Patients with head and neck cancer linked to high risk human papillomavirus, or HPV, have worse outcomes if they are current or former tobacco users, according to a new study from researchers at the University of Michigan Comprehensive Cancer Center.
High-risk HPVs are the same viruses that are associated with cancers of the uterine cervix.
The research suggests that current or former tobacco users may need a more aggressive treatment regimen than patients who have never used tobacco.
Past research shows that HPV-positive head and neck cancers tend to be more responsive to current treatments and these patients overall tend to have better outcomes than patients with HPV-negative tumors. However, the new study found that current tobacco users with HPV-positive tumors were five times more likely to have their cancer recur. Even former smokers had an increased risk of recurrence.
"Because the effect of HPV is so strong in giving a very good prognostic picture, we were surprised to find that smoking remained a huge issue, and it actually affected the outcome in patients who smoked," says senior study author Thomas Carey, Ph.D., professor of otolaryngology and pharmacology, and co-director of the Head and Neck Oncology Program at the U-M Comprehensive Cancer Center.
Results of the study appear in the Feb. 15 issue of Clinical Cancer Research.
The study looked at 124 patients with advanced oropharyngeal cancer, which is cancer of the tonsils or the base of the tongue. Most of these patients had HPV DNA in their tumors, which is consistent with HPV being a major factor in oropharyngeal cancer development. All 22 of the HPV-negative patients were tobacco users, and about two-thirds of the 102 HPV-positive patients were current or former tobacco users.
Of the HPV-positive patients who had never used tobacco, 6 percent had a recurrence of their cancer. Meanwhile, 19 percent of former tobacco users and 35 percent of current tobacco users had a recurrence. Still, the outcomes were better than the HPV-negative patients, all of whom were smokers, and among whom half recurred.
Tobacco users have traditionally been more likely than non-users to develop head and neck cancers. But a recent rise in these cancers linked to HPV has meant more non-smokers are being diagnosed with the disease. HPV-positive head and neck cancers tend to be more responsive to chemotherapy and radiation treatments, which has made researchers wonder if these highly toxic treatments could be reduced in this group of patients.
"The side effects of these treatments affect critical functions such as eating and swallowing. Since the HPV-positive tumors respond so well to treatment, our research team has been asking: Could we potentially spare patients some of these side effects while maintaining good outcomes if we reduce the doses given? If we decide to reduce intensity of treatment, our study shows we will want to take tobacco use into account. Any smoking or tobacco use increases the risk of recurrence or a second primary cancer," Carey says.
Researchers from U-M's multidisciplinary head and neck oncology program are planning a clinical trial to look at reducing treatment intensity for low-risk patients – those whose tumors express certain markers, including HPV, and who are not tobacco users. The trial is expected to begin this spring.
Head and neck cancer statistics: 35,720 Americans will be diagnosed with head and neck cancers this year and 7,600 will die from this disease, according to the American Cancer Society
Additional authors: Jessica Hooton Maxwell, Bhavna Kumar, Felix Y. Feng, Francis P. Worden, Julia Lee, Avraham Eisbruch, Gregory T. Wolf, Mark E. Prince, Jeffrey S. Moyer, Theodoros N. Teknos, Douglas B. Chepeha, Jonathan B. McHugh, Susan Urba, Jay Stoerker, Heather Walline, David Kurnit, Kitrina G. Cordell, Samantha J. Davis, Preston D. Ward, and Carol R. Bradford
Funding: National Institute of Dental and Craniofacial Research, Head and Neck Cancer Specialized Programs of Research Excellence (SPORE) grant, National Cancer Institute and State of Michigan
Reference: Clinical Cancer Research, Vol. 16, No. 4, Feb. 15, 2010
Resources:U-M Cancer AnswerLine,
Smart Data Transformation – Surfing the Big Wave
02.12.2016 | Fraunhofer-Institut für Angewandte Informationstechnik FIT
Climate change could outpace EPA Lake Champlain protections
18.11.2016 | University of Vermont
In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.
Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...
Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...
A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.
Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...
In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.
“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...
The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.
The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...
16.11.2016 | Event News
01.11.2016 | Event News
14.10.2016 | Event News
08.12.2016 | Life Sciences
08.12.2016 | Physics and Astronomy
08.12.2016 | Materials Sciences