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Stone LD, Kasten BB, Rao S, Gonzalez ML, Stevens TM, Lin D, Carroll W, Greene B, Moore LS, Fuson A, James S, Hartman YE, McCammon S, Panuganti B, Nabell LM, Li Y, Li M, Bailey L, Rosenthal EL, Jeyarajan H, Thomas CM, Warram JM. Interim Phase II Results Using Panitumumab-IRDye800CW during Transoral Robotic Surgery in Patients with Oropharyngeal Cancer. Clin Cancer Res 2024; 30:4016-4028. [PMID: 39012279 PMCID: PMC11398989 DOI: 10.1158/1078-0432.ccr-24-0940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/08/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024]
Abstract
PURPOSE The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has continually increased during the past several decades. Using transoral robotic surgery (TORS) significantly improves functional outcomes relative to open surgery for OPSCC. However, TORS limits tactile feedback, which is often the most important element of cancer surgery. Fluorescence-guided surgery (FGS) strategies to aid surgeon assessment of malignancy for resection are in various phases of clinical research but exhibit the greatest potential impact for improving patient care when the surgeon receives limited tactile feedback, such as during TORS. Here, we assessed the feasibility of intraoperative fluorescence imaging using panitumumab-IRDye800CW (PAN800) during TORS in patients with OPSCC. PATIENTS AND METHODS Twelve consecutive patients with OPSCC were enrolled as part of a nonrandomized, prospective, phase II FGS clinical trial using PAN800. TORS was performed with an integrated robot camera for surgeon assessment of fluorescence. Intraoperative and ex vivo fluorescence signals in tumors and normal tissue were quantified and correlated with histopathology. RESULTS Intraoperative robot fluorescence views delineated OPSCC from normal tissue throughout the TORS procedure (10.7 mean tumor-to-background ratio), including in tumors with low expression of the molecular target. Tumor-specific fluorescence was consistent with surgeon-defined tumor borders requiring resection. Intraoperative robot fluorescence imaging revealed an OPSCC fragment initially overlooked during TORS based on brightfield views, further substantiating the clinical benefit of this FGS approach. CONCLUSIONS The results from this patient with OPSCC cohort support further clinical assessment of FGS during TORS to aid resection of solid tumors.
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Affiliation(s)
- Logan D. Stone
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL
| | - Benjamin B. Kasten
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL
| | - Shilpa Rao
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL
| | | | - Todd M. Stevens
- Department of Pathology, University of Kansas Medical Center, Kansas City, KS
| | - Diana Lin
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL
| | - William Carroll
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL
| | - Benjamin Greene
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL
| | - Lindsay S. Moore
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL
| | - Andrew Fuson
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL
| | - Sherin James
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL
| | - Yolanda E. Hartman
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL
| | - Susan McCammon
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL
| | - Bharat Panuganti
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL
| | - Lisle M. Nabell
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL
- Department of Medicine, Division of Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL
| | - Yufeng Li
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Mei Li
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Luke Bailey
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL
| | - Eben L. Rosenthal
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University, Nashville, TN
| | | | - Carissa M. Thomas
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL
| | - Jason M. Warram
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL
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Lau F, Lisatchok M, Tamanini JB, Gazmenga FP, Texeira DNA, Couto EV, Chone CT. Treatment outcome of oropharyngeal squamous cell carcinoma through propensity score analysis. Braz J Otorhinolaryngol 2023; 89:101335. [PMID: 37813007 PMCID: PMC10570559 DOI: 10.1016/j.bjorl.2023.101335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/20/2023] [Accepted: 09/12/2023] [Indexed: 10/11/2023] Open
Abstract
According to an extensive database, the Objective is to compare surgical versus non-surgical treatment through Propensity Score (PS) for patients with Oropharyngeal Squamous Cell Carcinoma (OPSCC). METHODS We retrospectively evaluated epidemiological data from 8075 patients with OPSCC diagnosed between 2004 and 2014 and used PS matching to analyze possible prognostic factors for its outcomes with regression analyses. RESULTS Cox multiple regression analysis to study survival after PS matching shows that type of treatment was associated with death with a hazard ratio of 1.753 (p<0.05) of non-surgical treatment. However, it was not associated with recurrence (p>0.05). In the surgical treatment group, overall survival was 79.9% at one year, 36.4% at five years, and 20.5% at ten years. Disease-free survival was 90.1%, 64.8%, and 56.0% at 1, 5, and 10-years, respectively. In the non-surgical treatment group, overall survival was 60.6% at one year, 21.8% at five years, and 12.7% at ten years. Disease-free survival was 90.8%, 67.2%, and 57.8% at 1, 5, and 10-years, respectively. CONCLUSION Patients in the surgical treatment group had better outcomes related to survival. Recurrence is associated with the survival of OPSCC cancer. Recurrence-free survival is similar to both treatments. LEVEL OF EVIDENCE 2C.
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Affiliation(s)
- Fabio Lau
- Universidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil.
| | - Matheus Lisatchok
- Universidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Jonas Belchior Tamanini
- Universidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Fabio Portela Gazmenga
- Universidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Daniel Naves Araújo Texeira
- Universidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Eduardo Vieira Couto
- Universidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Carlos Takahiro Chone
- Universidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
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Heft Neal ME, Walline HM, Haring CT. Circulating Tumor DNA in Human Papillomavirus-Mediated Oropharynx Cancer: Leveraging Early Data to Inform Future Directions. Cancer J 2023; 29:215-219. [PMID: 37471611 DOI: 10.1097/ppo.0000000000000670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
ABSTRACT Circulating tumor DNA (ctDNA) has become an area of intense study in many solid malignancies including head and neck cancer. This is of particular interest for human papillomavirus-mediated oropharyngeal squamous cell carcinoma as this cohort of patients has excellent survival and is undergoing current clinical trials aimed at treatment de-escalation. Recent studies have demonstrated the prognostic implications of pretreatment ctDNA and the utility of monitoring ctDNA during and posttreatment; however, there is a need for a more critical understanding of ctDNA as it is beginning to be incorporated into clinical trials. This review discusses the current state of ctDNA in oropharynx cancer focusing on ctDNA kinetics and minimal residual disease detection and ends with a discussion of future applications.
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Affiliation(s)
| | - Heather M Walline
- From the Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI
| | - Catherine T Haring
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH
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