Studying head and neck cancer treatment

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Barbara Ruben

Cancers that are known collectively as head and neck cancers usually begin in the squamous cells that line the moist, mucosal surfaces inside the head and neck, such as inside the mouth, nose and throat.

While head and neck cancers account for approximately 3 percent of all cancers in the United States, these cancers are nearly twice as common in men as they are in women. Head and neck cancers are also diagnosed more often among people over age 50 than they are in younger people.

At least 75 percent of head and neck cancers are caused by tobacco and alcohol use, and people who use both are at greater risk of developing these cancers than people who use either tobacco or alcohol alone. Alcohol and tobacco use are not risk factors for salivary gland cancers.

Infection with cancer-causing types of human papillomavirus (HPV) is a risk factor for some types of head and neck cancers, particularly oropharyngeal cancers that involve the tonsils or the base of the tongue.

While head and neck cancers do not often recur, “when they do, they can be devastating,” said Dr. Alex I. Spira, principal investigator for two studies looking at new drugs to combat the cancers if they recur. Current treatments for cancers that come back “are relatively toxic, with low efficacy,” he said.

The two studies being undertaken by Virginia Cancer Specialists in Fairfax are part of a group of studies for head and neck cancers named for raptors. They are dubbed the Hawk and Condor studies.

Immunotherapy drugs studied

Both studies are looking at a new drug in development by AstraZeneca, so far known as MEDI4736. This drug is a kind of immunotherapy that may boost the ability of the immune system to detect and fight cancer.

In the Hawk study, patients with recurrent or metastatic cancer will be given MEDI4736 every two weeks for up to two years. All patients in the study will get the drug. The study will look at the drug’s safety, how well the disease is controlled and quality of life.

Patients in the study must be over age 18 and have been treated with a chemotherapy that contains platinum. Unlike that therapy, immunotherapy drugs are much better tolerated, according to Spira. “Relatively minor diarrhea and mild breathing issues are most common [side effects],” he said.

Among other restrictions, those in the study cannot have had prior exposure to immunotherapy and cannot be taking any other chemotherapy, biological, hormonal or investigational therapies during the trial. They cannot have active or prior documented autoimmune diseases or have inflammatory disorders or active infection including hepatitis B, hepatitis C or human immunodeficiency virus (HIV).

The Condor study

The Condor study is also investigating MEDI4736, but there are three arms to the study, to which participants will be randomly assigned. One group will take MEDI4736, a second group will take another immunotherapy drug that is not yet approved called Tremelimumab, and the third group will receive a combination of both drugs.

 Patients will receive the drugs every two weeks for a year, unless their disease progresses. Tumors will be assessed every eight weeks with a CAT scan or MRI.

Those in the Condor trial have basically the same qualifying factors as the Hawk study.

No compensation is offered for taking part in the studies, but the cost of the study drugs is covered.

For more information, or to see if you qualify to participate, call Virginia Cancer Specialists at (703) 208-3192.