Tobacco and alcohol consumption cause most oropharyngeal cancers, but the human papillomavirus (HPV) accounts for a growing number of cases. Many tumors caused by HPV tend to have favorable outcomes regardless of treatment, while others progress and metastasize.
However, oncologists currently treat all oropharyngeal cancers with the same aggressive level of therapy. To help doctors better determine appropriate levels of treatment, Case Western Reserve University will analyze computerized images of tissue samples for patterns that could become biomarkers for determining the relative risk for recurrence in oropharyngeal cancers.
“Right now, it’s a one-size-fits-all therapy for all of these patients with HPV head and neck cancers,” said primary investigator Anant Madabhushi, MD, the F. Alex Nason Professor II of Biomedical Engineering and founding director of the Case Western Reserve University Center for Computational Imaging and Personalized Diagnostics.
“There are currently very few validated biomarkers and approaches that are accurate enough to identify which of these cancers are more aggressive or which ones are less aggressive,” he said. “That has limited the ability of clinicians to even hold clinical trials to find out if they can de-escalate therapy for some of these patients—or who needs more aggressive therapy.”
The National Cancer Institute recently awarded a $3.15 million, five-year grant to the researchers and their industry partner Inspirata to pursue their work and build toward establishing those clinical trials. Their data so far indicate that the approach soon could become a clinically actionable tool.
Initial results on almost 400 oropharyngeal cancer patients suggests that the technology is independently prognostic of disease progression, meaning it could stand alone in helping clinicians figure out how aggressive the disease is and then make a more informed decision about how aggressively to treat the cancer.
“In those cancers, they’ve established whether you can modulate your therapy based on the risk profile for those tumors,” Madabhushi said. “But in head and neck, clinicians might have a sense that there are different risk profiles for different patients, but nobody knows for certain. We want to change that by giving them risk stratification tools to better help the patient.”