Pharmacology

Grant Detail

This is a chronological listing of grants held by this department, with the most recent listed first. New grants appear in this list weekly and contribute related to the department's Research Profile. The source of grants for this application comes directly from your institution.

Prospective, Longitudinal, Multi-Center, Descriptive Registry of Patients Receiv

Neil Hayes

Approximately 40,000 new cases of head and neck cancer are diagnosed each year in the United States,1 of which squamous cell carcinomas (SCC) represent the vast majority. At the time of diagnosis, approximately one third of patients with carcinomas of the oral cavity, half of patients with larynx carcinoma, and two-thirds of patients with carcinomas of the pharynx have regional disease. The relative 5-year survival rate for those presenting with regional disease is 50% while the survival of those presenting with distant disease is usually measured in months.2 Treatment of patients with early disease involves surgery or radiation therapy; outcomes for each modality are similar. For patients with more advanced disease, surgery combined with radiotherapy was the Â?gold standardÂ? until a few years ago. However, results of many recently published Phase III trials 3-9 show that chemotherapy given concurrently with radiation yields better local-regional control and survival rates than radiation alone in patients with locally advanced head and neck SCC. These trials established concurrent radiation and chemotherapy as a viable organ-preservation therapy in patients with locally advanced head and neck carcinoma. The local-regional relapse rates after combined therapy, however, range from 25-50% depending on the stage and site of head and neck carcinoma. In addition, two recent trials showed the benefit of concurrent radiation-chemotherapy given in the postoperative adjuvant setting for patients with high-risk tumor features. 10,11 Despite the impressive results of these trials, local disease recurrence was reported in approximately 20% of patients and benefits on overall survival were only seen in one trial. Furthermore, rates of severe early adverse events were significantly higher in the chemoradiotherapy arms, highlighting the harm/benefit trade-off associated with more intensified treatment. The need to improve upon rates of overall survival without unduly adding toxicity is prompting the study of new therapies and new uses of older therapies. One new class of agents, epidermal growth factor receptor inhibitors, has recently shown promise in the setting of advanced head and neck cancer. 12 Other novel approaches, including gene therapy, are also under investigation. Additionally, trials are underway to identify the optimal regimen of radiotherapy to be used in combination with chemotherapy and to evaluate the effectiveness of chemotherapeutic drugs approved for other cancers.