DEPARTMENT OF DEFENSE - CONGRESSIONALLY DIRECTED MEDICAL RESEARCH PROGRAMS

Early Career Investigators Are Developing Strategies to Improve Outcomes in Head and Neck Cancers

Posted April 15, 2022

In Fiscal Year 2020 (FY20), Congress included Head and Neck Cancers (HNCs) as a Topic Area under the Peer Reviewed Cancer Research Program (PRCRP). Head and neck cancers include cancers of the oral cavity, throat, larynx, nasal cavity, or salivary glands. Collectively, HNCs account for about 4% of all cancers in the United States, with an estimated 68,000 individuals diagnosed in 2021. HNC has military relevance for both active-duty Service Members and Veterans for several reasons. First, HNCs are twice as common in men and more common in individuals over 50.1 Secondly, tobacco and alcohol use, which is prevalent among active-duty Service Members and Veterans, increases the risk of HNC.2-5 Lastly, infection with human papillomavirus (HPV) is a risk factor for the development of HNC. Compared with the general population, Service Members are at a higher risk of HPV infection.6 The increase in HPV infections is linked with an incidence of HPV-related cancers, including several types of HNC;7 therefore, there is a risk that individuals infected with HPV in their early adulthood may develop HNC later in life. Despite these known risk factors, there remain major gaps across the entire cancer care spectrum, from understanding the biology and etiology to better diagnosis and treatment that will lead to better outcomes for survivors. One unmet need in the field of HNC is development of biomarkers to help clinicians make predictions on treatment success, development of resistance, or overall survival. In FY20, PRCRP funded two Career Development Awards for investigators to use computational and engineering strategies to improve outcomes in HNC.

Dr. German Corredor
Dr. German Corredor

Development of an Image-Based Diagnostic Tool (DigiTIL) to Predict Patient Outcomes in HPV-Positive Oropharyngeal Squamous Cell Carcinoma

German Corredor, Ph.D., Case Western Reserve University

As a trained engineer, Dr. Corredor’s interests include developing novel computational pathology approaches to predict prognosis in HNC patients. Oropharyngeal squamous cell carcinoma, a type of throat cancer, has been increasing in incidence during the last two decades. Approximately 80% of cases in the United States are due to HPV infection.8 This project aims to develop a novel computational tool called DigiTIL, a histology-based diagnostic tool. Dr. Corredor’s team plans to characterize digitized slides of the tumor microenvironment using image-extracted features, with the goal of more accurate prognostic assessments of disease outcome. Dr. Corredor hopes to employ the tool to identify potential differences between populations such as African/Caucasian Americans and Veterans/Non-Veterans. DigiTIL will be validated using cases from both Cleveland and Houston VA Medical Centers, to directly evaluate the benefit of DigiTIL in Veteran populations.

Link:
Public and Technical Abstracts: DigiTIL, a Computational Histomorphometric Predictor of Disease Recurrence and Overall Survival for p16-Positive Oropharyngeal Squamous Cell Carcinoma


Dr. Kyle Lafata
Dr. Kyle Lafata

Multiscale Characterization of Radiation Resistance in Head and Neck Squamous Cell Carcinoma

Kyle Lafata, Ph.D., Duke University
Website: https://www.kylelafata.com

Head and neck squamous cell carcinoma (HNSCC) is the sixth highest incidence among cancers worldwide and results in roughly 380,000 deaths annually.9 New diagnostic approaches that accurately capture the appearance, development, and behavior of HNSCC are critical to understanding the biology of these tumors to devise improved treatment strategies. With his academic training in medical physics, applied mathematics and data science, Dr. Lafata focuses his research on computational and mathematical approaches to precision oncology. At Duke, his lab works on the theory, development, and application of multiscale imaging biomarkers. Dr. Lafata plans to analyze positron emission tomography/computed tomography (PET/CT) and digital pathology data from HNSCC patients to identify and characterize quantitative biomarkers of radiation resistance and metabolic response to therapy. Animal models will be used for discovering mechanisms of resistance to standard therapies. Ultimately, this work will result in an image-guided computational platform to aid in pre-clinical, clinical, and biomarker research for HNSCC.

Link:
Public and Technical Abstracts: Multiscale Characterization of Radiation Resistance in Head and Neck Squamous Cell Carcinoma


Publications:

1 National Cancer Institute. Head and neck cancers. https://www.cancer.gov/types/head-and-neck/head-neck-fact-sheet

2 Odani S, Agaku IT, Graffunder CM, et al. 2018. Tobacco product use among military Veterans–United States 2010-2015. Morbidity and Mortality Weekly Report. 67(1):7-12. doi: http://dx.doi.org/10.15585/mmwr.mm6701a2.

3 National Institute on Alcohol Abuse and Alcoholism. Alcohol use and preventing alcohol-related problems among young adults in the military. https://pubs.niaaa.nih.gov/publications/arh284/252-257.htm

4 Di Credico G, Polesel J, Dal Maso L, et al. 2020. Alcohol drinking and head and neck cancer risk: The joint effect of intensity and duration. British Journal of Cancer. 123:1456-1463. doi: 10.1038/s41416-020-01031-z.

5 Sandulache VC, Hamblin J, Lai S, et al. 2015. Oropharyngeal squamous cell carcinoma in the Veteran population: Association with traditional carcinogen exposure and poor clinical outcomes. Head & Neck. 37(9):1246-1253. doi: 10.1002/hed.23740.

6 Saxena K, Dawson RS, Cyhaniuk A., et al. 2022. Clinical and economic burden of HPV-related cancers in the US Veteran population. Journal of Medical Economics. 25(1):299-308. doi: 10.1080/13696998.2022.2041855.

7 Women’s Health Policy. The HPV vaccine: Access and use in the U.S. https://www.kff.org/womens-health-policy/fact-sheet/the-hpv-vaccine-access-and-use-in-the-u-s/

8 Viens LJ, Henley SJ, Watson M, et al. 2016. Human papillomavirus-associated cancers–United States, 2008-2012. Morbidity and Mortality Weekly Report. 65(26):661-666. doi: 10.15585/mmwr.mm6526a1.

9 Global Burden of Disease 2019 Cancer Collaboration. 2022. Cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups from 2010 to 2019: A systematic analysis for the global burden of disease study 2019. JAMA Oncology. 8(3):420-444. e216987. doi: 10.1001/jamaoncol.2021.6987.

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Last updated Friday, April 15, 2022