The analysis of cathepsin L that mediates cellular SARS-CoV-2 infection leading to COVID-19 in head and neck squamous cell carcinoma.

The vulnerability of the oral cavity to SARS-CoV-2 infection is well-known, and cancer patients are at a higher risk of COVID-19, emphasizing the need to prioritize this patient population. Head and neck squamous cell carcinoma (HNSCC) is one of the most common malignant cancers associated with early metastasis and poor prognosis. It has been established that cancerous tissues express Cathepsin L (CTSL), a proteinase that regulates cancer progression and SARS-CoV-2 entry. Therefore, it is essential to evaluate the correlation between disease outcomes and CTSL expression in cancer tissues and predict the susceptibility of cancer patients to SARS-CoV-2. In this study, we used transcriptomic and genomic data to profile CTSL expression in HNSCC and developed a CTSL signature that could reflect the response of HNSCC patients to chemotherapy and immunotherapy. Additionally, we investigated the relationship between CTSL expression and immune cell infiltration and established CTSL as a potential carcinogenic factor for HNSCC patients. These findings could aid in understanding the mechanisms underlying the increased susceptibility of HNSCC patients to SARS-CoV-2 and contribute to the development of therapy for both HNSCC and COVID-19.

Comprehensive analysis of the novel omicron receptor AXL in cancers.

The SARS-CoV-2 is constantly mutating, and the new coronavirus such as Omicron has spread to many countries around the world. Anexelekto (AXL) is a transmembrane protein with biological functions such as promoting cell growth, migration, aggregation, metastasis and adhesion, and plays an important role in cancers and coronavirus disease 2019 (COVID-19). Unlike angiotensin-converting enzyme 2 (ACE2), AXL was highly expressed in respiratory system cells. In this study, we verified the AXL expression in cancer and normal tissues and found AXL expression was strongly correlated with cancer prognosis, tumor mutation burden (TMB), the microsatellite instability (MSI) in most tumor types. Immune infiltration analysis also demonstrated that there was an inextricable link between AXL expression and immune scores in cancer patients, especially in BLCA, BRCA and CESC. The NK-cells, plasmacytoid dendritic cells, myeloid dendritic cells, as one of the important components of the tumor microenvironment, were highly expressed AXL. In addition, AXL-related tumor neoantigens were identified and might provide the novel potential targets for tumor vaccines or SARS-Cov-2 vaccines research in cancer patients.

Effects of the COVID-19 pandemic on elderly patients with head and neck squamous cell carcinoma.

Background: The 2019 novel coronavirus disease (COVID-19) strongly affects health care activities in countries around the world. The diagnosis and treatment of cancer have also been involved, and elderly head and neck squamous carcinoma is one of them. This study aimed to assess the impact of COVID-19 on elderly patients with head and neck squamous cell carcinoma (HNSCC) in our center. Methods: This retrospective study analyzed the clinical characteristics of 400 HNSCC patients over 65 years of age, calculated their treatment interruption rates, and compared the time of delayed diagnosis. Results: The rate of elderly patients with HNSCC with a delayed diagnosis was higher in the "during COVID-19 pandemic" group (DCOV19 group) than in the "during COVID-19 pandemic" group (BCOV19 group), and the difference was statistically significant (p=0.0017). There was a substantial difference in the rate of treatment interruption between the two groups (p=0.002). Conclusions: This is the first study to explore the effect of the COVID-19 pandemic on visits and treatment interruptions in elderly patients with HNSCC. The current impact of the COVID-19 pandemic on HNSCC treatment has resulted in reductions and delays in diagnosing cancer and providing treatment.

Co-existence of Head and Neck Squamous Cell Carcinoma with Sinonasal Mucormycosis: Therapeutical Challenges

Pandemic was new experience for entire humanity. Medical fraternity was no exception. The cases of mucormycosis were on the rise during the second wave of the pandemic. Presented here are two cases which were combination of two diseases, one of which was squamous cell carcinoma of head and neck region and other one was sinonasal mucormycosis. Both patients were diabetics and had history of Coronavirus Disease-2019 (COVID-19) infection in past. Our literature search doesn't reveal any previously reported cases of this rare combination. There were certain challenges in management. Both diseases were lethal and treatment of one cannot be prioritised over other. Challenges in managing those cases were, reconstruction planning, perioperative management and postsurgery adjuvant therapy. In absence of previous experience to treat this combination or any literature available new treatment protocol were formulated. Cases were discussed in multidisciplinary team meetings and treatment plans were formulated. Mucormycosis and oral squamous cell carcinoma both were operated and reconstructed in same sitting. In one patient revision endoscopic debridement had to be done. Amphotericin B was started once diagnosis was confirmed. Patients were followed-up on weekly basis during first month and imaging was done every 15 days. Both patients had satisfactory recovery without any sign of progression of mucormycosis. Adjuvant radiation was given in both cases at appropriate time. At follow-up both patients were free from disease for six months. From these unique experiences it can be recommended that combination of sinonasal mucormycosis and squamous cell carcinoma of head and neck is very rare. Both diseases can be treated simultaneously. Excision and reconstruction can be done in single sitting. There is no need to delay or avoid adjuvant radiation. Multidisciplinary team approach is the key for treatment.

Practical tapered optical fiber system for in-situ label-free sensing of various antigens

A practical tapered optical fiber (TOF) biosensing system was developed for label-free detection using antigen-antibody pairs with repeatable results and a very high degree of sensitivity. This was done by attaching molecular recognition agents to a tapered fiber surface for augmenting sensitivity and specificity of analyte. The entire system included three main parts: a tunable laser, a tapered fiber, and an optical detector. Light from an unpolarized tunable fiber laser was introduced into the tapered fiber from one end, and the transmitted intensity was detected by a photodetector. In the tapered fiber area, the evanescent electromagnetic field, which extends outside the fiber, was able to detect minute changes in the refractive index caused by antigen-antibody pairs. Recorded data was analyzed using an innovative Fourier analysis method to find phase changes, which are directly related to the biomolecular concentration coated on fiber, from which antibody-antigen concentrations are obtained. Two experiments were performed to confirm the concept using two very different agents. The first was the protein Interleukin-8 (IL-8). Repeatable results with a sensitivity of 10 pg/mL were achieved. The second was human coronavirus OC43 (HCoV-OC43), a surrogate viral particle for SARS-CoV-2, with a sensitivity of 50 viruses/mL. Critical sources of error were identified and addressed for the purpose of using the device for real clinical diagnosis in various real-life environments, where viruses can reside in water, phosphate-buffer solution, or saliva, the most popular three environments in real clinical diagnosis. Our device was designed according to the principle that only one specific kind of antibody and antigen can be combined together. The device demonstrated good accuracy to chosen analyte(s) tailored to specific applications and offered the potential to develop a point-of-care device used in clinics, as well as for detecting a variety of viruses and biocontaminants. The reproducibility of TOFs was confirmed through multiple fabrications and consistent results. [ FROM AUTHOR] Copyright of Optical Engineering is the property of SPIE - International Society of Optical Engineering and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Effects of 1-year COVID-19 pandemic on head and neck cancer stage and treatment duration

Introduction The imposed radical governmental restrictions to combat the pandemic and the overstrained medical resources affected greatly, not only those infected from the novel virus, but also miscellaneous patient groups. Aim of this study was the assessment of the efficacy of oncologic healthcare during Covid-19 pandemic on patients with head neck squamous cell carcinoma in a tertiary university hospital in Germany. Material and Methods This retrospective, cross-sectional, observational study included 94 patients with newly diagnosed head and neck squamous cell carcinoma during a two-year period. Patients were assigned to two date-dependent groups;referrals before (Group A) and during (Group B) the Covid-19 pandemic. Time intervals from symptom(s) onset to diagnosis, diagnosis to treatment and treatment initiation to completion were recorded. Furthermore, TNM-stages and application of reconstructive surgery with free tissue transfer were determined. Results Despite the challenges and burden of the pandemic, tumor upstaging and treatment delays could not be observed. Conclusion A timely diagnosis and treeatment initiation plays a major role in prognosis of patients withs head and neck squamous cell carcinoma.

The Feasibility of a Digitized Peer-To-Peer Patient Support System for Patients With Locally Advanced Head and Neck Cancer Undergoing Chemoradiation

Background: Patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) undergo multimodality treatments that result in significant morbidity. For patients undergoing definitive chemoradiation, functional deficits and significant decrease in quality of life contribute to tremendous social isolation. Peer-to-peer (P2P) support programs have a number of beneficial effects including improved satisfaction with medical care, improved mood, and decreased social isolation. Online support groups represent a new and vastly underused and understudied medium. While there have been a few studies evaluating online support groups, to our knowledge none of these have focused specifically on patients with SCCHN. The goal of the current study is to conduct a randomized controlled trial (RCT) of a digitized peer-to-peer communication system for patients with newly diagnosed locally advanced SCCHN. Methods: This is a pilot feasibility study of a digitized smart-phone enabled P2P application. Eligible patients are at least 18 years old, able to speak/read English, and slated to start definitive chemoradiation for their locally advanced SCCHN at Moffitt Cancer Center. The mobile application serves as a digitized patient support group/P2P communication system. Patients are randomly assigned in a 2:1 ratio to receive the mobile application or standard of care supportive services. A convenience sample of thirty patients are chosen for this pilot study. Results: To date, eighteen patients have been enrolled to the study. Eleven patients were randomized to the intervention arm, and seven patients were randomized to the standard of care arm. Baseline surveys were administered to enrolled patients. Of the patients who filled out baseline surveys, the majority of patients (62%) desired to be matched with someone undergoing similar therapy, 25% preferred someone with comparable age, and 13% preferred someone of their own gender. One patient was unable to fill out baseline surveys due to worsening of their medical condition. Due to the COVID-19 pandemic, the trial was closed for the eight months but is now open to accrual. Conclusions: This trial is currently open and accruing patients. Feasibility will be analyzed after completion of study recruitment.

Clinical Role of Positron Emission Tomography/Computed Tomography Imaging in Head and Neck Squamous Cell Carcinoma.

Head and neck squamous cell carcinoma (HNSCC) imaging is nearly synonymous with positron emission tomography (PET) scans. Many of the nearly 60,000 newly diagnosed patients with HNSCC in the US-and 900,000 worldwide-will undergo a PET scan, if not multiple, throughout the course of their care. In this review, we describe the clinical utility of PET scans in HNSCC, emphasizing whereby their input is most impactful in improving patient outcomes as well as scenarios whereby PET/CT scans should be avoided. We also describe important considerations for capturing and processing PET scans with a special focus on the important role of tumor volume segmentation, scan timing relative to therapy, and concurrent conditions (eg, COVID-19). In addition, we will illustrate the latest innovations in the management of HNSCC. This article also will delve to exhibit novel potential biomarkers in the management of HNSCC. Finally, we describe future directions for PET imaging, including the advent of novel PET radiotracers as an alternative to 18F-fluorodeoxyglucose (18F-FDG).

The Evolution of Care of Cancers of the Head and Neck Region: State of the Science in 2020.

Cancers that arise in the head and neck region are comprised of a heterogeneous group of malignancies that include carcinogen- and human papillomavirus (HPV)-driven mucosal squamous cell carcinoma as well as skin cancers such as cutaneous squamous cell carcinoma, basal cell carcinoma, melanoma, and Merkel cell carcinoma. These malignancies develop in critical areas for eating, talking, and breathing and are associated with substantial morbidity and mortality despite advances in treatment. Understanding of advances in the management of these various cancers is important for all multidisciplinary providers who care for patients across the cancer care continuum. Additionally, the recent Coronavirus Disease 2019 (COVID-19) pandemic has necessitated adaptations to head and neck cancer care to accommodate the mitigation of COVID-19 risk and ensure timely treatment. This review explores advances in diagnostic criteria, prognostic factors, and management for subsites including head and neck squamous cell carcinoma and the various forms of skin cancer (basal cell carcinoma, cutaneous squamous cell carcinoma, Merkel cell carcinoma, and melanoma). Then, this review summarizes emerging developments in immunotherapy, radiation therapy, cancer survivorship, and the delivery of care during the COVID-19 era.

Fever range whole body hyperthermia for re-irradiation of head and neck squamous cell carcinomas: Final results of a prospective study.

OBJECTIVES: Fever-range whole body hyperthermia (FRWBH) has been shown to improve tumor oxygenation in vivo. A prospective pilot study addressed the question if addition of FRWBH to re-irradiation is feasible in recurrent head and neck squamous cell carcinomas (HNSCC) with unfavorable prognostic features. MATERIALS AND METHODS: The study completed accrual with the recruitment of ten patients between April 2018 and March 2020. Re-irradiation was administered using volumetric arc hyperfractionated radiotherapy with bi-daily 1.2 Gray (Gy) single fractions and a total dose of 66 Gy to all macroscopic tumor lesions. Concomitant chemotherapy consisted mostly of cisplatin (7 patients). FRWBH was scheduled weekly during re-irradiation. The study was registered in the clinicaltrials.gov database (NCT03547388). RESULTS: Only five patients received all cycles of FRWBH. Poor patient compliance, active infections during treatment and study restrictions due to the Covid-19 pandemic were the main reasons for omitting FRWBH. No increase of acute toxicity was observed by FRWBH. Exploratory evaluation of outcome data suggests that FRWBH treatment according to protocol does not seem to have a detrimental effect on tumor control or survival and might even increase treatment efficacy. CONCLUSION: FRWBH is difficult to apply concomitant to re-irradiation in HNSCC. No excess toxicity was observed in patients receiving FRWBH and exploratory analyses suggest potential anti-tumor activity and decreased patient-reported depression scores after FRWBH.

The SARS-CoV-2 host cell receptor ACE2 correlates positively with immunotherapy response and is a potential protective factor for cancer progression.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected more than 29 million people and has caused more than 900,000 deaths worldwide as of September 14, 2020. The SARS-CoV-2 human cell receptor ACE2 has recently received extensive attention for its role in SARS-CoV-2 infection. Many studies have also explored the association between ACE2 and cancer. However, a systemic investigation into associations between ACE2 and oncogenic pathways, tumor progression, and clinical outcomes in pan-cancer remains lacking. Using cancer genomics datasets from the Cancer Genome Atlas (TCGA) program, we performed computational analyses of associations between ACE2 expression and antitumor immunity, immunotherapy response, oncogenic pathways, tumor progression phenotypes, and clinical outcomes in 13 cancer cohorts. We found that ACE2 upregulation was associated with increased antitumor immune signatures and PD-L1 expression, and favorable anti-PD-1/PD-L1/CTLA-4 immunotherapy response. ACE2 expression levels inversely correlated with the activity of cell cycle, mismatch repair, TGF-ß, Wnt, VEGF, and Notch signaling pathways. Moreover, ACE2 expression levels had significant inverse correlations with tumor proliferation, stemness, and epithelial-mesenchymal transition. ACE2 upregulation was associated with favorable survival in pan-cancer and in multiple individual cancer types. These results suggest that ACE2 is a potential protective factor for cancer progression. Our data may provide potential clinical implications for treating cancer patients infected with SARS-CoV-2.

Respiratory and pulmonary complications in head and neck cancer patients: Evidence-based review for the COVID-19 era.

BACKGROUND: Pulmonary complications and infections frequently affect patients with head and neck squamous cell carcinoma (HNSCC). Common characteristics can predispose these patients to the development of severe respiratory illness, which may be particularly relevant during the 2019 coronavirus disease (COVID-19) pandemic. METHODS: A scoping review was performed to assess the impact of pulmonary comorbidities and adverse respiratory outcomes in HNSCC patients. RESULTS: Advanced age, history of tobacco and alcohol abuse, and cardiopulmonary comorbidities are significant risk factors for the development of adverse respiratory outcomes. Treatment toxicities from radiation or chemoradiation therapy significantly increase these risks. CONCLUSION: Respiratory complications are a frequent cause of morbidity and mortality among HNSCC patients, and the COVID-19 pandemic may disproportionately affect this population. Interventions designed to decrease smoking and alcohol use, improve oral hygiene, and aggressively manage medical comorbidities are important to the long-term management and health of these patients.