The National Cancer Institute (NCI), part of the National Institutes of Health (NIH), has awarded a two-year grant to Dr. Brian L. Schmidt, professor of oral and maxillofacial surgery at the NYU College of Dentistry, and Dr. Donna G. Albertson, professor at the UCSF Helen Diller Family Comprehensive Cancer Center. The grant will fund groundbreaking research to customize treatment for oral cancer patients. Drs. Schmidt and Albertson have identified candidate genomic markers in tumors that predict if an oral cancer is likely to spread (metastasize) to the neck.
Oral cancer is often fatal if it spreads to the neck and remains untreated. Current clinical and radiographic examination provides limited information for diagnosis of early neck metastasis of oral cancer. Nearly all cancers within the oral cavity must be surgically removed. An additional and extensive surgery (neck dissection) is also performed to remove lymphatic tissue in the neck if there is any clinical or radiographic evidence of neck metastasis. Patients who present with no evidence of metastasis in the neck often undergo a preemptive neck surgery because untreated occult (hidden) metastasis reduces life expectancy by half.
The work of Drs. Schmidt and Albertson will validate genomic markers that will ultimately be used to rule out neck dissection in oral cancer patients with no clinical evidence of neck metastasis and who have tumors containing specific genomic profiles. Dr. Alberston notes, "It has taken us eight years of research to converge on a genomic marker that could be used to tailor treatment for oral cancer patients. We look forward to testing this marker in a clinical study and this funding will help us to develop the appropriate laboratory test for such a trial."
Currently, neck surgery for those suffering from oral cancer entails a three-to-four hour major procedure involving critical anatomic structures and is associated with life-altering morbidity, including stroke. For most patients this procedure is unneeded but employed as a pragmatic solution to the dilemma posed by the specter of occult metastasis. Dr. Schmidt states, "We can dramatically improve quality of life if we can accurately identify those who do not need a neck dissection. Morbidity and recovery time would be reduced, and we would alleviate anxiety for many patients and families."
Dr. Schmidt will conduct the clinical portion of the study through the NYU Bluestone Center for Clinical Research, which he directs. Dr. Schmidt and his team will recruit subjects, enroll patients, and collect the specimens. The samples will then be sent to the UCSF Helen Diller Family Comprehensive Cancer Center where Dr. Albertson's group will process and analyze the samples. Drs. Schmidt and Albertson foresee improved care for oral cancer patients once their newly identified genomic marker is validated.