Advances in so-called big data and the “omics” revolution — the use of genomics, proteomics and metabolomics to better understand cancers at the molecular level — have enabled UCLA’s head and neck cancer researchers to move toward personalized treatments in ways that would have been unthinkable a generation ago. Among other things, this has paved the way for the development of targeted drug treatments. “As we gather more data, and as machine-learning and other data-evaluation systems are put into place, we will continue to see more targeted therapies for these diseases, allowing us to provide personalized care,” says Maie St. John, MD, PhD, chair of the UCLA Department of Head and Neck Surgery and co-director of the UCLA Head and Neck Cancer Program.
UCLA has been a leader in introducing immunotherapy for the treatment of head and neck cancers, including immune checkpoint inhibitor therapy — an approach, successful in a number of cancers, that uses drugs to block specific proteins that act as brakes on the immune system, unleashing a more robust immune response against the cancer. Dr. St. John and her team have also joined with bioengineering colleagues to design and synthesize a modular polymer platform that can deliver targeted chemoprevention or immunotherapy, enabling head and neck surgeons to release immunomodulators or other medications during the surgery to prevent recurrence and improve outcomes. Another exciting innovation involves the development of a UCLA-developed camera system capable of imaging and seeing cancer at microscopic levels intraoperatively, thus allowing for precise surgical resection. This system is now being developed for imaging tumors in patients undergoing robotic surgery, once again in order to allow for precision head and neck surgery. Dr. St. John and her team also are working collaboratively in multidisciplinary teams to develop screens for patients at risk for HPV+ head and neck cancers, as well as developing innovations in head and neck cancer personalized vaccine immunotherapy.
The translational nature of head and neck cancer research at UCLA is hastened by the workings of the UCLA Head and Neck Cancer Program and its Head and Neck Tumor Board, a multidisciplinary team of surgeons, radiation therapists, medical oncologists, pathologists, radiologists, pain specialists, psychologists and others who meet to discuss each patient’s case and recommend a treatment plan.
“All of the experts in that room have clinical or basic research that they bring to the discussion, which ensures that the most cutting-edge options are being considered,” says Elliot Abemayor, MD, PhD, co-director of the UCLA Head and Neck Cancer Program. Dr. Abemayor is engaged in collaboration with David Wong, DMD, DMSc, in the UCLA School of Dentistry and the UCLA Molecular Biology Institute, to develop salivary diagnostics to detect markers for head and neck cancers. In conjunction with bioengineers, this group has developed sensitive biosensors for diagnostic saliva analyses to help in detection and treatment evaluation of head and neck cancer patients. The goals include earlier, non-invasive diagnosis of head and neck cancers to optimize treatment outcomes and assessing markers for rapid diagnosis of head and neck tumors, thereby personalizing individual care.
“We are privileged to work in an environment that is highly conducive to collaboration, innovation and translational research all with the patient as our focus,” Dr. St. John says. “Our goal is to listen to and address what patients want, and to continue to advance the field.”