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HeadLines - Does the DNA of Head and Neck Tumors Hold Secrets for Better Treatment?

Summer 2010

Does the DNA of Head and Neck Tumors Hold Secrets for Better Treatment?

Date: June 14, 2010

Nishant Agrawal
Nishant Agrawal is on the trail of mutations that could yield important treatment insights.
Keith Weller

Imagine sifting through every individual grain of sand on a square-mile stretch of shoreline. It’s much like the task Nishant Agrawal and his collaborators have set for themselves as, in a quest to better understand head and neck cancer, they conduct a genome sequence on eight malignant head and neck tumors known as squamous cell carcinomas.

While advancements in surgery and oncology have enhanced physicians’ ability to treat head and neck cancer in just the last decade, disadvantages still remain. For instance, when it comes to chemotherapy, there are multiple types, and different ones work better for different patients. Physicians are often challenged to predict which one will most benefit a given patient, how many treatment rounds will be needed, whether surgery alone is enough, or whether the patient will need both chemotherapy and surgery.

As a result, treatments are generally nonspecific to the individual, and patients may endure multiple treatment modalities in hopes of improving their prognosis and outcome. But, says Agrawal, a better understanding of the genetics of head and neck cancer could give oncologists the tools and knowledge they need to tailor cancer therapies to individuals.

By studying the DNA of head and neck tumors, researchers strive to better understand the root cause of cancer as it develops. “It is widely accepted that cancer is a disease caused by accumulation of mutations in specific genes,” Agrawal explains. “We are looking to find these changes in head and neck cancer since they have not been described in a comprehensive, unbiased manner.”

To do so, Agrawal—along with colleagues David Sidransky, Victor Velculescu and other collaborators from around Hopkins—are examining the DNA of eight different tumors. “First we collect tumors and blood from patients. From there we harvest both tumor DNA and normal DNA,” he explains. “With that, we will sequence the DNA and identify any non-inherited mutations.”

Identifying these mutations provides insight into how cells become cancerous, Agrawal says. “Fully understanding the compendium of molecular alterations in head and neck cancer should set the stage for targeted molecular testing in individual patients and focused treatments so that we can increase efficacy while decreasing toxicity.”