Background and Significance

With an expected 40,000 new cases and 11,500 deaths in the year 2006, squamous cell carcinoma of the head and neck (SCCHN) accounts for 4% to 5% of all newly diagnosed cancers in the United States. More than 2/3 of patients present with locally advanced (stage III/IV) SCCHN, which has a poor 5-year survival rate after definitive local treatments, such as surgery, radiation therapy, or chemotherapy. Because of the large number of aging smokers and ex-smokers in the U.S. population, the incidence of aerodigestive cancers, including lung cancer and SCCHN, will remain high for the next two to three decades despite the overall decline in smoking. The past two decades of neoadjuvant and adjuvant chemotherapy research, including large-scale trials, have failed to improve survival of locally advanced SCCHN. It is important to note that recent data from concurrent chemoradiotherapy or induction chemotherapy followed by concurrent chemoradiotherapy are encouraging; however, the long-term survival of this population remains far from satisfactory. Because the highest rate of treatment failure occurs in the head and neck region, it is likely that improved locoregional control must accompany improved control of distant metastases before survival will improve. Even if SCCHN survivors are fortunate to overcome the high risk of recurrence, they remain at high risk for developing second primary tumors, which are usually fatal. Therefore, new innovative approaches to treatment and prevention for SCCHN are highly important. Our proposed Head and Neck Cancer SPORE research program addresses key challenges in the treatment and prevention of head and neck cancer, and investigates molecular mechanisms and clinical potential of innovative therapies.

The purpose of the Emory University Head and Neck Cancer SPORE is to create a new synergistic mechanism that accelerates discovery in head and neck cancer research at Emory and our collaborating institutions. The overarching focus is to facilitate, critically review, and move new discoveries to patients more rapidly than currently possible, always with the objective of decreasing the morbidity, suffering, disability and death caused by this disease.

It is the intent of this particular research program to establish, foster and maintain support of meritorious translational head and neck cancer research, centered at Emory, and to leverage the unique advantages of our particular environment. We are proposing a team approach in which individual facets of the SPORE program will work synergistically to develop novel strategies that will enhance both prevention and therapy for head and neck cancer.