March 2011

Clinical Trial Focuses on High Risk Head and Neck Cancer Patients

A clinical trial now being offered at UNC Lineberger focuses on treatment for head and neck patients who are considered to have a high risk for relapse following curative therapy. High risk patients are defined as those who are Stage 4a or 4b.

The trial - 09-266-B - randomizes patients to the mTOR inhibitor, everolimus, verses placebo for one year following completion of any definitive therapy.

"Patients with locally advanced squamous cell cancer of the head and neck undergo intensive therapy with curative intent, however nearly 40-50% of these patients will have recurrent disease, often with limited salvage options. The mTOR pathway is activated in many head and neck cancers,” says Juneko Grilley-Olson, MD, (pictured above) assistant professor in the division of hematology oncology and the primary investigator of the clinical trial. “This trial tests an important question: whether adjuvant therapy with everolimus can improve progression free survival and ultimately overall survival in these high risk patients."

The trial has a correlative component, requiring pretreatment 10 tumor slides and 10 normal slides, where biomarkers predictive of clinical benefit will be examined.

For more information about this trial, email Dr. Grilley-Olson or call her at 919-966-4432.

New Test Helps Identify Benign and Malignant Thyroid Neoplasms

UNC physicians are studying new ways to determine whether thyroid masses are malignant or benign.

In roughly 20% of all fine needle aspirates of thyroid masses, the diagnosis of “follicular neoplasm” is given and regarded as indeterminate or suspicious for malignant disease.

Currently, surgery to remove half of the thyroid for pathology to assess is the gold standard for this population of patients with thyroid masses. If malignancy is found, the patient returns for additional surgery. A more accurate pre-operative distinction of follicular thyroid lesions would enhance appropriate surgical therapy.

“Our goal is to find another way to define the state of a thyroid mass besides surgery,” says Mihir Patel, MD, a resident with UNC Otolaryngology/Head and Neck Surgery. Dr. Patel and his colleagues began testing samples from patients in the operating room – the results are hopeful.

“Although sensitivity was in the 60s, the specificity and the positive predictive value was 100%,” says Dr. Patel. “We isolated a membrane protein that might be helpful in determining malignancy, and we plan to confirm the test through a clinical trial.”

For more information about this test, contact Dr. Patel at 919-966-3342.

Photo credit: stock.xchng