Medicine and Health Sciences Commons^™

Metformin Increases Natural Killer Cell Functions In Head And Neck Squamous Cell Carcinoma Through Cxcl1 Inhibition, Mckenzie Crist, Benyamin Yaniv, Sarah Palackdharry, Maria A. Lehn, Mario Medvedovic, Timothy Stone, Shuchi Gulati, Vidhya Karivedu, Michael Borchers, Bethany Fuhrman, Audrey Crago, Joseph Curry, Ubaldo Martinez-Outschoorn, Vinita Takiar, Trisha M. Wise-Draper

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

BACKGROUND: Metformin slows tumor growth and progression in vitro, and in combination with chemoradiotherapy, resulted in high overall survival in patients with head and neck cancer squamous cell carcinoma (HNSCC) in our phase 1 clinical trial (NCT02325401). Metformin is also postulated to activate an antitumor immune response. Here, we investigate immunologic effects of metformin on natural killer (NK) and natural killer T cells, including results from two phase I open-label studies in patients with HNSCC treated with metformin (NCT02325401, NCT02083692).

METHODS: Peripheral blood was collected before and after metformin treatment or from newly diagnosed patients with HNSCC. Peripheral immune cell …

Impact Of Adjuvant Radiation Therapy After Definitive Surgery In Senior Adults >80 Years Old With Advanced Head And Neck Squamous Cell Carcinoma On Overall Survival., Joann M Butkus, Meghan Crippen, Voichita Bar-Ad, Adam Luginbuhl

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Background: Adjuvant radiotherapy (RT) following surgical resection confers a survival benefit for adult patients with locally advanced head and neck squamous cell carcinoma (HNSCC). We aim to investigate if adjuvant RT provides a similar survival advantage to patients ages 80+ through a national curated database.

Methods: This retrospective cohort study queried the National Cancer Database (NCDB) for all cases of HNSCC between 2004-2016. Patients treated with surgical resection alone were compared to those treated with surgery plus adjuvant RT. Overall survival (OS) was compared within adult (age <80 >years) and senior adult (age ≥80 years) cohorts using Kaplan-Meier analysis. Hazard ratios …

Accrual-Monitoring Practices For Various Disease Trials Among Aaci Member Cancer Centers, Zachary T Elliott, Zachary N. Goldberg, Ramez Philips, Jennifer Johnson, Margaret Kasner, William Kevin Kelly, Sarah Osipowicz, Rachael Dampman, Joseph Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Progress in the management of rare diseases, including rare cancers, is dependent upon clinical trials; however, as many as 32% of rare-disease trials go uncompleted or unpublished due to insufficient accrual. Monitoring practices may differ between institutions. We sought to survey the regulatory standards for various trial types among major U.S. cancer centers. A 10-question survey was designed using Qualtrics assessment software. The survey was sent via email to an internal server of member institutions of the Association of American Cancer Institutes (AACI). Of 103 AACI centers, 31% completed the survey (n = 32). Respondents differed in their definitions …

Otolaryngology Subspecialty Surgical Rescheduling Rates During The Covid-19 Pandemic, Emily S Sagalow, Alexander Duffy, Priyanga Selvakumar, David Cognetti

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Objective: In the beginning of the COVID-19 pandemic in spring 2020, elective and oncologic surgical cases were cancelled. After adequate safety protocols were established, each subspecialty within otolaryngology faced unique challenges in reengaging patients for surgical scheduling.

Study design: Retrospective review from March to May 2020.

Setting: Single academic institution.

Methods: Patients whose otolaryngology surgery was cancelled due to COVID-19 hospital precautions were identified. Rescheduling rates were analyzed by subspecialty. Case completion was determined as the percentage of initially cancelled cases that were completed within 6 months of their original planned dates.

Results: Of 833 otolaryngology cases scheduled between March …

Tadalafil Enhances Immune Signatures In Response To Neoadjuvant Nivolumab In Resectable Head And Neck Squamous Cell Carcinoma, Adam J. Luginbuhl, Jennifer Johnson, Larry Harshyne,, Alban J Linnenbach, Sanket Kumar Shukla, Angela Alnemri, Gaurav Kumar, David Cognetti, Joseph Curry, Nikita Kotlov, Zoya Antysheva, Sandrine Degryse, Kyle Mannion, Michael K Gibson, James Netterville, Brandee Brown, Rita S. Axelrod, Ralph G. Zinner, Madalina Tuluc, Stacey Gargano, Benjamin E Leiby, Ayako Shimada, M G Mahoney, Ubaldo E. Martinez-Outshoorn, Ulrich Rodeck, Young J Kim, Andrew P. South, Athanassios Argiris

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Purpose: We hypothesize that the addition of the phosphodiesterase-5 inhibitor tadalafil to the PD-1 inhibitor nivolumab, is safe and will augment immune-mediated antitumor responses in previously untreated squamous cell carcinoma of the head and neck (HNSCC).

Patients and methods: We conducted a two-arm multi-institutional neoadjuvant randomized trial in any-stage resectable HNSCC (NCT03238365). Patients were stratified at randomization by human papillomavirus (HPV) status. Patients in both arms received nivolumab 240 mg intravenously on days 1 and 15 followed by surgery on day 28. Those in the combination therapy arm also received tadalafil 10 mg orally once daily for 4 weeks. Imaging, …

Otitis Media Practice During The Covid-19 Pandemic., Tal Marom, Jacob Pitaro, Udayan Shah, Sara Torretta, Paola Marchisio, Ayan Kumar, Patrick Barth, Sharon Ovnat Tamir

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

The global coronavirus disease-2019 (COVID-19) pandemic has changed the prevalence and management of many pediatric infectious diseases, including acute otitis media (AOM). Coronaviruses are a group of RNA viruses that cause respiratory tract infections in humans. Before the COVID-19 pandemic, coronavirus serotypes OC43, 229E, HKU1, and NL63 were infrequently detected in middle ear fluid (MEF) specimens and nasopharyngeal aspirates in children with AOM during the 1990s and 2000s and were associated with a mild course of the disease. At times when CoV was detected in OM cases, the overall viral load was relatively low. The new severe acute respiratory syndrome …