Head Squamous Cell Carcinoma Research Articles

Immunotherapy response in patients with cutaneous squamous cell carcinoma of head and neck with cranial nerve involvement.

Metastatic or locally advanced cutaneous squamous cell carcinoma (cSCC) can be treated with immunotherapy (IO). Cranial nerve involvement (CNI) is uncommon in cSCC and is a poor prognostic factor. Our aim is to describe how patients with CNI respond to IO monotherapy and/or as an adjunct to RT. Under an IRB approved protocol, patients with histologically proven cSCC of the head and neck with CNI treated with IO were retrospectively reviewed. Twelve patients were included and received cemiplimab or pembrolizumab. Eight patients had CNI at diagnosis, and 4 at time of recurrence after non-IO therapy. Best responses were complete response (1), partial response (7), stable disease (1), progressive disease (2), and pending response (1). Nine patients are alive, 6 of which remain on IO. In this cohort, IO showed clinical response in 83% of patients, indicating IO can be an effective monotherapy, reserving RT for instances of local failure after IO.

Peripheral blood epigenetic immune-profiling and survival outcomes with anti-programmed death (PD)-1 based therapy in recurrent/metastatic (R/M) squamous cell carcinoma of head and neck (SCCHN).

6062 Background: Most patients with R/M SCCHN do not derive durable benefit from standard-of-care anti-PD-1-based therapy. The currently utilized biomarker, PD-ligand-1 combined proportion score is limited by the availability and heterogeneity of tumor samples. There is an unmet need to develop easily accessible peripheral blood-based biomarkers for response to immunotherapy. Methods: We are conducting a prospective multi-center study to identify peripheral blood derived DNA-based methylation biomarkers measured in patients with R/M SCCHN on treatment with FDA-approved anti-PD-1 based therapy. DNA isolated from these samples undergo bisulfite conversion, methylation profiling using Illumina EPIC microarray, and cellular deconvolution to generate peripheral blood immune profiles (PMID 35140201), including granulocytic (g) and monocytic (m) myeloid derived suppressor cell (MDSC) scores. Associations between baseline peripheral blood immune profiles before the start of treatment with progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan Meier curves and Cox proportional hazards models adjusted for age and sex. Additionally, logistic regression models adjusted for age and sex were utilized to investigate the baseline immune profiles between subgroups of patients who received anti-PD-1 monotherapy with durable clinical benefit for at least 1 year (Group A) versus progression or death within 100 days (Group B) from start of therapy. Results: 61 patients with R/M SCCHN who received anti-PD-1 based therapy as of Oct 31, 2022, were eligible for this preliminary analysis. Mean (SD) age of the entire population was 66.4 (11.8) years, 82% were male. gMDSC score was the only immune parameter with a statistically significant association with PFS (HR 2.6 (1.40 – 4.87) independent of age and sex, with higher scores stratified by median value associated with shorter PFS (Median PFS: 75 days vs. 145 days). Memory CD4 T cells, total CD4 T cells, percentage of T regulatory /CD4 cells, and absolute memory B cells were significantly associated with OS in this population, independent of age and sex (Table). Among the subgroup treated with anti-PD-1 monotherapy, Group A with durable benefit (n = 7, 86% male, mean age: 64.7 years) had significantly higher proportion of CD4 naïve/total CD4 cells (p = 0.03), and significantly lower gMDSC (p = 0.015) & mMDSC (p = 0.000049) scores, compared with Group B (n = 27, 78% male, mean age: 66.4 years). Conclusions: Peripheral blood DNA-based epigenetic immune profiling can recognize clinically relevant methylation biomarkers of benefit from anti-PD-1 therapy before the start of treatment. [Table: see text]

Use of Geftinib and Methotrexate in Residual Cases of Squamous Cell Carcinoma of Head and Neck after Radical Treatment

Use of Geftinib and Methotrexate in Residual Cases of Squamous Cell Carcinoma of Head and Neck after Radical Treatment

NEO ADJUVANT THERAPIES IN ORAL CANCER – A REVIEW

One of the most prevalent cancers in the world today is Squamous cell carcinoma of Head and Neck (HNSCC), which is distinguished by a physiologically heterogeneous group of tumors, non-specific biomarkers, and a dismal prognosis. Although the traditional surgical therapy methods have made positive strides, they results in long-term deformity, a shift in one's sense of self, and physically debilitating effects, whereas chemo and radiation therapy result in serious toxicities that have a detrimental influence on patients' quality of life. In order to enhance individual health outcomes and survival, neo-adjuvant therapeutic approaches were developed. Thus the current article reviews the various neo-adjuvant therapies and their significance in contrast to conventional surgery.

Abstract CT164: Tisotumab vedotin (TV) in squamous cell carcinoma of head and neck (SCCHN): interim analysis from innovaTV 207

Abstract Introduction: TV, a tissue factor (TF)-directed antibody-drug conjugate, is approved under accelerated approval in the US at a dose of 2.0 mg/kg IV administered every 3 weeks (Q3W) for adult patients (pts) with recurrent or metastatic (r/m) cervical cancer who have progressed on or after chemotherapy. TV is also being evaluated in several advanced solid tumors known to express TF, including SCCHN; antitumor activity has been observed at the approved dose level. Previous reports show that modifying the dosing schedule to optimize key PK parameters such as AUC, Cmax, and Ctrough can lead to further improvement in clinical efficacy. A population PK model based on 399 pts across clinical trials suggests that when TV is administered at 1.7 mg/kg IV on Days 1 and 15 of a 28-day cycle (Q2W), pts are predicted to achieve 24% higher AUC, a higher Ctrough level, and a lower Cmax, compared with the approved cervical cancer regimen (2.0 mg/kg Q3W). Here, we report the first analysis of TV 1.7mg/kg Q2W for r/m SCCHN that has progressed after prior platinum combination with or without immunotherapy. Methods: innovaTV 207 (NCT03485209) is an open label phase 2 multi-center study evaluating TV monotherapy or in combination for advanced tumors, including pts with r/m SCCHN. In Part C of the study, eligible pts could have received up to 3 lines of systemic therapy for r/m disease and must have received prior therapy with a platinum-based regimen and a checkpoint inhibitor (CPI), if eligible. TV was administered at 1.7 mg/kg IV Q2W. The primary endpoint was objective response rate (ORR), and secondary endpoints included safety and tolerability. Results: At data cutoff (28Nov2022), 15 pts with SCCHN were treated. The median number of prior lines for r/m disease was 2. All pts received prior platinum therapy and majority (93%) received a CPI. 67% of pts received cetuximab and 53% received taxanes, for r/m SCCHN. Confirmed ORR was 40% (95% CI: 16.3, 67.7), with 1 complete response and 5 partial responses. The safety profile was generally consistent with that observed across TV monotherapy clinical studies. 13 pts experienced a treatment-related adverse event (TRAE), most commonly asthenia (n=7), peripheral sensory neuropathy (PSN) (n=7), and vomiting (n=5). 4 pts experienced Grade ≥3 TRAEs. 2 pts discontinued treatment due to an AE (PSN and dry eye, n=1 each). 11 pts received 3 or more cycles of treatment (1 cycle = 28 days). Conclusions: For pts with r/m SCCHN who have progressed after prior platinum combination and immunotherapy, TV may be a promising treatment option. Preliminary data suggest encouraging antitumor activity at a higher exposure with Q2W administration while maintaining an acceptable safety profile. The innovaTV 207 study is still enrolling and different dosing regimens are currently being evaluated across advanced solid tumors. Citation Format: Beatriz Cirauqui, Sebastien Salas, William William, Ariel E. Birnbaum, Kristi Schmidt, Xuesong Guan, Ibrahima Soumaoro, Leonardo Nicacio, Fortunato Ciardiello. Tisotumab vedotin (TV) in squamous cell carcinoma of head and neck (SCCHN): interim analysis from innovaTV 207 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr CT164.

Prospective study on the effect of topical honey on radiation-induced mucositis induced by concurrent chemotherapy and radiation or radiation alone given as radical or adjuvant treatment in head and neck squamous cell malignancies

Pain imparts additional morbidity and economic burden to patients by requiring parenteral analgesia, interruption of radiation therapy (RT) and/or hospitalization, and parenteral or tube feeding, all of which negatively impact patients' quality of life. There are various drugs tried to relieve pain associated with radiation-induced mucositis.
 The aim: The aim of the study is to evaluate the effect of the topical application of pure natural honey on radiation-induced mucositis in patients undergoing concurrent chemo-radiation or radiation alone for radical or adjuvant treatment for head and neck squamous cell malignancies.
 Materials and methods: It is a hospital-based prospective study enrolling patients with histopathologically proven head and neck cancers. All histopathologically proven patients of squamous cell carcinoma of Head & Neck cancer (carcinoma of the oral cavity, oropharynx) receiving chemotherapy and radiotherapy or radiotherapy alone in the definitive or adjuvant setting and who meet our inclusion and exclusion criteria will be taken up as study group.
 Results: Mean age of patients was 49 years, most males 87 %. The oral cavity was the most common primary site (84 %), followed by the oropharynx (16 %). Most cases were locally advanced cancer stage IV (60 %). The set of mucositis is after 5 fractions in both study and control groups, but 89 % in the control group, compared to 33 % in the study group. On grade 3, mucositis is delayed in the study group compared to the control group, and no patients in the study group had grade 4 mucositis.
 Conclusions: All patients in the study developed mucositis. On the set of grade 3, mucositis is delayed in the study group compared to the control group, and no patients in the study group had grade 4 mucositis. Honey is effective in preventing grade 3 and 4 mucositis. Honey showed no effect on weight loss and oral infections in this study.

Progress of Tumor-Derived Exosomes in Head and Neck Squamous Cell Carcinoma

Exosomes are extracellular vesicles 40 to 160 nm in diameter that mainly mediate information transmission and substance exchange between cells, and increasing evidence suggests that exosomes are involved in the development of tumors and have great potential in cancer diagnosis and treatment. Squamous cell carcinoma of head and neck is one of the common malignant tumors in the whole body. Although various treatments continue to develop, the 5-year survival rate remains only 50%, which may be related to its characteristics such as easy lymphatic metastasis, chemotherapy resistance and poor radiotherapy sensitivity. Researchers are paying more and more attention to TDE, and studies connected to it have significantly improved our understanding of the causes, development, diagnosis, and prognosis of HNSCC. Head and neck squamous cell carcinoma-derived exosomes involve tumor initiation, progression, immune regulation, diagnosis and treatment application, and are anticipated to serve as therapeutic targets and biomarkers for early tumor diagnosis, and new ideas for improving the survival rate and prognosis of patients with head and neck squamous cell carcinoma are provided by their related studies. Here, in order to bring our knowledge of exosomes derived from head and neck squamous cell carcinoma up to date, we examine the development of research on tumor-derived exosomes in the disease.

Lenvatinib Can Overcome Immune Resistance in Head and Neck Cancer and Achieve Durable Remission.

Squamous cell carcinoma head and neck is the sixth most common cancer worldwide and.[1] Multimodality therapies have been advocated for locoregional relapse or metastatic disease.[2] Combination therapy with lenvatinib has been considered to overcome resistance and improve the efficacy.[3] In a recent study of lenvatinib and pembrolizumab conducted in heavily pretreated recurrent and metastatic head and neck cancer, the median overall survival OS was 6.2 months, and the median progression-free survival (PFS) was 4.6 months.[4]

PATTERN OF NECK LYMPH NODE METASTASIS AND FACTORS AFFECTING THE LYMPH NODE METASTASIS IN SQUAMOUS CELL CARCINOMAS OF HEAD AND NECK

Background: Head and neck cancer exhibits metastases to cervical lymph nodes through certain lymphatic drainage routes. The 5-year survival rate for patients with neck metastases reduces depending on the number and level of nodes involved. To assess the patterns of lymph Objective: node metastasis for squamous cell carcinoma of head and neck and analyse the prognostic factors of cervical node status and highlight their effect on treatment and prognosis. The study entailed a cross sectional analysis of Method: 66 patients with squamous cell carcinoma of head and neck radiologically or pathologically proven. Data collected and was analysed by a chi square test using SPSS (version 20). Of the 66 clinically Results: node-positive patients, 18 had bilateral lymph node metastasis and 48 had ipsilateral LNM. In all primary sites pattern of lymph drainage was followed except for in 1 case of carcinoma larynx where metastasis was to level II and IV without involvement of level III. We Conclusion: concluded majority of the HNSCC cases followed normal pattern of drainage and in individuals with oral cavity and oropharynx SCC, the incidence of bilateral neck LNMs are high particularly to level II of contralateral side. With higher stage of the disease and long duration of symptoms chances of lymph node metastasis is high thus worsening the prognosis. Bilateral neck dissection is recommended for primary surgical treatment, with the exception of early stages, when ipsilateral neck dissection may be performed

Effect of Triphaladi Choornam Mouthwash and Chlorhexidine Gluconate Mouthwash in Radio-Chemotherapy Induced Oral Mucositis in NonMetastatic Squamous Cell Carcinoma of Head and Neck: A Comparative Study

Background: The cases of lung and mouth cancer have boomed in the last decade due to various reasons, the major one being tobacco consumption. In non-metastatic squamous cell cancer of the head and neck, oral mucositis becomes prominent, especially during chemo or radiotherapy. Such patients also often suffer from stomatitis, xerostomia and pharyngitis. Materials and methods: This comparative study comprises of 36 patients undergoing chemo and radiotherapy. Here, 18 patients each are randomly allocated in two groups. One group receiving the existing prophylactic treatment i.e., chlorhexidine gluconate mouthwash and the other group received, Triphaladi choornam for gargling. Both the groups were asked to perform gargling, from the first day of radiation therapy to 21 days thereafter. Analytical tools: The effectiveness of both mouthwashes was compared for their healing potential and quality of life by WHO oral mucositis scale and Patient Reported Oral Mucositis Symptoms (PROMS)scale respectively. Conclusion: The reduction in mucositis and betterment of quality of life was significant in the group which received ayurvedic mouthwash compared to the prophylactic treatment group.

Micrometastasis detection using modified papanicolaou stain in nodal tissues of oral squamous cell carcinoma - A histological study.

Cervical lymph node metastasis is the most important prognostic factor in Squamous Cell Carcinoma of Head and Neck (SCCHN). Detection and evaluation of micro-metastasis forms the basis for diagnosis, staging, treatment options and prognosis. Lymph node prognostic factors are extremely important for the survival and recurrence in the patient. Assessing lymph node metastasis in the absence of clinical enlargement is challenging. To evaluate micrometastasis and individual tumor cells (ITC) in regional lymph nodes of oral squamous cell carcinoma (OSCC) by modified papanicolaou (PAP) stain and re-evaluate the tumor staging. The retrospective study was executed at MS Ramaiah University of Applied Sciences. The current study constituted a total of 40 lymph nodes from OSCC patients, metastatic (n=20) and non-metastatic lymph nodes (n=20). All sections were stained with H & E followed by modified PAP stain. Modified PAP was used for identification of micrometastasis deposits. The Chi square test was employed to analyze significance. Modified PAP stain proved to be more accurate (p = 0.006) than H and E stain in detecting micrometastasis which accounted for 15% of non-metastatic lymph node sections used in our study. Special stain like modified PAP stain is valuable and sensitive in detecting micro-metastasis over H and E stain. Detection of micrometastasis in OSCC patients is advantageous for the patient as it influences staging, it modifies the treatment plan in terms of both radiotherapy and chemotherapy.

Treatment outcomes of cetuximab-containing regimen in locoregional recurrent and distant metastatic head and neck squamous cell carcinoma

BackgroundRecurrent/ metastatic squamous cell carcinoma of head and neck (R/M SCCNH) is still a difficult-to-treat disease with poor clinical outcomes and limited treatment choices. In view of locoregional recurrent versus distant metastatic SCCHN, the therapeutic efficacy of cetuximab-containing regimen and relevant prognostic factors for these two groups may be different. Thus, the aim of this study was to explore the treatment outcomes of cetuximab-containing regimen in locoregional recurrent and distant metastatic SCCHN groups, and to identify clinical factors correlated with better survival outcomes.MethodsFrom 2016 to 2020, patients with R/M SCCHN who received cetuximab-containing regimen in our institute were enrolled in this study. Clinical outcomes including overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and disease control rate (DCR) were evaluated in both locoregional recurrence and distant metastasis groups. Exploratory analysis were conducted to investigate major clinical features associated with better outcomes.ResultsA total of 107 patients with locoregional recurrent SCCHN (N = 66) and distant metastatic SCCNH (N = 41) who received cetuximab-containing regimen were enrolled in this retrospective study. Patients with oral cavity cancer and patients with disease recurrence within 6 months after radiation therapy were significantly increased in locoregional recurrence group. The median OS (15.6 vs. 9.7 months, P = 0.004) and PFS (5.8 months vs. 4.2 months, P = 0.008) were longer in locoregional recurrence group than in distant metastasis group. In multivariate analysis of clinical features, locoregional recurrence was still an important risk factor associated with better OS (Hazzard ratio (HR) 0.64, p = 0.06) and PFS (HR 0.67, p = 0.075). In addition, a trend of favorable disease control rate (DCR; 62.5% vs. 45.0%, p = 0.056) was noted in locoregional recurrence group. In locoregional recurrence group, prior salvage surgery was associated with longer OS (HR = 0.24, P = 0.008) and PFS (HR = 0.30, P = 0.005).ConclusionSCCHN with locoregional recurrence is associated with better disease control and survival outcomes comparing to distant metastatic SCCHN when treated with cetuximab-containing regimen. Salvage surgery for locoregional recurrence may further improves clinical outcome.

Safety and preliminary activity of pembrolizumab-carboplatin-paclitaxel in heavily pretreated and/or fragile patients with PDL1-positive recurrent/metastatic head and neck cancer.

Novel chemo-immunotherapy (chemo-IO) combinations should be evaluated, which may be suitable for cisplatin-unfit or fluoropyrimide-ineligible patients with recurrent or metastatic squamous cell carcinoma of head and neck (R/M SCCHN) to guarantee higher and deeper responses than IO alone. The aim of the present study was to review our experience using pembrolizumab-carboplatin-paclitaxel (pembro + CP) in patients with R/M SCCHN. This was a retrospective study of patients with R/M SCCHN who received pembro + CP in any-line via a compassionate-use program. The present study evaluated safety using Common Terminology Criteria for Adverse Events v4.0, compliance, overall response rate (ORR) and disease control rate (DCR) using Response Evaluation Criteria in Solid Tumors 1.1, duration of treatment, progression-free survival (PFS) and overall survival (OS). Between March 2020 and August 2021, 10 patients were identified (median age, 64 years; female, 60%; Eastern Cooperative Oncology Group 2, 80%). A total of 8 patients received pembro + 3-weekly carboplatin-paclitaxel (3wkCP). A total of 2 patients received pembro + weekly carboplatin-paclitaxel (wkCP). Patients received a median of 3 lines (range, 0-6) of systemic therapy prior to pembro + CP and 80% received IO in previous lines. Grade 1-2 adverse events (AEs) occurred in 100% of patients. Grade 3-5 AEs occurred in 30% of patients [all grade 3 (anemia, neutropenia, thrombopenia, hypertension)]. The mean numbers of pembro + wkCP and pembro + 3wkCP cycles were 2.5 and 6. The ORR (n=7) was 14% (1/7) with one complete response. The DCR was 43% (3/7). The median PFS (n=7) and OS (n=10) times since pembro + CP were 5 months (95% CI, 1-9) and 6 months (95% CI, 0.5-14), respectively. In this small retrospective series of heavily pretreated patients, pembro + CP was well tolerated, and compliance was high. Studies should be conducted to prospectively evaluate the safety and efficacy of this combination in patients with R/M SCCHN.

Pretreatment nutritional status, HPV infection, and tumor infiltrating lymphocyte as prognostic predictors in patients with head and neck squamous cell carcinoma after chemotherapy.

The survival rate in head and neck cancer varies among the subtypes, yet, the factors associated with survival between studies are still conflicting. This study aimed to investigate the association between pretreatment nutritional status, human papilloma virus (HPV) infection, tumor infiltrating lymphocyte (TIL), and treatment response after chemotherapy in patients with head and neck squamous cell carcinoma (HNSCC) in Indonesia. Further, factors associated with overall survival were also assessed. This was a retrospective cohort study. Data were collected between January 2015 and January 2018. A total of 30 patients with histopathologically proven squamous cell carcinoma head and neck cancer who had received at least three cycles of chemotherapy were included. Nutritional status was assessed using body mass index (BMI). The mean BMI was 21.8 kg/m2 (Standard Deviation 3.98). The underweight patients had a higher risk of progressive disease (OR = 12.1, 95% CI = 1.1-135.6, P = 0.04) compared to patients with higher BMI. Neither HPV infection nor TIL was associated with treatment response and overall survival (P > 0.05). The median survival for the underweight patients was 9 months (95% CI = 3.00-15.00), whereas the median survival for normal and obese patients was 14 months (95% CI = 9.33-18.67). Underweight is associated with a significantly higher risk of progressive disease and tends to have shorter overall survival in patients with HNSCC. Yet, neither HPV infection nor TIL was associated with treatment response and overall survival.

Regulatory and effector T cell subsets in tumor-draining lymph nodes of patients with squamous cell carcinoma of head and neck

BackgroundA crucial role for the immune system has been proposed in the establishment and progression of head and neck squamous cell carcinoma (HNSCC). In this study, we investigated the cytokine and regulatory profiles of T cells in tumor draining lymph nodes (TDLNs) of patients with HNSCC.ResultsThe frequencies of CD4+TNF-α+ and CD4+TNF-αhi negatively were associated with poor prognostic factors such as LN involvement (P = 0.015 and P = 0.019, respectively), stage of the disease (P = 0.032 and P = 0.010, respectively) and tumor size (P = 0.026 and P = 0.032, respectively). Frequencies of CD8+IFN-γ+ and CD8+IFN-γ+ TNF-α+ T cells showed negative relationship with tumor grade (P = 0.035 and P = 0.043, respectively). While, the frequencies of CD4+IL-4+, CD8+IL-10+, CD8+IL-4+T cells were higher in advanced stages of the disease (P = 0.042, P = 0.041 and P = 0.030, respectively) and CD4+IFN-γ+TNF-α−, CD8+IL-4+ and CD8+IFN-γ+TNF-α− T cells were higher in patients with larger tumor size (P = 0.026 and P = 0.032, respectively). Negative associations were found between the frequencies of CD4+CD25+Foxp3+ and CD4+CD25+Foxp3+CD127low/− Treg cells and cancer stage (P = 0.015 and P = 0.059).ConclusionThis study shed more lights on the changes in immune profile of T cells in TDLNs of HNSCC. Larger tumor size and/or LN involvement were associated with lower frequencies of CD4+TNF-α+, CD8+IFN-γ+ and CD8+IFN-γ+TNF-α+ but higher frequency of CD4+IL-4+ T cells. Moreover, Foxp3+Tregs correlated with good prognostic indicators.

Pembrolizumab versus cetuximab concurrent with radiotherapy in patients with locally advanced squamous cell carcinoma of head and neck unfit for cisplatin (GORTEC 2015-01 PembroRad): a multicenter, randomized, phase II trial

To evaluate potential synergistic effect of pembrolizumab with radiotherapy (RT) compared with a standard-of-care (SOC) cetuximab-RT in patients with locally advanced-squamous cell carcinoma of head and neck (LA-SCCHN). Patients with nonoperated stage III-IV SCC of oral cavity, oropharynx, hypopharynx, and larynx and unfit for receiving high-dose cisplatin were enrolled. Patients received once-daily RT up to 69.96 Gy in 33 fractions with weekly cetuximab (cetuximab-RT arm) or 200 mg Q3W pembrolizumab during RT (pembrolizumab-RT arm). The primary endpoint was locoregional control (LRC) rate 15 months after RT. To detect a difference between arms of 60%-80% in 15-month LRC, inclusion of 66 patients per arm was required to achieve a power of at least 0.85 at two-sided significance level of 0.20. Between May 2016 and October 2017, 133 patients were randomized to cetuximab-RT (n= 66) and pembrolizumab-RT (n= 67). Two patients (one in each arm) were not included in the analysis (a consent withdrawal and a progression before treatment start). The median age was 65 years (interquartile range 60-70 years), 92% were smokers, 60% were oropharynx (46% of oropharynx with p16+) and 75% were stage IV. Median follow-up was 25 months in both arms. The 15-month LRC rate was 59% with cetuximab-RT and 60% with pembrolizumab-RT ]odds ratio 1.05, 95% confidence interval (CI) 0.43-2.59; P= 0.91]. There was no significant difference between arms for progression-free survival (hazard ratio 0.85, 95% CI 0.55-1.32; P= 0.47) and for overall survival (hazard ratio 0.83, 95% CI 0.49-1.40; P= 0.49). Toxicity was lower in the pembrolizumab-RT arm than in the cetuximab-RT arm: 74% versus 92% patients with at least one grade ≥3 adverse events (P= 0.006), mainly due to mucositis, radiodermatitis, and rash. Compared with the SOC cetuximab-RT, pembrolizumab concomitant with RT did not improve the tumor control and survival but appeared less toxic in unfit patients with LA-SCCHN.

Dynamic contrast-enhanced MRI and Doppler sonography in patients with squamous cell carcinoma of head and neck treated with induction chemotherapy.

In view of the inherent limitations associated with performing dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) in clinical settings, current study was designed to provide a proof of principle that Doppler sonography and DCE-MRI derived perfusion parameters yield similar hemodynamic information from metastatic lymph nodes in squamous cell carcinomas of head and neck (HNSCCs). Strong positive correlations between volume fraction of plasma space in tissues (Vp ) and blood volume (r=0.72, p=0.02) and between Vp and %area perfused (r=0.65, p=0.04) were observed. Additionally, a moderate positive correlation trending towards significance was obtained between volume transfer constant (Ktrans ) and %area perfused (r=0.49, p=0.09).

32P Prosaposin A as a potential biomarker in patients of squamous cell carcinoma of head and neck

Head and neck squamous cell carcinoma (HNSCC) is one of the leading causes of cancer as well as cancer related deaths. Most patients present in a locally advanced state which lead to significant morbidity and mortality. A biomarker for HNSCC has potential for earlier detection and better treatment of cases but it’s search has been elusive so far. In a previous analysis by investigators as well as at our centre, the levels of Prosaposin A (PSAP) were found to be differentially expressed in the serum of HNSCC patients when compared to age and sex matched healthy controls.

Corneodesmosin as a potential target of oral squamous cell carcinoma.

Objective:The relationship between oral squamous cell carcinoma (OSCC) and Corneodesmosin (CDSN) remains unclear. This study aims to explore the correlation between CDSN and the prognosis and survival time of patients with OSCC.Methods:Bioinformatics were used to identify the hub role of CDSN in the OSCC. A total of 200 patients with OSCC were recruited. Clinical and follow-up data were recorded, and the expression level of CDSN was detected. Pearson chi-square test and Spearman correlation coefficient were used to analyze the relationship between prognosis and related parameters in patients with OSCC. Univariate and multivariate Logistic regression and Cox proportional risk regression were applied for further analysis, and receiver operating characteristic curve and survival curve of subjects were plotted.Results:CDSN was identified as the most significant hub gene of the OSCC by the cytoHubba. By the comparative toxicogenomics database (CTD) analysis, there was strong relationship between the CDSN and mouth neoplasms, head and neck neoplasms, squamous cell carcinoma of head and neck. The OSCC patients with low expression level of CDSN have poor overall survival compared with the high expression level of CDSN (HR = 0.75, 95% confidence interval [95%CI]: 0.57-0.98, P = .036). Spearman correlation coefficient analysis showed that CDSN expression level was significantly correlated with prognosis (ρ = -0.528, P < .001). Multivariate Logistic regression analysis showed that poor prognosis (odds ratio [OR] = 0.096, 95%CI: 0.049-0.189, P < .001) was significantly associated with low expression of CDSN. Cox regression analysis showed that the survival time of OSCC patients was shorter when CDSN expression was low (HR = 0.588, 95%CI: 0.420-0.823, P = .002). Strong predictive value of CDSN for the OSCC survival time was obtained by the biological process (BP)-neural network and support vector machine (SVM).Conclusion:CDSN was significantly correlated with OSCC, and the shorter the survival time of patients with OSCC was, the worse the prognosis was.

673P A prospective comparative study on biweekly docetaxel, cisplatin, 5-fluorouracil, leucovorin (TPFL) versus triweekly TPF as an induction chemotherapy in locally advanced squamous cell carcinoma of head and neck

Induction chemotherapy (ICT) is widely used in locally advanced squamous cell carcinoma of head and neck (SCCHN). Triweekly TPF (Docetaxel/Cisplatin/5FU) is most commonly used regimen but is associated with significant neutropenia. Hence, we conducted a phase II randomised prospective study to see if biweekly TPF regimen was associated with equal response rates with lesser toxicities in our setting.