Publications by authors named "Ashish Chintakuntlawar"
Background: The overall survival of patients with advanced thyroid cancers that have progressed following targeted therapies is limited, indicating a strong need for salvage treatments.
Methods: We retrospectively analyzed patients with refractory advanced thyroid cancer treated with pemetrexed-carboplatin (PC) at Mayo Clinic since 2019.
Results: Eleven patients, three with anaplastic thyroid cancer (ATC), seven with differentiated or poorly differentiated thyroid cancer (DTC), and one with oncocytic carcinoma of the thyroid, were treated with novel salvage PC.
Background: Poly (ADP-ribose) polymerase inhibitors (PARPis) are approved as first-line therapies for breast cancer gene ()-positive, human epidermal growth factor receptor 2-negative locally advanced or metastatic breast cancer. They are also effective for new and recurrent ovarian cancers that are - or homologous recombination deficiency (HRD)-positive. However, data on these mutations and PARPi use in the Middle East are limited.
View Article and Find Full Text PDF: Non-Hodgkin lymphoma (NHL) has the sixth-highest malignancy-related mortality in the United States (US). However, inequalities exist in access to advanced care in specific patient populations. We aim to study the racial disparities in major adverse cardiovascular and cerebrovascular events (MACCEs) in NHL patients.
View Article and Find Full Text PDFArticle Synopsis
- Patients with metastatic HPV-associated oropharyngeal cancer often have a good survival rate of over 2 years but face limited treatment options after immunotherapy, prompting the exploration of capecitabine as a salvage therapy.
- A retrospective study investigated the outcomes of 10 patients who received capecitabine, primarily as a fourth-line treatment, with results showing a median survival of 10.5 months, and a clinical benefit rate of 70%.
- Findings suggest that capecitabine may provide extended benefits for some heavily pretreated patients, but further research is needed to identify predictive factors for response and to confirm its efficacy through larger studies.
Article Synopsis
- The study analyzed long-term clinical outcomes for 89 patients with salivary duct carcinoma (SDC), revealing a poor prognosis associated with the disease.
- Key findings indicated that the median age at diagnosis was 66 years and the 5-year overall survival rate was only 42%.
- Factors such as lymph node involvement, higher disease staging, and perineural invasion were significantly linked to worse survival outcomes and increased risk of distant metastasis.
Article Synopsis
- This study investigates how absolute lymphocyte count (ALC) impacts outcomes in patients with HPV-related oropharyngeal cancer before, during, and after treatment.
- The research was based on a retrospective analysis of 197 patients treated between 2006 and 2018, using statistical methods to assess ALC's influence on cancer progression and survival.
- Key findings indicate that a lower baseline ALC is linked to poorer overall survival, while a lower postoperative ALC increases the risk of cancer progression.
Article Synopsis
- Study examines factors contributing to delays in diagnosing non-HPV-associated oropharyngeal squamous cell carcinoma (HPV(-)OPSCC) at a tertiary care center from 2006 to 2016.
- * A total of 70 patients analyzed, showing median time from symptom onset to diagnosis was 69 days, with significant delays often due to patients seeing multiple providers.
- * Findings suggest that education for both patients and healthcare providers is crucial to improve the timely diagnosis of HPV(-)OPSCC and reduce delays caused by misdiagnosis.
The Number of Radiographically Positive Lymph Nodes Further Stratifies Patient Survival Among Clinical N1 Patients With Human Papillomavirus-Associated Oropharyngeal Cancer.
Adv Radiat Oncol
February 2022
Article Synopsis
- HPV-associated oropharyngeal squamous cell carcinoma (HPV[+]OPSCC) needs refined clinical staging to enhance treatment decisions, specifically by analyzing the number of radiographically positive lymph nodes in patients classified as clinical N1 (cN1).
- A study involving 260 patients who underwent surgical treatment and various radiation therapies found that the count of positive lymph nodes significantly influenced progression-free survival (PFS), with higher counts correlating to worse outcomes.
- The findings suggest using the number of positive lymph nodes as a meaningful categorization tool for cN1 patients with HPV(+)OPSCC, warranting further research to validate these results.
Long-Term Toxic Effects, Swallow Function, and Quality of Life on MC1273: A Phase 2 Study of Dose De-escalation for Adjuvant Chemoradiation in Human Papillomavirus-Positive Oropharyngeal Cancer.
Int J Radiat Oncol Biol Phys
October 2022
Purpose: Patients with human papillomavirus oropharyngeal cancer are highly curable but risk significant long-term toxic effects with standard therapy. This study investigated a de-escalation strategy of decreased adjuvant radiation therapy and chemotherapy after transoral robotic surgery, and reports on long-term functional and quality of life (QOL) outcomes.
Methods And Materials: Eligible patients had a p16-positive oropharyngeal cancer and ≤10 pack-year smoking history and underwent surgery followed by treatment with either 30 Gy delivered in 1.
Purpose Of Review: The aim of this review is to describe less known and emerging disparities found in the prevention and survival outcomes for patients with head and neck cancer (HNC) that are likely to play an increasingly important role in HNC outcomes and health inequities.
Recent Findings: The following factors contribute to HNC incidence and outcomes: (1) the effect of rurality on prevention and treatment of HNC, (2) dietary behavior and nutritional factors influencing the development of and survival from HNC, and (3) barriers and benefits of telehealth for patients with HNC. Rurality, nutrition and diet, and telehealth usage and access are significant contributors to the existing health disparities associated with HNC.
Context: Metastatic pheochromocytomas and paragangliomas (mPPGL) are rare vascular neuroendocrine tumors that highly express vascular growth factors. Systemic treatment options in cases of unresectable multisite disease are limited. Multikinase inhibitors that inhibit angiogenesis, such as lenvatinib, have proven effective in several other malignancies, and may be a viable option for mPPGL.
View Article and Find Full Text PDFObjective: Esthesioneuroblastoma (ENB) is a rare malignant neoplasm arising from the olfactory epithelium of the cribriform plate. The goal of this study was to update our oncologic outcomes for this disease and explore prognostic factors associated with survival.
Materials And Methods: We performed a retrospective analysis of patients with ENB treated at a single tertiary care institution from January 1, 1960, to January 1, 2020.
Article Synopsis
- The text discusses the growing field of systemic treatment options for advanced thyroid cancer, highlighting its multidisciplinary nature and evidence-based approaches.
- An expert panel conducted a comprehensive literature review to create best practice statements and assess consensus using the modified Delphi method.
- Key findings include a molecular understanding of thyroid cancer, defined characteristics of advanced disease, and 20 statements on management, molecular evaluation, and targeted treatments.
Detectable Postoperative Circulating Tumor Human Papillomavirus DNA and Association with Recurrence in Patients With HPV-Associated Oropharyngeal Squamous Cell Carcinoma.
Int J Radiat Oncol Biol Phys
July 2022
Article Synopsis
- The study aims to evaluate how detectable ctHPVDNA (circulating tumor HPV DNA) is in patients with HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) after surgery but before starting additional therapy, and to assess if this detectability indicates a higher risk of cancer recurrence.
- A total of 204 samples were analyzed from patients, including 45 pre-surgery and 159 post-surgery, with significant findings that 94% had ctHPVDNA detectable before surgery, while only 41% did post-surgery.
- Results showed that patients with detectable ctHPVDNA after surgery had an 83% survival rate without recurrence after 18 months, compared to a 100% rate for those
Article Synopsis
- The study investigates the effectiveness of CT and PET/CT scans in detecting involvement of more than 4 lymph nodes (rN2) and extranodal extension (rENE) in patients with HPV-positive oropharyngeal cancer.
- Results showed CT had a sensitivity of 59% and specificity of 92% for detecting more than 4 lymph nodes, while both imaging techniques performed similarly overall.
- Patients with fewer than 4 involved lymph nodes (rN0-1) had a high likelihood of being classified as pN0-1, indicating that rN0-1 status can help guide treatment decisions and clinical trial participation.
Purpose: Radiation therapy (RT) plays an important role in locoregional tumor control for anaplastic thyroid cancer (ATC). Due to its rarity, RT guidelines for ATC are lacking. We describe ATC patterns of nodal disease at presentation and progression and propose corresponding RT target volumes.
View Article and Find Full Text PDFEsthesioneuroblastoma (ENB) is a rare olfactory malignancy that can present with locally advanced disease. At our institution, patients with ENB in whom the treating surgeon believes that a margin-negative resection is initially not achievable are selected to undergo induction with chemotherapy with or without radiotherapy prior to surgery. In a retrospective review of 61 patient records, we identified six patients (10%) treated with this approach.
View Article and Find Full Text PDFObjective: To describe and compare rates of metachronous and synchronous second primaries of the contralateral tonsil in patients with primary HPV(+) tonsillar squamous cell carcinoma (SCC).
Study Design: Retrospective cohort study.
Materials And Methods: This is a single tertiary care center retrospective case series, from 2006 to 2019, of HPV(+) tonsillar SCC patients who underwent primary surgical resection with unilateral wide-field tonsillectomy or bilateral tonsillectomy for diagnostic or therapeutic purposes.
Phase 1 study of safety, tolerability and immunogenicity of the human telomerase (hTERT)-encoded DNA plasmids INO-1400 and INO-1401 with or without IL-12 DNA plasmid INO-9012 in adult patients with solid tumors.
J Immunother Cancer
July 2021
Background: Human telomerase reverse transcriptase (hTERT) is frequently classified as a 'universal' tumor associated antigen due to its expression in a vast number of cancers. We evaluated plasmid DNA-encoded hTERT as an immunotherapy across nine cancer types.
Methods: A phase 1 clinical trial was conducted in adult patients with no evidence of disease following definitive surgery and standard therapy, who were at high risk of relapse.
Article Synopsis
- The study investigates the impact of delayed diagnosis on patients with human papillomavirus-associated oropharynx squamous cell carcinoma (HPV(+)OPSCC), focusing on those diagnosed more than 12 months after symptom onset.
- Findings reveal that patients with a delayed diagnosis tend to present with more advanced disease stages, yet their long-term survival rates remain relatively high and comparable to those diagnosed earlier.
- Despite the increased disease burden at presentation, the study concludes that oncologic outcomes for delayed diagnosis patients are favorable, suggesting that treatment should not be postponed based solely on diagnosis timing.
Background: Cutaneous squamous cell carcinomas (CSCC) involving the head and neck are common, but initial presentation or recurrence limited to the cranial nerves is rare.
Methods: We conducted a retrospective study of 21 patients with clinical perineural invasion (PNI) from CSCC and no measurable disease by RECIST 1.1.
Article Synopsis
- There is a significant shift in the treatment of aggressive thyroid cancers, focusing on matching patients with targeted therapies based on their genetic mutations or fusions, like selective RET inhibitors.
- The role of genomics is becoming important for predicting outcomes and determining the best treatment options, including potential responses to traditional therapies.
- Although progress has been made, especially in clinical trials, more work is needed to improve treatment outcomes for difficult cases of thyroid cancer, such as radioactive-iodine refractory and anaplastic thyroid cancers, emphasizing the importance of clinical trial participation.
Article Synopsis
- A study compared the costs of treating HPV+ oropharyngeal squamous cell carcinoma using three different methods: definitive chemoradiation (CRT), surgery with adjuvant radiation (RT), and surgery with a de-escalated approach (MC1273).
- The analysis included data from 56 CRT patients, 101 adjuvant RT patients, and 66 MC1273 patients, highlighting the significant differences in disease severity and treatment costs among these groups.
- Results indicated that total treatment costs were lowest in the MC1273 group, with lower per-patient follow-up costs compared to the other methods, suggesting potential benefits of de-escalated treatment strategies.
Background: Aggressive dose de-escalated adjuvant radiation therapy (RT) in patients with human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPV(+)OPSCC).
Methods: Patients with HPV(+)OPSCC on a phase II clinical trial of primary surgery and neck dissection followed by dose de-escalated RT (N = 79) were compared with a cohort of patients who received standard adjuvant therapy (N = 115). Local recurrence-free, regional recurrence-free, distant metastases-free survival, and progression-free survival (PFS) were assessed.