Mouthwash may hold the key to determining whether these cancers will come back.
Researchers have discovered a mouthwash-based saliva test that can detect biomarkers associated with head and neck cancers. In a study published in JAMA Otolaryngology – Head & Neck Surgery, researchers suggest that two key biomarkers in saliva collected from an oral rinse after initial treatment can effectively assess recurrence risk. Elevated levels of the biomarkers, CD44 and total protein levels, show a strong association with the likelihood of cancer recurrence.
According to Dr. Elizabeth Franzmann, a co-corresponding author of the study, “This simple yet powerful test could pave the way for less invasive and more accurate monitoring for patients who have already undergone treatment for head and neck cancers.”
Head and neck cancers make up nearly 4% of all cancer diagnoses in the U.S., with men over the age of 50 being particularly susceptible, according to the National Cancer Institute (NCI). Primary treatment for these cancers typically involves surgery or radiation, both of which can significantly impact a patient’s quality of life. Recurrence of the disease can worsen these side effects, making early detection vital for improving survival rates and overall livelihood.
“It can be very difficult to determine if what you’re observing is just post-treatment changes or a cancer recurrence,” said Dr. Joseph Califano, co-corresponding author and director of UC San Diego’s Hanna and Mark Gleiberman Head and Neck Cancer Center. “The identification of reliable biomarkers could offer a new way to distinguish between the two, eliminating some of the guesswork.”
“These patients suffer terribly,” Franzmann said. “The more we can minimize those effects by catching recurrence early, the better we can mitigate patient morbidity and mortality.”
The new study is an extension of previous research conducted by Franzmann’s lab, which found that the same two biomarkers can help determine the level of risk associated with developing oral or oropharyngeal cancers.
The clinical trial, which involved more than 160 patients from multiple cancer centers, used both laboratory tests and experimental lateral-flow tests (similar to a stick-based pregnancy and COVID-19 tests) to measure the presence of CD44 and total protein in saliva samples. The team found that patients with heightened levels of these biomarkers had a significantly higher risk of the cancers returning. Specifically, patients with approximately double the normal protein levels three months after treatment were found to have a 65% greater risk of returning, while those with CD44 levels three times the normal range had a 62% higher chance of coming back.
This test could potentially be used during routine follow-up visits, offering immediate results to both patients and physicians. “It would be really useful if we had a test that was inexpensive and could be performed and resulted while the patient was in the office,” Franzmann said, adding that further research is needed, however, to validate results and come up with the best uses for the new technology. In future studies might also focus on applying the same methods to detect the resurgence of other cancers.
The team concluded in their paper, “The CD44 and TP rapid POC test holds some promise, but further development is needed for this indication.”
Sources:
Salivary CD44 and Total Protein Levels to Detect Risk for Oral and Oropharyngeal Cancer Recurrence
Saliva test offers hope for head and neck cancer patients
Expression of CD44 in Head and Neck Squamous Cell Carcinoma—An In-Silico Study
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