Personalised medicine in solid tumours
Advances in head and neck cancer include new knowledge about aetiology and progress in organ-preserving treatment methods. Head and neck cancer (HNC) is primarily related to smoking, although another risk factor, human papillomavirus (HPV), has begun to appear in recent years.
Carcinomas related to HPV are a distinct entity occurring in young adults, not heavy smokers, and usually develop locally and with a better prognosis, probably as a result of their different molecular profile. Organ preservation with chemoradiation is feasible in localised head and neck cancer, without compromising survival.
Lines of research
Our group follows four lines of research
1.- Monitoring the evolutionary incidence of oropharyngeal cancer (OPSCC) induced by HPV in our region and identifying new molecular mechanisms in these tumours, related to increased radiosensitivity. For the next few years we are planning to expand this research, analysing all patients with oropharyngeal cancer treated between 2011 and 2015 in six large hospitals in Madrid, and studying the percentage positive for HPV. This will give us a clear picture of the incidence of ear, nose and throat cancer related to HPV infection in our region. We have requested a project to study the gene expression profile in oropharyngeal cancer positive and negative for HPV, with potential implications for treatment choice.
2.- Advancing organ preservation treatment of locally advanced head and neck tumours within a multidisciplinary approach of chemotherapy, radiotherapy and immunotherapy. We will participate in a randomised phase III study on the effects of interleukocyte injection of leukocyte plus radiotherapy in patients with advanced squamous cell carcinoma of the oral cavity.
3.- Testing new drugs that can reduce acute and late toxicity derived from chemoradiation, such as mucositis or xerostomy. Recruitment for our phase III multi-centre study on the benefit of clonidine in the prevention of oral mucositis in head and neck cancer patients is complete and statistical analysis is planned for this year. Likewise, recruitment has already been completed for the study on intranasal fentanyl for the treatment of pain associated with oral mucositis.
4.- We are also working on surgical rehabilitation, including oral implants and mandibular reconstruction to improve the quality of life of head and neck cancer patients. A review of dissection after chemoradiation for head and neck cancer has been done in collaboration with the otolaryngology and radiotherapy services to establish which patients under conservative treatment need to be operated on.
Laura Cerezo Padellano
Hospital Universitario La Princesa
| Other team members. Hospital Universitario La Princesa: