October 14, 2004
Dana-Farber to lead national trial on head and neck cancer
Marshall Posner, MD
Marshall Posner, MD, director of the Head and Neck Oncology Program, has received $2.3 million in funding for a Phase III clinical trial that could determine the best treatment for patients with cancers of the mouth, tongue, larynx, and other oral and throat structures. The cancers are squamous cell carcinomas, which affect the linings of these structures and are by far the most common forms of head and neck cancer.
A dozen or more research centers around the country will carry out the study, which compares two regimens in which patients receive intense courses of radiation and chemotherapy aimed at curing them without requiring drastic surgery.
The trial, funded by the drug company Aventis, will involve 330 patients nationwide, 75 of them at Dana-Farber. Posner is the principal investigator for the overall study, called the Paradigm Trial. The protocol was co-written by Posner, Roy Tishler, MD, and Robert Haddad, MD, all of the Dana-Farber/Brigham and Women's Cancer Center Head and Neck Oncology Program.
The current standard treatment for head and neck cancers, known as "chemoradiotherapy," uses a combination of chemotherapy drugs and high-intensity radiation given simultaneously over several weeks.
In preliminary studies, Posner and his colleagues have obtained better results with what they call "sequential therapy." Patients initially receive a large dose of chemotherapy with Taxotere, platinum, and 5-FU, which often shrinks the tumor dramatically. This is followed by the chemoradiotherapy regimen aimed at preventing the spread of remaining cancer cells.
If the sequential therapy improves patient survival compared to the current chemoradiation treatment — as Posner believes — it will likely become the standard therapy for these cancers, which strike about 40,000 patients a year nationwide.
"This has been an enormous undertaking," Posner says. "It is a high-impact trial with the possibility of changing practice standards in the United States for treating squamous cell carcinomas of the head and neck."
