Validation of NRG Oncology's prognostic nomograms for oropharyngeal cancer in the Veterans Affairs database

Nelson, Tyler J.; Thompson, Caroline A.; Zou, Jingjing; Kumar, Abhishek; Sangchan, Prangrawee; Williamson, Casey W.; Vitzthum, Lucas K.; Sharabi, Andrew B.; Murphy, James D.; Fakhry, Carole; Mell, Loren K.

doi:10.1002/cncr.34141

Cited by 4 publications

(3 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The generalized competing risks (GCE) model is an approach to risk-stratify patients by considering the relative hazard of cancer and non-cancer related events [ 78 , 79 , 80 , 81 , 82 , 83 ]. The GCE is also called the ω score, which is a ratio developed for all head and neck cancer patients.…”

Section: Novel Predictive Assessmentsmentioning

confidence: 99%

Management of Older Adults with Locally Advanced Head and Neck Cancer

Dickstein

Lehrer²,

Hsieh³

et al. 2022

Cancers

View full text Add to dashboard Cite

Thirty percent of patients with head and neck squamous cell carcinoma (HNSCC) are at least 70 years of age. This number continues to rise as life expectancy continues to increase. Still, older adults with HNSCC remain underrepresented in clinical trials, resulting in ambiguity on optimal management. Older adults are a complex patient population, often requiring increased support due to issues relating to functional and performance status, medical comorbidities, and medication management. Furthermore, in older adults with HNSCC, many of these conditions are independently associated with increased toxicity and worse outcomes. Toxicity in the older adult remains difficult to predict and to understand, and as treatment decisions are based on treatment tolerability, it is essential to understand the toxicities and how to minimize them. Novel predictive scores are being developed specifically for older adults with HNSCC to understand toxicity and to assist in personalized treatment decisions. There are clinical trials presently underway that are investigating shortened radiation courses and novel, less toxic systemic treatments in this population. In the forthcoming sections, we provide a detailed overview of the clinical data, treatment paradigms, and considerations in this population. This review provides a comprehensive overview of existing clinical data and clinical considerations in the older adult head and neck cancer population. Additionally, we provide a detailed overview of pertinent current and ongoing clinical trials, as well as future areas for investigation.

show abstract

Section: Novel Predictive Assessmentsmentioning

confidence: 99%

Management of Older Adults with Locally Advanced Head and Neck Cancer

Dickstein

Lehrer²,

Hsieh³

et al. 2022

Cancers

View full text Add to dashboard Cite

show abstract

“…Faraji et al [46] 2023 161 vets with HPV-related OPSCC treated with transoral robotic surgery (TORS) Survival outcomes for vets treated with TORS +/-adjuvant therapy equivalent to civilian population Feinstein et al [33] 2017 209 vets with HPV-related OPSCC within the VA Greater Los Angeles System Survival outcomes for vets with HPV-related OPSCC equivalent to civilian population Nelson et al [47] 2022 4,007 vets with HPV-related OPSCC treated with radiation within the VA CDW NRG Oncology nomograms effective for predicting recurrence and survival outcomes in vet populations…”

Section: Survival Outcomesmentioning

confidence: 99%

Consideration of liquid biomarkers for surveillance of HPV-related oropharyngeal cancer in veteran populations

Smith,

Spector,

Brenner

et al. 2024

J Cancer Metastasis Treat

View full text Add to dashboard Cite

The incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) will continue to rise in the United States over the next several decades. Thus, efforts to reduce treatment intensity, mitigate long-term physical and psychological sequelae of treatment, and simplify surveillance regimens for patients with HPV-related OPSCC are critical. Liquid biomarkers, namely plasma circulating tumor HPV DNA (ctDNA), have shown considerable promise for improvements in these domains by guiding personalized and adaptive treatment de-escalation paradigms and predicting disease recurrence in the survivorship period. Preliminary reports suggest an even broader impact of plasma HPV ctDNA assays for HPV-related OPSCC surveillance beyond the mere detection of cancer recurrence and metastasis. For instance, such assays may reduce the need for costly imaging studies, alleviate the financial toxicities of survivorship care, and improve care access and patient satisfaction. Currently, veterans and underserved populations are disproportionately affected by the financial burden of cancer surveillance and survivorship care. These disparities negatively impact oncologic outcomes, healthcare access, and utilization, specifically among veterans with HPV-related OPSCC. As such, we posit that HPV ctDNA monitoring may be of unique benefit and impact in the surveillance period for these patients specifically. Herein, we provide a narrative review of the current literature supporting the formal clinical evaluation of HPV ctDNA monitoring in veterans with HPV-related OPSCC.

show abstract

“…The Generalized Competing Event (GCE) model is a way of risk-stratifying patients by weighing the relative hazard of cancer-and non-cancer-related events. [61][62][63][64][65][66] The GCE is also known as the omega (ω) score, and is a ratio that was developed for all cancer patients. The ratio is a proportion of the risk of cancer recurrence to non-cancer mortality, such that the closer the ratio is to 1, the higher the risk of cancer progression relative to mortality from other causes, while a value closer to 0 designates a higher likelihood of mortality from other causes.…”

Section: Geriatric Assessmentsmentioning

confidence: 99%

Clinical and Therapeutic Considerations for Older Adults with Head and Neck Cancer

Dickstein¹,

Powers²,

Vujović³

et al. 2023

CIA

View full text Add to dashboard Cite

Approximately 30% of patients with head and neck squamous cell carcinoma (HNSCC) are at least 70 years of age, and this percentage is expected to increase as the population increases and lives longer. Elderly patients are underrepresented in head and neck oncology clinical trials, and there is minimal evidence on the management of HNSCC for this population. Subsequently, despite their best intentions, physicians may unknowingly recommend an ill-suited course of therapy, which may result in suboptimal oncological or functional outcomes or adverse events. Surgical approaches have the potential to carry a higher risk of morbidity and mortality in older adults, especially in patients with multiple comorbidities. Definitive radiation therapy treatment in patients with HNSCC frequently involves 7 weeks of daily radiation, sometimes with concurrent chemotherapy, and this demanding treatment can be difficult for older adult patients, which may lead to treatment interruptions, potential removal of concurrent systemic therapy, compromised outcomes, and diminished quality of life. There are clinical trials currently underway investigating altered fractionation regimens and novel, less toxic systemic treatments in this population. This review provides an overview of how best to approach an older adult with HNSCC, from initial work-up to treatment selection.

show abstract

Validation of NRG Oncology's prognostic nomograms for oropharyngeal cancer in the Veterans Affairs database

Cited by 4 publications

References 21 publications

Management of Older Adults with Locally Advanced Head and Neck Cancer

Management of Older Adults with Locally Advanced Head and Neck Cancer

Consideration of liquid biomarkers for surveillance of HPV-related oropharyngeal cancer in veteran populations

Clinical and Therapeutic Considerations for Older Adults with Head and Neck Cancer

Contact Info

Product

Resources

About