2023
Screening for extranodal extension in HPV-associated oropharyngeal carcinoma: evaluation of a CT-based deep learning algorithm in patient data from a multicentre, randomised de-escalation trial
Kann B, Likitlersuang J, Bontempi D, Ye Z, Aneja S, Bakst R, Kelly H, Juliano A, Payabvash S, Guenette J, Uppaluri R, Margalit D, Schoenfeld J, Tishler R, Haddad R, Aerts H, Garcia J, Flamand Y, Subramaniam R, Burtness B, Ferris R. Screening for extranodal extension in HPV-associated oropharyngeal carcinoma: evaluation of a CT-based deep learning algorithm in patient data from a multicentre, randomised de-escalation trial. The Lancet Digital Health 2023, 5: e360-e369. PMID: 37087370, PMCID: PMC10245380, DOI: 10.1016/s2589-7500(23)00046-8.Peer-Reviewed Original ResearchConceptsExtranodal extensionOropharyngeal carcinomaShort-axis diameterChallenging cohortPathology reportsECOG-ACRIN Cancer Research GroupDe-escalation trialsCancer Research GroupDe-escalation strategiesSurgical pathology reportsNational Cancer InstituteInter-reader agreementLargest short-axis diameterPostoperative chemoradiationProtocol exclusionsConcurrent chemoradiationPrimary endpointMulticentre trialPretreatment CTAdjuvant strategiesHuman papillomavirusTreatment selection toolUS National InstitutesPretreatment identificationStudy protocol
2021
Treatment De-intensification for HPV-Positive Oropharynx Cancer: What Is Currently Acceptable?
Cmelak AJ, Ferris RL, Chen AM, Seiwert T, Burtness B. Treatment De-intensification for HPV-Positive Oropharynx Cancer: What Is Currently Acceptable? Journal Of Clinical Oncology 2021, 39: 2732-2733. PMID: 34043410, DOI: 10.1200/jco.21.00594.Peer-Reviewed Original ResearchHypoxia-Guided Therapy for Human Papillomavirus-Associated Oropharynx Cancer
Burtness B, Contessa J. Hypoxia-Guided Therapy for Human Papillomavirus-Associated Oropharynx Cancer. Journal Of The National Cancer Institute 2021, 113: 652-653. PMID: 33429429, PMCID: PMC8168139, DOI: 10.1093/jnci/djaa187.Peer-Reviewed Original Research
2020
A novel surgeon credentialing and quality assurance process using transoral surgery for oropharyngeal cancer in ECOG-ACRIN Cancer Research Group Trial E3311
Ferris RL, Flamand Y, Holsinger FC, Weinstein GS, Quon H, Mehra R, Garcia JJ, Hinni ML, Gross ND, Sturgis EM, Duvvuri U, Méndez E, Ridge JA, Magnuson JS, Higgins KA, Patel MR, Smith RB, Karakla DW, Kupferman ME, Malone JP, Judson BL, Richmon J, Boyle JO, Bayon R, O'Malley BW, Ozer E, Thomas GR, Koch WM, Bell RB, Saba NF, Li S, Sigurdson ER, Burtness B. A novel surgeon credentialing and quality assurance process using transoral surgery for oropharyngeal cancer in ECOG-ACRIN Cancer Research Group Trial E3311. Oral Oncology 2020, 110: 104797. PMID: 32679405, PMCID: PMC7771718, DOI: 10.1016/j.oraloncology.2020.104797.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedFemaleHumansMiddle AgedOropharyngeal NeoplasmsProspective StudiesQuality Assurance, Health CareRobotic Surgical ProceduresSurgeonsConceptsOropharyngeal cancerTransoral surgeryOropharyngeal bleedingPositive marginsTransoral resectionGrade III/IVSurgical oncology trialsPost-operative therapySurgical quality assuranceSurgical pathology reportsFinal pathologic marginsMulti-institutional dataPathologic marginsBleeding rateClinical trialsPathology reportsLower incidenceOngoing quality assuranceOncology trialsSurgical expertiseMeticulous evaluationSurgeon expertiseTransoral headPatientsSurgeryHigh Dose Cisplatin: Still the One?
Husain ZA, Burtness BA. High Dose Cisplatin: Still the One? International Journal Of Radiation Oncology • Biology • Physics 2020, 107: 615-616. PMID: 32589986, DOI: 10.1016/j.ijrobp.2019.09.026.Peer-Reviewed Original Research
2019
Impact of contralateral lymph nodal involvement and extranodal extension on survival of surgically managed HPV-positive oropharyngeal cancer staged with the AJCC eighth edition
Miccio JA, Verma V, Kelly J, Kann BH, An Y, Park HS, Eskander A, Burtness B, Husain Z. Impact of contralateral lymph nodal involvement and extranodal extension on survival of surgically managed HPV-positive oropharyngeal cancer staged with the AJCC eighth edition. Oral Oncology 2019, 99: 104447. PMID: 31630059, DOI: 10.1016/j.oraloncology.2019.104447.Peer-Reviewed Original ResearchMeSH KeywordsAgedFemaleHumansLymph NodesMaleNeoplasm StagingOropharyngeal NeoplasmsPrognosisSurvival AnalysisConceptsOropharyngeal squamous cell carcinomaExtranodal extensionLymphovascular invasionKaplan-Meier overall survival analysisContralateral lymph node involvementHPV-positive oropharyngeal cancerFuture staging systemsNational Cancer DatabaseLymph node involvementLymph nodal involvementSquamous cell carcinomaAJCC eighth editionOverall survival analysisPathologic nodalInferior OSNodal involvementNode involvementWorse OSClinical stagingPrognostic factorsOropharyngeal cancerPositive marginsPrognostic importanceCell carcinomaCox regressionPoint/Counterpoint: Do We De-escalate Treatment of HPV-Associated Oropharynx Cancer Now? And How?
Wirth LJ, Burtness B, Nathan CO, Grégoire V, Richmon J. Point/Counterpoint: Do We De-escalate Treatment of HPV-Associated Oropharynx Cancer Now? And How? American Society Of Clinical Oncology Educational Book 2019, 39: 364-372. PMID: 31099643, DOI: 10.1200/edbk_238315.Peer-Reviewed Original ResearchConceptsDe-escalate treatmentOropharyngeal carcinomaHPV-positive oropharyngeal carcinomaNeck cancer clinical researchNew systemic agentsPhase II trialPhase III trialsTreatment-related morbidityHigh cure ratesCancer clinical researchConcurrent cisplatinII trialOropharynx cancerPrimary surgeryDose intensityIII trialsInstitutional seriesInvasive resectionMultimodality treatmentSystemic agentsSystemic therapyPrimary diseaseCure rateToxic therapiesMultimodality strategyRole of Treatment Deintensification in the Management of p16+ Oropharyngeal Cancer: ASCO Provisional Clinical Opinion
Adelstein DJ, Ismaila N, Ku JA, Burtness B, Swiecicki PL, Mell L, Beitler JJ, Gross N, Jones CU, Kaufman M, Le QT, Semrad TJ, Siu LL, Ridge JA. Role of Treatment Deintensification in the Management of p16+ Oropharyngeal Cancer: ASCO Provisional Clinical Opinion. Journal Of Clinical Oncology 2019, 37: jco.19.00441. PMID: 31021656, DOI: 10.1200/jco.19.00441.Peer-Reviewed Original ResearchConceptsProvisional clinical opinionASCO's provisional clinical opinionsTreatment deintensificationOropharyngeal cancerClinical opinionClinical trialsGood prognosis subsetPractice-changing dataTransoral surgical techniquesAmerican Joint CommitteeCancer (AJCC) staging systemEarly-stage diseaseCurrent treatment standardsCurrent treatment approachesCurrent eighth editionLong-term toxicityBetter treatment resultsLate toxicitySystemic treatmentStaging systemIntensity-modulated radiation therapy (IMRT) planningSurgical techniqueTherapeutic decisionsAmeliorate toxicityASCO's membership
2018
Radiotherapy plus cetuximab or cisplatin in human papillomavirus-positive oropharyngeal cancer (NRG Oncology RTOG 1016): a randomised, multicentre, non-inferiority trial
Gillison ML, Trotti AM, Harris J, Eisbruch A, Harari PM, Adelstein DJ, Jordan RCK, Zhao W, Sturgis EM, Burtness B, Ridge JA, Ringash J, Galvin J, Yao M, Koyfman SA, Blakaj DM, Razaq MA, Colevas AD, Beitler JJ, Jones CU, Dunlap NE, Seaward SA, Spencer S, Galloway TJ, Phan J, Dignam JJ, Le QT. Radiotherapy plus cetuximab or cisplatin in human papillomavirus-positive oropharyngeal cancer (NRG Oncology RTOG 1016): a randomised, multicentre, non-inferiority trial. The Lancet 2018, 393: 40-50. PMID: 30449625, PMCID: PMC6541928, DOI: 10.1016/s0140-6736(18)32779-x.Peer-Reviewed Original ResearchConceptsHPV-positive oropharyngeal carcinomaProgression-free survivalOverall survivalNon-inferiority trialCisplatin groupCetuximab groupOropharyngeal carcinomaSevere toxicityEligibility criteriaPositive oropharyngeal squamous cell carcinomaHuman papillomavirus-positive oropharyngeal cancerNational Cancer Institute-USAZubrod performance status 0Oropharyngeal squamous cell carcinomaAdequate bone marrowPerformance status 0Replacement of cisplatinZubrod performance statusInferior overall survivalTobacco smoking historyAmerican Joint CommitteeNon-inferiority criteriaSquamous cell carcinomaStandard of careNon-inferiority marginPatterns of failure in high-metastatic node number human papillomavirus-positive oropharyngeal carcinoma
Lee NCJ, Kelly JR, Park HS, An Y, Judson BL, Burtness BA, Husain ZA. Patterns of failure in high-metastatic node number human papillomavirus-positive oropharyngeal carcinoma. Oral Oncology 2018, 85: 35-39. PMID: 30220317, DOI: 10.1016/j.oraloncology.2018.08.001.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrachytherapyCarcinoma, Squamous CellCombined Modality TherapyFemaleFollow-Up StudiesHumansLymphatic MetastasisMaleMiddle AgedNeck DissectionNeoplasm MetastasisNeoplasm Recurrence, LocalOropharyngeal NeoplasmsPapillomavirus InfectionsProgression-Free SurvivalProportional Hazards ModelsRadiotherapy, AdjuvantRetrospective StudiesSalvage TherapyConceptsProgression-free survivalInvolved lymph nodesDistant metastasisPatterns of failureLocoregional recurrenceLymph nodesHuman papillomavirus-positive oropharyngeal carcinomaMultivariate analysisEdition American Joint CommitteeRate of DMWorse progression-free survivalHigh DM rateDedicated clinical trialsAmerican Joint CommitteeCancer (AJCC) staging systemProportional hazards regressionExternal beam radiationOropharynx cancerFree survivalNeck dissectionOropharyngeal carcinomaOverall survivalDisease recurrenceIntraoperative brachytherapyOPC patientsNational treatment times in oropharyngeal cancer treated with primary radiation or chemoradiation
Morse E, Judson B, Husain Z, Burtness B, Yarbrough W, Sasaki C, Cheraghlou S, Mehra S. National treatment times in oropharyngeal cancer treated with primary radiation or chemoradiation. Oral Oncology 2018, 82: 122-130. PMID: 29909886, DOI: 10.1016/j.oraloncology.2018.02.010.Peer-Reviewed Original ResearchMeSH KeywordsAgedCarcinoma, Squamous CellChemoradiotherapyFemaleHumansMaleMiddle AgedOropharyngeal NeoplasmsPrognosisRetrospective StudiesSurvival AnalysisTime FactorsConceptsRadiation treatment durationHuman papilloma virus-positive tumorsVirus-positive tumorsOverall survivalOropharyngeal cancerTreatment durationTreatment endMedian durationTreatment initiationTreatment delayHuman papilloma virus-associated tumorsHuman papilloma virus-negative tumorsEnd intervalOropharyngeal squamous cell carcinomaCox proportional hazards regressionNational Cancer DatabaseProportional hazards regressionSquamous cell carcinomaVirus-associated tumorsVirus-negative tumorsMultivariable logisticHazards regressionCell carcinomaHuman papillomaCancer DatabaseUpfront surgery versus definitive chemoradiotherapy in patients with human Papillomavirus-associated oropharyngeal squamous cell cancer
Kelly JR, Park HS, An Y, Yarbrough WG, Contessa JN, Decker R, Mehra S, Judson BL, Burtness B, Husain Z. Upfront surgery versus definitive chemoradiotherapy in patients with human Papillomavirus-associated oropharyngeal squamous cell cancer. Oral Oncology 2018, 79: 64-70. PMID: 29598952, DOI: 10.1016/j.oraloncology.2018.02.017.Peer-Reviewed Original ResearchMeSH KeywordsAgedAlphapapillomavirusChemoradiotherapyFemaleHumansMaleMiddle AgedOropharyngeal NeoplasmsProspective StudiesSquamous Cell Carcinoma of Head and NeckSurvival AnalysisConceptsNational Cancer DatabasePrimary surgeryOverall survivalAdjuvant chemoradiotherapyDefinitive chemoradiotherapyUpfront surgerySurgical patientsHuman papillomavirus-associated oropharyngeal squamous cell carcinomaOropharyngeal squamous cell carcinomaPropensity score-matched analysisOropharyngeal squamous cell cancerCox proportional hazards regressionMultivariable Cox regressionNon-private insuranceInferior overall survivalMargin-negative resectionSquamous cell cancerProportional hazards regressionSquamous cell carcinomaLog-rank testChi-square testClinicopathologic predictorsSimilar OSSurgery patientsTrimodal therapy
2017
Comparison of Survival Outcomes Among Human Papillomavirus–Negative cT1-2 N1-2b Patients With Oropharyngeal Squamous Cell Cancer Treated With Upfront Surgery vs Definitive Chemoradiation Therapy: An Observational Study
Kelly JR, Park HS, An Y, Contessa JN, Yarbrough WG, Burtness BA, Decker R, Husain Z. Comparison of Survival Outcomes Among Human Papillomavirus–Negative cT1-2 N1-2b Patients With Oropharyngeal Squamous Cell Cancer Treated With Upfront Surgery vs Definitive Chemoradiation Therapy: An Observational Study. JAMA Oncology 2017, 3: 1107-1111. PMID: 28056116, PMCID: PMC5824218, DOI: 10.1001/jamaoncol.2016.5769.Peer-Reviewed Original ResearchConceptsOropharyngeal squamous cell carcinomaHPV-negative oropharyngeal squamous cell carcinomaNegative oropharyngeal squamous cell carcinomaMultivariable Cox regressionPrimary surgical resectionOverall survivalUpfront surgerySurgical resectionObservational studyChemoradiation therapySurgical patientsAdjuvant CRTSurvival outcomesCox regressionNational Cancer Data BaseOropharyngeal squamous cell cancerDefinitive chemoradiation therapyMost surgical patientsConcurrent chemoradiation therapyHPV-positive diseaseMargin-negative resectionOptimal patient selectionPrimary treatment modalityUpfront surgical resectionKaplan-Meier analysisPurpose of Induction Chemotherapy in E1308 and Importance of Patient-Reported Outcomes in Deintensification Trials
Marur S, Cmelak AJ, Burtness B. Purpose of Induction Chemotherapy in E1308 and Importance of Patient-Reported Outcomes in Deintensification Trials. Journal Of Clinical Oncology 2017, 35: jco.2017.72.291. PMID: 28430529, DOI: 10.1200/jco.2017.72.2918.Peer-Reviewed Original ResearchMeSH KeywordsChemoradiotherapyHumansInduction ChemotherapyOropharyngeal NeoplasmsPapillomaviridaePatient Reported Outcome MeasuresThe prognostic value of extranodal extension in human papillomavirus‐associated oropharyngeal squamous cell carcinoma
An Y, Park HS, Kelly JR, Stahl JM, Yarbrough WG, Burtness BA, Contessa JN, Decker RH, Koshy M, Husain ZA. The prognostic value of extranodal extension in human papillomavirus‐associated oropharyngeal squamous cell carcinoma. Cancer 2017, 123: 2762-2772. PMID: 28323338, DOI: 10.1002/cncr.30598.Peer-Reviewed Original ResearchMeSH KeywordsCarcinoma, Squamous CellChemoradiotherapy, AdjuvantFemaleHead and Neck NeoplasmsHumansMaleMiddle AgedMultivariate AnalysisNeoplasm InvasivenessNeoplasm StagingOropharyngeal NeoplasmsOtorhinolaryngologic Surgical ProceduresPapillomaviridaePapillomavirus InfectionsPrognosisPropensity ScoreProportional Hazards ModelsRadiotherapy, AdjuvantRetrospective StudiesSquamous Cell Carcinoma of Head and NeckSurvival RateConceptsOropharyngeal squamous cell carcinomaENE-positive patientsHPV-positive oropharyngeal squamous cell carcinomaExtranodal extensionHPV-positive patientsOverall survivalPrimary surgeryPT4 tumorsAdjuvant chemoradiationConcurrent chemoradiotherapyAdjuvant treatmentPositive oropharyngeal squamous cell carcinomaPT3/pT4 tumorsMultivariable Cox regression analysisNational Cancer Data BasePredictors of OSPropensity score-matched comparisonAdjuvant concurrent chemoradiotherapyCharlson-Deyo scoreInvolved lymph nodesAdverse prognostic factorInferior overall survivalLymph node statusCox regression analysisSingle-institution studyTRAF3/CYLD mutations identify a distinct subset of human papillomavirus‐associated head and neck squamous cell carcinoma
Hajek M, Sewell A, Kaech S, Burtness B, Yarbrough WG, Issaeva N. TRAF3/CYLD mutations identify a distinct subset of human papillomavirus‐associated head and neck squamous cell carcinoma. Cancer 2017, 123: 1778-1790. PMID: 28295222, PMCID: PMC5419871, DOI: 10.1002/cncr.30570.Peer-Reviewed Original ResearchConceptsHPV-positive HNSCCNeck squamous cell carcinomaDe-escalation therapyHPV-positive HNSCCsMechanisms of HPVRecurrent metastatic diseaseBetter overall survivalSquamous cell carcinomaNuclear factor-κB signalingFactor-κB signalingNew therapeutic strategiesNuclear factor κBHPV vaccineCancer Genome AtlasCurative optionHPV statusMetastatic diseaseOverall survivalCervical cancerPatient survivalSmoking characteristicsCell carcinomaHuman papillomavirusLifelong morbidityClinical trialsA Comparison of Prognostic Ability of Staging Systems for Human Papillomavirus–Related Oropharyngeal Squamous Cell Carcinoma
Husain ZA, Chen T, Corso CD, Wang Z, Park H, Judson B, Yarbrough W, Deshpande H, Mehra S, Kuo P, Decker RH, Burtness BA. A Comparison of Prognostic Ability of Staging Systems for Human Papillomavirus–Related Oropharyngeal Squamous Cell Carcinoma. JAMA Oncology 2017, 3: 358-365. PMID: 27737449, DOI: 10.1001/jamaoncol.2016.4581.Peer-Reviewed Original ResearchConceptsOropharyngeal squamous cell cancerAJCC/UICC systemStaging systemStage IAStage IBHuman papillomavirusPrognostic abilityUICC systemAJCC/UICC staging systemStage IICurrent American Joint CommitteeOropharyngeal squamous cell carcinomaInternational Cancer Control (UICC) staging systemOropharyngeal cancer NetworkNational Cancer DatabasePrimary radiation therapyOverall survival rateAmerican Joint CommitteeCancer/UnionEdition staging systemKaplan-Meier methodSquamous cell cancerNovel staging systemSquamous cell carcinomaLog-rank testThe risk of level IB nodal involvement in oropharynx cancer: Guidance for submandibular gland sparing irradiation
Lee NCJ, Kelly JR, Park HS, Yarbrough WG, Burtness BA, Husain ZA. The risk of level IB nodal involvement in oropharynx cancer: Guidance for submandibular gland sparing irradiation. Practical Radiation Oncology 2017, 7: e317-e321. PMID: 28356201, DOI: 10.1016/j.prro.2017.02.004.Peer-Reviewed Original ResearchMeSH KeywordsCarcinoma, Squamous CellFemaleHead and Neck NeoplasmsHumansLymph Node ExcisionLymph NodesLymphatic MetastasisMaleMiddle AgedNeoplasm StagingOrgan Sparing TreatmentsOropharyngeal NeoplasmsPapillomaviridaeParotid GlandRadiotherapy, AdjuvantRetrospective StudiesSquamous Cell Carcinoma of Head and NeckSubmandibular GlandXerostomiaConceptsOropharyngeal squamous cell cancerPositive nodesNodal involvementLevel Ib lymph nodesIb lymph nodesPrimary surgical treatmentRetrospective chart reviewCohort of patientsCommon side effectsSquamous cell cancerIpsilateral neckNodal dissectionOropharynx cancerChart reviewNeck irradiationLymph nodesSurgical treatmentCell cancerLevel IbNodal stationsNegative imagingRadiation therapyLower riskSide effectsPatients
2016
E1308: Phase II Trial of Induction Chemotherapy Followed by Reduced-Dose Radiation and Weekly Cetuximab in Patients With HPV-Associated Resectable Squamous Cell Carcinoma of the Oropharynx— ECOG-ACRIN Cancer Research Group
Marur S, Li S, Cmelak AJ, Gillison ML, Zhao WJ, Ferris RL, Westra WH, Gilbert J, Bauman JE, Wagner LI, Trevarthen DR, Balkrishna J, Murphy BA, Agrawal N, Colevas AD, Chung CH, Burtness B. E1308: Phase II Trial of Induction Chemotherapy Followed by Reduced-Dose Radiation and Weekly Cetuximab in Patients With HPV-Associated Resectable Squamous Cell Carcinoma of the Oropharynx— ECOG-ACRIN Cancer Research Group. Journal Of Clinical Oncology 2016, 35: 490-497. PMID: 28029303, PMCID: PMC5455313, DOI: 10.1200/jco.2016.68.3300.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAntineoplastic Combined Chemotherapy ProtocolsCarcinoma, Squamous CellCetuximabChemoradiotherapyDisease-Free SurvivalDrug Administration ScheduleExanthemaFemaleHuman papillomavirus 16HumansInduction ChemotherapyMaleMiddle AgedNeutropeniaOropharyngeal NeoplasmsPapillomavirus InfectionsRadiotherapy DosageRemission InductionConceptsOropharyngeal squamous cell carcinomaComplete clinical responseCycle of ICPhase II trialProgression-free survivalSquamous cell carcinomaWeekly cetuximabII trialCell carcinomaPack-year smoking historyResectable squamous cell carcinomaFavorable-risk patientsPrimary end pointOverall survival rateHigh cure ratesCancer Research GroupGy of radiationRadiation doseLong-term toxicityRadiation dose reductionChemoradiation resultsICS respondersInduction chemotherapyLate sequelaeClinical responseTreatment de-intensification strategies for head and neck cancer
Kelly JR, Husain ZA, Burtness B. Treatment de-intensification strategies for head and neck cancer. European Journal Of Cancer 2016, 68: 125-133. PMID: 27755996, PMCID: PMC5734050, DOI: 10.1016/j.ejca.2016.09.006.Peer-Reviewed Original ResearchMeSH KeywordsCarcinoma, Squamous CellChemoradiotherapyCombined Modality TherapyHead and Neck NeoplasmsHumansMinimally Invasive Surgical ProceduresOropharyngeal NeoplasmsOtorhinolaryngologic Surgical ProceduresPapillomavirus InfectionsRadiotherapy DosageRadiotherapy, AdjuvantSquamous Cell Carcinoma of Head and NeckConceptsHigh-risk human papillomavirus infectionHuman papillomavirus infectionLong-term morbiditySquamous cell cancerSquamous cell carcinomaDe-intensification strategiesIntensive treatment regimensAltered fractionation schemesDefinitive chemoradiationAdjuvant radiationPapillomavirus infectionCell cancerImpairs qualityTreatment regimensCell carcinomaNeck cancerRecent trialsSimilar efficacySuch cancersInvasive surgeryTreatment intensityCancerRadiation dosePreliminary dataSurgery