About 8,000 Americans die of oral cancer each year, according to the Columbia University College of Dental Medicine. While the 5-year survival rate is approximately 60% when it is diagnosed early, doctors have no way of forecasting which of these patients have a more aggressive and fatal form of the disease. Now, a Columbia researcher is developing a prognostic tool to help doctors provide personalized and potentially more effective treatment.
The National Institute of Dental and Craniofacial Research has awarded a 4-year grant of $1,368,000 to Angela J. Yoon, DDS, MPH, MAMSc, director of the college’s Oral and Maxillofacial Pathology Division to support this work, which aims to develop a test that will detect a tumor’s molecular signature. Doctors can then use this information to better predict whether a given cancer is likely to progress more rapidly, prompting personalized treatment.
In a preliminary study, Yoon has identified specific molecules that, combined with risk factors such as tobacco and alcohol use, can increase a person’s susceptibility to aggressive forms of oral cancer. In the current project, Yoon is looking for the snippets of microRNA associated with more aggressive forms of oral cancer. This will enable specialists to determine which individuals harbor high levels of the microRNA associated with aggressive disease.
“We want to identify those at high risk for cancer-specific death from the group of people who are already assigned to stage I or II,” said Yoon. “Since 80% of oral cancer patients are in early stage at the time of diagnosis, a window of opportunity exists in which accurate prognostication and subsequent decisions for appropriate treatment could dramatically improve 5-year survival for patients.”
Yoon already is paving the way for the personalized treatments that physicians and patients will require to leverage her new prognostic tool. She is currently working with oncologists at Columbia’s College of Physicians and Surgeons to investigate the efficacy of immunomodulatory therapy, which can help the immune system identify and kill cancer cells. Oncologists prescribe such medications prior to surgery to shrink tumor size and boost survival rates.
“Once we’ve identified a cancer as a high risk, we need to provide treatment that will improve survival,” said Yoon. “I believe it is the responsibility of clinicians in academia to diligently look for ways to improve patient care.”