According to a study, a researcher shows the genetic testing of head and neck tumours, which could lead to more personalized treatments for patients. A new method could lead to better outcomes for patients. The study was published in JAMA Otolaryngology-Head & Neck Surgery.
Head and neck cancers have been grouped into two categories based on the presence of p16, a tumour suppressor protein. Tumours found positive for p16 are less aggressive than those without it, and they have treated accordingly, often with clinical trials using lower doses of radiotherapy. Tumour testing has traditionally been done using immunohistochemistry stains. In Stepp's study, tumours were tested using a method that looks at RNA gene expression in a high throughput manner.
This method was pioneered to study how certain breast cancers might respond to treatment. Stepp found a wide range of genetic expressions for tumours falling within the p16 positive bucket. Stepp used these results to determine the relative aggressiveness of a tumour based on certain genetic markers. With a more specific tumour phenotype, physicians can better determine a course of treatment.
"Ultimately, we'd like to be able to say which treatment modality a patient will best respond to and the likelihood of recurrence," Stepp said. "We're trying to individualize the treatment of head and neck cancers. That's the big picture." This proof of concept study was conducted in 21 patients and Stepp is working now on an expanded study to validate these results.
This kind of clinical research with immediate relevance in patient care is the type of science that drew Stepp to medical school after he completed his doctoral studies at Georgetown University, where he focused on HPV. He remembers a transformative experience that began to steer him towards medical school. While working on a research project at the NIH Clinical Center, Stepp entered a patient's room to collect samples to bring back to the lab.
In the room, Stepp found a shy 13-year-old girl, covered in warts caused by HPV. Upon his entering the room, the girl burst into tears. As author continues this line of research, he hopes to expand the use of his testing method to maximize the effectiveness of treatments for head and neck cancers.
The home run will be when we can prove this test shows what sort of treatment a patient needs to have the best shot at remission or of not having cancer anymore.