@JNCI_Now We defined the gene expression profiles distinguishing HPV+ OPSCCs that are prone to recur after TORS-based therapy. These the tumor-intrinsic and immune-related traits were tightly interrelated and generalizeable to nonsurgical cases as well. academic.oup.com/jnci/advanc…

🦠💡Next up - TRINITY trial presented by Zachary Zumsteg at @CedarsSinai, investigating reduced dose/volume CRT after TORS with excellent 2-yr PFS. #ASTRO26 @ASTRO_org @xrtGenomics @DanielMaMD @RobertFerrisMD @drdavidpalma

So proud to be a Pennsylvanian with a Republican Senator like Dave McCormick. Thank you Senator McCormick for strongly supporting biomedical research and NIH. washingtonpost.com/opinions/…

Highlighting our infographic with @AHNS on the significance of discordant HPV confirmatory testing in p16+ oropharyngeal cancer and current US guidelines for using it.

Very thoughtful commentary from the stellar Red Journal H&N editors! redjournal.org/article/S0360…

Question born in a clinic. 74 patients with HNSCC undergoing CTRT. Two blinded oncologists grading toxicities. Now in Red Journal Mucositis, ≥G2 κ: 0.23–0.41 | 91.9% vs 70.2%, Assessor = hidden covariate in every tox endpoint doi.org/rmn6 @IJROBP @RadOncTMC

The final paper from ⁦⁦Gough/Crittenden Lab ⁦@providence⁩ is out in J of Immunology. Kaede tracking shows the tumor-draining lymph node refills irradiated tumors with T cells — support for lymphatic-sparing immunoradiotherapy in H&N cancer. academic.oup.com/jimmunol/ar…

Updated results from JCOG 1008 (bolus versus weekly cis for postoperative CRT in high-risk patients) are out. Weekly cisplatin was clearly non-inferior and in fact numerically superior from both a disease- and safety- perspective. The clear winner. It will be very interesting to see the final results from HN009 (definitive CRT), especially in an HPV-negative population that may be at higher risk for treatment-related toxicity. ascopubs.org/doi/full/10.120…

Dr Gillison played a central role in elucidating the clinical and molecular epidemiology of HPV+ oropharyngeal cancer and made critical contributions to our understanding of HPV genome states in malignancy.

Mark was a phenomenal human being and leader - a great loss.

Some interesting results to unpack here

So, you want to lead a randomized trial? I ran a poll: How many people have near veto power over the approval & design of an investigator initiated oncology randomized trial? Only 23% guessed right. Answer: >50! @RielyMD @mtmdphd Here are the steps to do an RCT? Thread 1/

New @Nature study: >50% of lung cancer metastases are seeded by other metastases, not the primary tumor. This "seeding from seeding" reveals a complex evolutionary cascade that allows cancer to colonize the body. nature.com/articles/s41586-0…

It is a well-written editorial, and I agree with some parts and disagree with others. However, I am very disappointed that @TheLancet would choose a member of the scientific advisory board of IBA (a proton manufacturer) to write an editorial about protons. The author of an important commentary should not have such an intrinsic conflict of interest with the subject matter.

Now published: New study on the controversial role of confirmatory HPV testing in p16+ OPCs 📚 Corresponding author: @BasuLab1 Read more: ascopubs.org/doi/10.1200/PO-… link in our bio 🔗 #AcademicMedicine #Research #HPV #headandneckcancer

📢Thoughtful discussion of the utility of #protontherapy "[...] importance of integrating patient-reported outcomes into trial design and focusing on endpoints that matter most to long-term survivors. The goal is [...] thoughtful selection of patients" thelancet.com/journals/lance…

Come for the critically important data on protons for oropharyngeal cancer, stay for the beautifully written paper. TORPEdO is out, and it is fascinating and instructive. I will warn you upfront that this is a long thread, but there is a lot here to discuss! thelancet.com/journals/lance…

Background: We cure most locally advanced OPSCC patients with IMRT + cisplatin, but late dysphagia, xerostomia, dysgeusia, and weight loss still wreck QoL. Protons spare OARs beautifully on paper. Does that actually help patients? TORPEdO was built to answer exactly that.

Our new study on the controversial role of confirmatory HPV testing in p16+ OPCs found 6% RNAScope false negatives but no true negatives, supporting only selective, CAP guideline-based use of confirmatory tests when pre-test probability of HPV-relatedness is high. ascopubs.org/doi/10.1200/PO-…

@Jdcramer has made a critical point below about KEYNOTE-689. The EFS rules in KN-689 require careful review to interpret these results.  A protocol-specific event was determined by blind independent central review (BICR), but if growth in the pre-surgical CT was perceived to be a “flare” (i.e. potential progression), surgery was supposed to proceed unless unresectable (protocol quote below). In order to be considered an event, repeat imaging was required 4-8 weeks later, and obviously if the tumor was still resectable the patient would go to surgery before then. This definition means it was extremely difficult to have an event before surgery, even if the tumor grew and the surgery was more extensive than initially anticipated. Thus some patients may have been harmed by neoadjuvant treatment, but we would not see that in the event data. Thus there is this important disconnect: 82 patients in the pembro arm stopped the drug due to progression (by the investigator, as shown in the CONSORT diagram), even though there were only 69 progression events (by BICR, used for endpoint analyses). Is perioperative immunotherapy doing something favorable and important in a subset of these patients? Yes, and hopefully we can refine its use to the right population and with the right regimen (adding neoadjuvant chemo or RT?). Is it distinctly possible/probable that some patients are progressing on neoadjuvant pembro, leading to a worse outcome in some domain, but we cannot see that in these data? Yes, unfortunately, also true.