on providers to make clinical trials available if we’re going to improve that number from 3 percent. 

There are a lot of exciting agents being studied now in head and neck cancer – immunotherapy drugs, antibody drug conjugates, novel mechanisms, cell therapies, vaccines. So, there’s certainly no paucity of interest in developing drugs in head and neck cancer and technologies as well. So, there are clinical trials available, and I think we, as a community, need to make a – need to do better in enrolling patients on those studies. 

Head and Neck Cancer Treatment and Research Updates

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Head and Neck Cancer Treatment and Research Updates from Patient Empowerment Network on Vimeo.

What is the latest head and neck cancer news? Expert Dr. Ezra Cohen discusses research updates in immunotherapy and shares credible resources for staying informed about head and neck cancer treatment and research.

Dr. Ezra Cohen is a medical oncologist, head and neck cancer researcher and Chief Medical Officer of Oncology at Tempus Labs.

Download Resource Guide

See More from Evolve Head & Neck Cancer

 

Related Resources:

Head and Neck Cancer Clinical Trials | What Are the Benefits

Head and Neck Cancer Clinical Trials | What Are the Benefits?

 Head and Neck Cancer Research | How Innovation Leads to Advances in Care

Head and Neck Cancer Research | How Innovation Leads to Advances in Care

 How Is Head & Neck Cancer Treatment Approached?

How Is Head & Neck Cancer Treatment Approached?

Transcript:

Katherine:

Well, thank you so much for taking time out of your schedule to join us today. As you know, head and neck cancer research has been progressing quickly. What recent developments do you think patients should know about? 

Dr. Cohen:

Well, there are a lot, really. And I think probably the first and foremost is the impact that immunotherapy is having on treatment for head and neck cancer. And that is mostly in the form of a drug called pembrolizumab (Keytruda). It’s an anti-PD1 antibody that really – what it does is stimulate a specific cell type in the immune system called T cells. And now, it’s approved for the treatment of patients with recurrent or metastatic disease.

However, for patients, I think probably the most important development over the last little while is the realization of the important of the multidisciplinary team in the management of patients with head and neck cancer.  

It used to be that the care was driven by a single oncologist or a single individual, but over the last, I would say mostly over the last decade, maybe a little but more than that. There’s becoming this realization more and more and the implementation, of course, of these multidisciplinary approaches involving a surgeon, a radiation oncologist, a medical oncologist, but much more than that. A speech and language pathologist, a swallowing expert, nutritionist, psychologist, pharmacists, dentists, of course oral surgeons.  

With the, now, the prospective data to validate that in a multidisciplinary setting, with a multidisciplinary tumor board where each patient is discussed with all of these individuals providing input. The outcomes are substantially better. And so, for patients, I think that that’s had the greatest impact, because we’re talking about patients who can be cured for the most part.  

And those cure rates increasing just simply by getting the right people involved in their care. 

Katherine:

Yeah. Very important, then. As I mentioned a few minutes ago, patients should be aware of all of their options. How can patients stay informed as the treatment landscape expands and changes?  

Dr. Cohen:

Yeah. It’s challenging because not only are patients and their caregivers grappling with this diagnosis, and it’s a brand-new world for almost all of them. Many patients have never had to deal with cancer ever before. Pile onto that the functional and social aspects of having head and neck cancer. Remember this is a cancer that affects so much of what makes us human – our ability to communicate, to speak, to eat, to swallow. And so, now, patients are flung into this situation, and it is challenging to find good information.  

Having said that, often the oncologists that are involved in the person’s care should be a great source of information, especially if those oncologists have experience treating head and neck cancer. And incidentally, just as an aside, there is also data and mounting data that the more experienced a center is in treating head and neck cancer, the better the outcomes. And so, that’s something that patients may want to think about as they choose their providers.

But then there are also public sources. There are support groups for head and neck cancer. The Head and Neck Cancer Alliance is one of those. SPOHNC is another and they’re excellent sources of information for patients. American Cancer Society is always a very good source of information, mostly for cancer basics but they do have the pages that are dedicated to head and neck cancer.  

And then the American Society of Clinical Oncology, or ASCO, actually does have a patient-facing part of their organization, and that can help not only with information about the disease, but it can also help find providers that have a specific interest in this type of cancer. 

What Do Patients Need to Know About Head and Neck Cancer Research?

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What Do Patients Need to Know About Head and Neck Cancer Research? from Patient Empowerment Network on Vimeo.

Is there developing research that head and neck cancer patients should know about? Dr. Jessica Geiger explains how treatment approaches are evolving and how patients can stay up-to-date on the latest advances.

Dr. Jessica Geiger is a medical oncologist at the Cleveland Clinic. Learn more about Dr. Geiger. 

See More From The Pro-Active Head and Neck Cancer Patient Toolkit

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Transcript:

Katherine Banwell:

Cancer research is developing rapidly. What are you excited about when it comes to head and neck cancer research? 

Dr. Jessica Geiger:

Well, I think there’s a lot of different clinical trials that are coming out in what we call the neo-adjuvant space so before you go for a surgery. Again, head and neck cancer is a little bit different when we think of other more common cancers. 

And what I mean by that is it’s one thing to be able to surgically remove cancer or to ablate it completely with radiation. The problem with the head and neck area as you can imagine, it’s such a small area. There’s a lot of precious real estate there, as I always describe to patients. And so, it’s one thing to cure the cancer, to cut it out completely. But then we have functional and sometimes cosmetic concerns after that, too. So, I think one of the biggest things that we are always trying to look to be successful in is are there therapies, are there treatments where we can shrink down the initial cancer so that the resulting surgery or the fields of radiation are not so severe? So, we’re maintaining the cure rates that we have. We’re improving on the cure rates that we have. But also thinking about how can we improve the quality of life and the function and the cosmetic outcome after their cancer treatment? And I think that’s really exciting. 

Katherine Banwell:

It is. It’s great.  And I’m sure there’s been so much development in the field, even in the last 10 years. 

Dr. Jessica Geiger:

There has. And another comment to make on that point, too, when we’re thinking about clinical trials especially. There’s really two big subsets of squamous cell cancer, head and neck squamous cell carcinoma, and that’s HPV-positive that’s related to the HPV, the human papilloma virus and HPV-negative. HPV-negative is what we think of historically as being caused by years of smoking often with heavy drinking. That’s kind of the traditional head and neck cancer patient. But over the last couple of decades now, there’s a completely different disease that we have recognized. And that’s related to HPV. And these patients tend to be light or never smokers at all. They tend to be younger, different demographic of patients. The good news is those cancers seem to respond better to cancer treatment, particularly radiation- and chemotherapy-based. 

So, as I mentioned before, trying a neo-adjuvant approach to kind of reduce the impact of surgery or the impact of radiation, particularly with HPV-related disease. We know that it’s a different disease that behaves much better than HPV-negative. So, trying clinical trials to what we call de-intensify therapy. So, maintaining the high cure rate. But reducing the toxicities related to treatment so that – you know, these are younger patients. They’re cured of their cancer. But they still require a feeding tube. Or they have a lot of chronic pain in the neck. They have a lot of morbidity with the treatment. And so, trying to reduce that down to again, maintain high cure rates, but help with quality of life in the years to come. 

Katherine Banwell:

How can patients stay up-to-date on developing research? 

Dr. Jessica Geiger:

That’s a really good question. 

Every once in a while, there are sound bites or news articles that are kind of in the mainstream press and in the mainstream news. I would just encourage patients to – if they read something or see a headline to reach out to their oncology team and have a discussion. What is this research? What does it mean for me? Does it apply to me? How is this information being used for cancer treatment? How would this impact my treatment or my follow up? It’s really hard to kind of navigate through what is, in terms of research, what is immediately clinically impactful or clinically meaningful at that time. 

Katherine Banwell:

Are there any websites that you recommend to patients? 

Dr. Jessica Geiger:

The American Head and Neck Society has a good website. And there’s a couple of other, depending on what state you live in or regions of certain states.  

There’s a lot of different support groups for head and neck cancer patients that I would encourage patients to reach out. Because especially in the regional, geographic location where you are, it may be worthwhile to be able to have those conversations. Because you can walk down the street and not know if somebody’s had it. But I’ve had more patients over the last several months, especially HPV-related disease patients who have mentioned something to me along the lines of, “I had mentioned to an acquaintance or a friend of a friend. And suddenly, I know three or four other people who have had this cancer. And I had no idea. And now we’re talking about how we have to carry a water bottle with us all the time because we can’t swallow dry foods. And how we have to be very mindful of what we’re eating when we order at a restaurant.” And so, just trying to navigate a bigger world, narrowing it down to where you live to have those meaningful contacts of other patients who have gone through what you have gone through. 

How Is Treatment for Head and Neck Cancer Evolving?

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How Is Treatment for Head and Neck Cancer Evolving? from Patient Empowerment Network on Vimeo.

How is head and neck cancer treatment evolving over time? Watch as expert Dr. Samantha Tam from Henry Ford Health System explains current areas of research focus in head and neck cancer – and how researchers are working toward the best care for patients. 

See More From The Head & Neck Cancer TelemEDucation Empowerment Resource Center

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Transcript:

Samantha Tam, MD, FRCSC, MPH: 

So, treatment of head and neck cancer is constantly evolving with the introduction of immuno-therapeutic agents, understanding the role of that in the treatment of head and neck cancer is currently undergoing a lot of research. And there’s a lot of interest in curiosity about how we can utilize that in conjunction with the more traditional treatments of head and neck cancer. Another major focus in head and neck cancer now is to ensure that we’re not overtreating our patients, especially those with HPV-positive disease, and so understanding the balance between treatment care of the disease as well as maximizing function and quality of life after treatment of the disease has become a major focus in head and neck cancer and is certainly at the forefront of our minds.