Barbara A. Burtness, MD, professor of Medicine (Medical Oncology), clinical research program leader, Head and Neck Cancers Program, co-director, Developmental Therapeutics Research Program, Yale Cancer Center, discusses emerging immunotherapies and ongoing clinical trials in head and neck cancer.

Immunotherapy agents began being investigated for the treatment of head and neck cancer about 2 to 3 years ago, Burtness explains. Results of the Keystone-012 trial, which examined pembrolizumab in patients with HPV-positive/HPV-negative disease, demonstrated an overall response rate (ORR) of 25%. Evidence suggests that if PD-L1 or PD-L2 expression is present, ORR may be higher. There are now ongoing phase III trials examining the agent in platinum-refractory disease and as a first-line therapy compared with chemotherapy.

Ongoing trials are also investigating MEDI4736, which has demonstrated a 50% ORR in a subset of PD-L1 positive patients. MEDI4736 is also being examined in combination with tremelimumab. Finally, results of a phase III trial looking at nivolumab in patients with platinum-refractory disease can be expected some time in 2016.

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Barbara A. Burtness, MD, professor of Medicine (Medical Oncology), clinical research program leader, Head and Neck Cancers Program, co-director, Developmental Therapeutics Research Program, Yale Cancer Center, discusses emerging immunotherapies and ongoing clinical trials in head and neck cancer.


Dr. Burtness on Emerging Immunotherapies in Head and Neck Cancer

Barbara Burtness, MD, Chief, head and neck medical oncology, co-leader, developmental therapeutics, Fox Chase Cancer Center, compares the biological differences between advanced head and neck cancers that are derived from traditional factors and those from the human papillomavirus (HPV).

Traditional head and neck cancer is closely associated with exposure to tobacco and alcohol. The biology of this type of cancer is well understood and generally contains a mutation in 

, and carries a high mutation burden. This type of cancer is generally very resistant to therapy.

Head and neck cancers that are caused by HPV infection develop primarily in the oropharynx. There are many different strains of HPV with several high-risk cancer causing variations; HPV-16 is the most common form in the US. HPV-16 related cancer does not generally develop a 

 mutation, which makes this type less resistant to chemotherapy. The expression of viral oncoproteins leads to the degradation of both p53 and Rb proteins, which causes a compensatory upregulation of p16. The overall low mutational burden in HPV-positive head and neck cancers results in a higher treatment response than HPV-negative types.

Burtness describes 2 large studies that evaluated the effects of intensifying therapy in advanced head and neck cancer. The first was the TROG 02.02 that looked at the impact of radiotherapy quality on outcomes and the second was the RTOG 0129 that examined the effects of radiation and cisplatin intensity. These trials demonstrated that therapy intensity and quality did not significantly improve cure rates, however subset analyses within these trials did find that HPV status effected outcomes significantly. Patients that were HPV-positive experienced 80-85% better outcomes, compared to those that were HPV-negative.

Dr. Barbara Burtness, from Fox Chase Cancer Center, on the 2 Types of Head and Neck Cancer

Dr. Burtness on 2 Types of Head and Neck Cancer

Barbara Burtness, MD, Chief, head and neck medical oncology, co-leader, developmental therapeutics, Fox Chase Cancer Center, discusses how the 7th Annual Multidisciplinary Symposium on Head and Neck Cancer was designed around the unique nature of head and neck cancer.

The radiation, surgical, and medical oncologist will evaluate each patient treated for head and neck cancer. The speakers, topics, and those in attendance will represent these multiple disciplines.

Dr. Barbara Burtness from Fox Chase Cancer Center on the Head and Neck Symposium Design

Dr. Burtness on the Head and Neck Symposium Design

Barbara Burtness, MD, Chief, head and neck medical oncology, co-leader, developmental therapeutics, Fox Chase Cancer Center, discusses the upcoming 7th Annual Multidisciplinary Symposium on Head and Neck Cancer taking place November 19, 2011, in Philadelphia, PA. As the co-chair of the conference, in conjunction with Ezra Cohen, MD, she designed many of the educational activities and needs of the conference.

Burtness explains the symposium will cover many diverse topics including new surgical strategies, differential treatment based on HPV status, the role of biomarkers in predicting response, and further breaking down the types of tumors that compose head and neck cancer.

7th Annual Multidisciplinary Symposium on Head and Neck Cancer

Dr. Barbara Burtness from Fox Chase Cancer Center Discusses the Upcoming Head and Neck Cancer Symposium

Barbara Burtness, MD

Articles

Dr. Burtness on Emerging Immunotherapies in Head and Neck Cancer

Dr. Burtness on 2 Types of Head and Neck Cancer

Dr. Burtness on the Head and Neck Symposium Design

Dr. Burtness on the Head and Neck Cancer Symposium