I work as a medical oncologist in the Dana-Farber Head and Neck Oncology Program. One of the most appealing aspects of head and neck cancer is the accessibility of target tumor for biopsy. The majority of patients, whether newly diagnosed or with recurrent disease, will have tumor present within the head and neck region that can be readily biopsied prior to, during, and after treatment. This affords an invaluable resource for correlative studies that, beyond caring for patients with head and neck cancer and running clinical trials, is a major focus of my research efforts.
We have published the trial, “Phase I Study of Gefitnib Plus Celecoxib in Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck.” This study showed that the combination of EGFR and COX-2 inhibition was well-tolerated, and may be more effective than EGFR tyrosine kinase inhibition (TKI) alone in SCCHN. Predictive markers EGFR TKIs were evaluated, and results suggested that factors other than EGFR gene alterations or KRAS mutations account for response in SCCHN. Building on this experience, we now have a 2nd generation of clinical trials underway investigating combined target therapy in SCCHN.
Another important research initiative is a collaboration between the Dana-Farber Head and Neck Oncology Program and Dr. Frederick Wang of the Division of Virology at Brigham and Women’s Hospital. We are developing a program of immunotherapy for EBV-associated nasopharyngeal carcinoma (NPC). In conjunction with the Connell O’Reilly Families Center for Cell Therapies we have established the Standard Operating Procedures for GMP production of an autologous T cell immunotherapy product. A pilot clinical trial protocol will beunderway before the end of 2006. Extensive translational studies will investigate immune factors that may be responsible for benefit. We plan for this pilot study to generate the necessary preliminary data to not only improve our strategies for therapy, but also obtain support for more definitive study of T cell immunotherapy in NPC. Ultimately, we expect this work to lead to development of vaccine approaches that will have broad implications in EBV-associated malignancy.