Chemo: Tongkanker welke is gerelateerd aan HPV - human papillomavirus reageert goed op chemo en behouden bijna altijd hun organen. Andere vormen van tongkanker niet. Artikel geplaatst 18 mei 2008

7 mei 2014: lees ook dit artikel:

Keelkanker wordt meer en meer veroorzaakt door het HPV virus via orale sexs, maar geeft wel betere overlevingskansen. Dit is de conclusie van arts-onderzoeker Marieke Rietbergen van het VUmc in haar promotieonderzoek.

18 mei 2008: Bron: American Cancer Society
Tongkanker welke is gerelateerd aan het HPV - human papillomavirus blijkt uitstekend te reageren op chemo. Ook als het al uitgezaaid is. Andere vormen van tongkanker waar EGFR expressie bij wordt gemeten reageert echter veel minder of eigenlijk niet en is meestal onbehandelbaar met chemo. Het lijkt dus zeer zeker zinvol om bij tongkanker of andere vormen van mond- en keel kanker eerst te testen op het HPV - human papillomavirus voordat met chemo wordt begonnen.
De resultaten:

De onderzoekers gaven een eerste chemokuur aan 66 mensen met gevorderde tong- en keelkanker, ook kanker van de amandelen en tongbasis. 54 patienten reageerden op de chemokuur en ontvingen daarna een volledige behandleing met zowel chemo als bestraling. 11 patienten (11) die mneit op de eerste chemokuur reageerden werden geopereerd. Van de de 54 patienten die goed regeerden op de eerste chemokuur is nog 62% in leven met geen aantoonbare kanker en 73 % kon zijn/haar organen volledig behouden. Van de 11 patienten die voor een operatie in aanmerking kwamen ovelreefden slechts 4 patienten de ingreep. Uit vervolg onderzoek bleek dat vooral de patienten met PPV bijna allemaal hun kanker voerleefden met de aanpak van chemo en bestraling en met behoud van hun organen. Dus konden nog praten en slikken enz. .

Tonsil and tongue cancers linked to human papillomavirus (HPV) are most responsive to current chemotherapy and radiation treatments, while those that express high levels of a growth factor called EGFR are the least responsive and most deadly

Source: University of Michigan Comprehensive Cancer Center

HPV Tied to Better Tongue, Tonsil Cancer Outcomes

WEDNESDAY, May 14 (HealthDay News) -- Tonsil and tongue cancers linked to human papillomavirus (HPV) are most responsive to current chemotherapy and radiation treatments, while those that express high levels of a growth factor called EGFR are the least responsive and most deadly, a new study concludes.

University of Michigan Comprehensive Cancer Center researchers identified a series of markers that identify which patients are most likely to survive these types of cancers. The findings are a promising step toward the development of individualized treatments for tonsil and tongue cancers, according to the authors of two papers published online May 12 in the Journal of Clinical Oncology and expected to be in the July 1 print issue.

"The chemotherapy and radiation therapy we use to treat this type of cancer is very aggressive. If we can identify those patients most likely to respond, we could reduce the intensity of the therapy for those likely to have the best outcomes. At the same time, we hope to identify new treatments that specifically target those tumors that we know are not responding to current therapies," Thomas Carey, co-director of the head and neck oncology program at the U-M Comprehensive Cancer Center, said in a prepared statement. He was the senior author on both papers.

The researchers gave an initial course of chemotherapy to 66 people with advanced oropharyngeal cancer, which includes cancer of the tonsils and the base of the tongue. Patients (54) who responded to this initial treatment then received a full course of simultaneous chemotherapy and radiation. Patients (11) who didn't respond to the initial chemotherapy were referred for surgery.

Of the 54 patients who responded to the initial chemotherapy, 62 percent are alive today without evidence of cancer, and 73 percent fully preserved their organs. Of the 11 patients referred for surgery, only four survived.

"For most patients, the chemoradiation was very effective. But a subset of patients still do not do well. Our next step was to look at the biomarkers to see if we could determine which patients were responding to treatment, based on tumor biology," said Carey, who is also an associate chair and professor of otolaryngology and pharmacology at the U-M Medical School.

The researchers found that 64 percent of the tumors were positive for high-risk strains of HPV. Almost all of the HPV-positive tumors responded to initial chemotherapy, and 78 percent of those patients survived with their organs intact. Of the HPV-negative patients, only four of 15 survived. In addition, patients with the EGFR marker had worse outcomes.

"The combination of markers was an important indicator. Patients whose tumors expressed high levels of EGFR did poorly. But those who had high EGFR and were also HPV-positive had some protection. Patients with high EGFR and low HPV fared the worst," Bhavna Kumar, a research laboratory specialist who was lead author on both papers, said in a prepared statement.

The U-M team also found that patients with low expression of protein called p53 and high expression of a protein called BCLXL also had poor outcomes.

chemo, HPV virus, mondkanker, keelkanker, tongkanker