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Barbara Burtness, MD, professor of Medicine, Yale Cancer Center, discusses the evolution of molecular testing in head and neck cancer.
Barbara Burtness, MD, professor of Medicine, Yale Cancer Center, discusses the evolution of molecular testing in head and neck cancer.
This area is evolving very rapidly, but HPV status is being used to determine which clinical trials patients with head and neck cancer are eligible for, Burtness explains. Additionally, in clinical practice, there is no evidence that physcians should de-escalate treatment for HPV-positive patients yet, but it does restrain them for overtreatment. For example, cetuximab (Erbitux) may be an acceptable substitute for cisplatin in some of these patients, she adds.
Another new agent potentially on the horizon is buparlisib. It is unclear whether that agent should be selected on the basis of having a PIK3CA mutation, however. Not all patients will respond to immunotherapy agents, so the knowledge of having a PTEN mutation, FGFR amplification, or PIK3CA mutation may help select patients for phase I clinical trials.
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