The overall goal of this study is to study circulating tumor DNA (ctDNA) in the blood to determine how cancer cells in patients react to treatment. DNA is short for deoxyribonucleic acid. DNA contains information that determines in part the traits, such as eye color, height, or disease risk, that are passed on from parent to child. This reaction will be measured by studying patient blood that will be collected before and during treatment until there is disease progression.
Arising in cosmetically and functionally critical areas, head and neck cancer (HNC) and its treatment cause commonly causes life-altering changes in appearance, swallowing, and speaking with resultant functional and social impairment and decreased quality of life. Concern about body image is a common problem with negative consequences in patients with HNC. Despite its importance, there is little data about body image disturbance in patients with HNC.
The objective of this study is to examine the how body image concerns in patients with head and neck cancer change over time and to identify which patients are at risk for developing concerns about body image. This study will provide preliminary data to inform future studies with the long-term goal of improving patient care by preventing and treating concerns about body image in patients with head and neck cancer.
Patient-centered oncology care guided by patient-reported outcomes (PROs) is highly prioritized by the American Cancer Society and the National Cancer Institute. Routine use of PROs in cancer care is associated with improved processes of care, patient outcomes (including overall survival), and shared decision making. Shared decision making is critical for patients with HNSCC, because HNSCC occurs in cosmetically and functionally critical areas. Thus, patients with HNSCC are often forced to prioritize amongst potential treatment-related morbidities and functional outcomes related to appearance, swallowing, and speaking. Understanding how HNSCC patients prioritize functional outcomes in relation to one another would facilitate patient-centered head and neck oncology care. Unfortunately, there is a paucity of data on this topic. To date, there is minimal data about the temporal stability of patient priorities and it remains unknown how patient priorities relate to patient function or health-related quality of life (HRQOL) over time. These gaps in understanding prevent the delivery of optimal patient-centered cancer care that matches patient needs over time. This study will address how patients prioritize functional outcomes in relation to one another and what factors underpin those priorities.
The long-term goal of the research is to develop comprehensive patient-centered strategies for HNSCC patients based on knowledge of functional domain prioritization so that counseling, treatment, and supportive care can be patient-centered. The overall objective of this proposal is to use PRO measures to provide preliminary data examining how patient priorities relate to function and HRQOL over time. The central hypothesis is that patient functional priorities change over time such that patients more highly prioritize the functional domains in which they have decrements in function and de-prioritize the functional domains in which they maintain high function. Confirmation of this hypothesis will promote the development of patient-centric interventions at different points along the treatment spectrum to improve patient care. Our hypothesis will be tested by completing the following Specific Aims:
Specific Aim 1: To characterize how patient functional priorities change over time. Prior work has characterized functional priorities for patients with HNSCC in a cross-sectional manner. However, it remains unknown whether patient priorities change over time. In this study, patients will rate their functional outcome priorities using the Chicago Priority Scale before, during, and up to 9 months after treatment. Characterizing temporal changes in functional priorities will address this knowledge gap.
Specific Aim 2: To use PRO measures to examine the relationship between patient functional priorities and patient function and HRQOL over time. Prior work has addressed the relationship between patient priorities and function in a cross-sectional fashion, but it is unknown whether changes in function over time affect changes in priorities over time. In this study, reliable, validated PRO measures of swallowing, voice, body image, and HRQOL will be used to assess function and HRQOL before, during, and up to 9 months post-treatment. Longitudinal data about patient priorities, function, and HRQOL will be analyzed to examine how patient priorities relate to changes in function and HRQOL over time. Examining the relationship between patient priorities and function and HRQOL over time will address this critical knowledge gap.
Successful completion of these aims will yield the following expected outcomes. For Aim 1, it is expected that patient priorities will change over time and head and neck specific priorities will be less highly prioritized prior to treatment and more highly prioritized after treatment. For Aim 2, it is expected that patients will more highly prioritize the areas in which they have decrements in function over time and de-prioritize the areas in which they maintain high function. This pilot study will provide preliminary data to inform future studies with the long-term goal of improving patient care by 1) facilitating pre-treatment counseling via provision of information about expected prioritized functional outcomes, 2) guiding treatment decision-making to focus on treatment paradigms that minimize morbidity in a patient-centric way, and 3) directing provision of patient-centered supportive care resources for the right need for the right patient at the right time.
Future directions following this pilot study include: 1) scaling up the pilot study into an appropriately powered multi-site study, 2) extending into the survivorship period to assess the long-term relationship between priorities and function over time, and 3) synthesizing patient priority and patient function data to create patient-centric PRO performance measures.
This is for adults diagnosed with locally advanced oral cavity cancer.The purpose of this study is to look at the effectiveness of nivolumab in patients with oral cavity cancer that is amendable to surgery. Patients will have screening tests to determine eligibility. If eligible, subjects will have three to four doses of nivolumab prior to undergoing surgery. After surgery, subjects will enter a follow up period.
This study is for participants who have been diagnosed with head and neck cancer that requires surgery as well as post-operative radiation and possibly cisplatin. The investigational drug in this study is Pembrolizumab. Pembrolizumab is a medication that is currently being tested in multiple cancers. It works by turning on your immune system to recognize and fight your cancer. The purpose of this study is to test the safety and the benefit of adding pembrolizumab to treatment that participants will already be getting for their cancer. Participants can be expected to be in this study for up to 3 years.
This study is for subjects who have been diagnosed with head and neck cancer and are being treated with radiation therapy and chemotherapy. This treatment is expected to irritate the mouth and throat and cause a condition called oral mucositis, which may cause pain and difficulty swallowing. The investigational drug in this study is an oral rinse called BRILACIDIN. It is being studied to see if it can prevent or decrease the occurrence of oral mucositis. The purpose of this study is to see if BRILACIDIN can prevent or decrease the occurrence of oral mucositis. Participants can expect to be in this study for 14-15 weeks.
This study seeks to assess the evolving biomarkers identifiied in head and neck cancers including smoking related and human papillomavirus related markers and their correlation with clinical outcomes, quality of life, survivorship and cancer control.
Head and neck cancer patients will be offered the opportunity to participate in HeadNOG which includes survey information about cancer diagnosis, signs and symptoms, demographics, cancer site, stage and histology and long term outcomes.
This analysis will then assess RNA/DNA biomarkers and lipid profiles, and their role in the etiopathogenesis, treatment and outcomes for head and neck cancer.
It is the goal of HeadNOG to provide a date resource that results in strategies for personalized care of head and neck cancer patients in South Carolina for the future.
Ultimately, it is hoped that biomarkers will direct patient care and improve quality of life and cancer control.
This study is for adult male and female patients with a virus associated with head and neck cancer. The purpose of this study is to study the effects, good and/or bad of performing surgery through your mouth (what is referred to as transoral surgery) followed by treatment that is selected based on studying your cancer under a microscope by a doctor (called a pathologist), on you and your human papillomavirus associated oropharynx cancer. The study is being done because we think that the results of studying your cancer under the microscope can help us be more careful about how much extra treatment needs to be given after surgery.
This research will develop and test a specialized survivorship care planning intervention for head and neck cancer patients and their caregivers at the end of treatment. In the first phase of this research, we will conduct interviews with individuals with head and neck cancer and their caregivers and health care providers to understand the challenges faced at the end of treatment. In the second phase of this research, we will conduct a randomized controlled trial to test the feasibility and impact of a survivorship care planning intervention on patient and caregiver psychosocial and care outcomes (N=80 dyads). Head and neck cancer patients and their primary caregivers will enroll in the study who are approaching the end of treatment or have completed treatment within the past 18 months and be randomized to the intervention group or usual care. Participants in the intervention group will participate in a clinic session followed by one telephone call. Participants in the usual care group will receive survivorship materials in person or by mail. All participants will complete 2 interviews. Information gained from this study will help researchers understand the best ways to help families prepare for life after treatment for head and neck cancer.