Mouthwash-Based Test Could Predict Head and Neck Cancer Recurrence

Head and neck cancers comprise close to 4% of all cancer cases in the U.S., predominantly affecting individuals over the age of 50. Men are over twice as likely to develop this type of cancer compared to women. The primary treatments, surgery and radiation, can severely impact functions such as speech, swallowing, and physical appearance, significantly diminishing the quality of life. These impacts can intensify with cancer recurrence, which is challenging to detect as it is hard to distinguish between normal post-treatment changes and a recurrence of the cancer. Early detection of recurrence could greatly reduce the severity of outcomes for patients. Now, a new test using a simple mouthwash to detect biomarkers shows promise in predicting disease recurrence in patients with head and neck cancer.

A previous study by researchers at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine (Miami, FL, USA) explored how biomarkers in oral rinses could indicate a person’s risk of developing oral or oropharyngeal tumors, which are among the most common head and neck cancers. They identified two crucial biomarkers: CD44, a molecule linked to tumor initiation, and total protein levels. In this new study, the researchers, along with their collaborators, examined whether levels of these biomarkers could predict recurrence in patients already diagnosed with the disease. Their clinical trial involved over 160 patients from multiple cancer centers, who used oral-rinse samples up to 18 months post-treatment.

Image: Dr. Elizabeth Franzmann was first author of the study that showed elevated levels of either of two biomarkers found in saliva is associated with recurrence of head and neck cancer (Photo courtesy of Sylvester Cancer)

To analyze the presence of these biomarkers, the team employed both laboratory tests and experimental lateral-flow tests, similar to the technology used in home pregnancy and COVID-19 tests. Laboratory assays showed a correlation between the levels of these biomarkers and subsequent disease recurrence. Specifically, patients with total protein levels approximately twice the normal amount three months after treatment exhibited a 65% higher risk of recurrence. Similarly, those with triple the normal CD44 levels showed a 62% increased risk of recurrence. These findings, detailed in JAMA Otolaryngology – Head & Neck Surgery, could improve the prediction and detection of recurrence in head and neck cancers. Additionally, the study provided preliminary data supporting the development of a rapid, point-of-care test to measure these biomarkers, potentially accelerating its availability for clinical use.

“Our study suggests biomarker detection in saliva collected from an oral rinse after initial treatment offers potential to readily assess recurrence risk,” said Elizabeth Franzmann, MD, a head and neck surgeon at Sylvester, and co-corresponding author of the study. “Elevated levels of either of two biomarkers were associated with disease return.”

Related Links:
Sylvester Comprehensive Cancer Center