• GW Head and Neck Cancer Program
  • A Leader in Minimally Invasive Treatment Options
  • The GW Cancer Center’s Head and Neck Cancer Program is made up of an internationally renowned team of experts in a variety of different specialties. Every patient’s case is unique, which is why we take an individualized approach to treatment. Because head and neck cancer patients often face a variety of challenging side effects and other complications from treatment, our multidisciplinary team includes specialists in otolaryngology, head and neck surgery, plastic surgery, medical and surgical dermatology, medical oncology, radiation oncology, nutrition and other supportive care services. Our team offers patients the most cutting edge and minimally invasive treatment options available.

Program Information

The GW Cancer Center’s Head and Neck Cancer Program oversees the care of patients with all cancers of the head and neck, including laryngeal and hypopharyngeal cancer, nasal cavity and sinus cancer, nasopharyngeal cancer, oral cancer, esophageal cancer, thyroid cancer and salivary cancer. This includes patients with active cancers, as well as patients with suspected cancers who are in need of diagnostic testing or surveillance. The Head and Neck Cancer Program also collaborates with GW’s Cutaneous Oncology Program to treat patients with certain types of skin cancer.

Our recommendations for treatment are individualized to the stage and type of each patient’s cancer or condition. Our personalized approach to treatment also means minimizing the many functional and cosmetic concerns that can be associated with head and neck cancers. Here at GW, the physicians treating our patients are also on the frontlines of innovative research into advanced treatment options, like radiation-sparing approaches and minimally invasive surgery.

Our multidisciplinary approach allows patients to have access to a wide variety of specialists during their visit, including:

  • Medical and radiation oncologists coordinate chemotherapy, immunotherapy and radiation therapy treatments to achieve the best outcomes possible for patients
  • Surgeons who specialize in surgical oncology of the head and neck use minimally invasive procedures and robotically assisted surgery, which means smaller incisions, less scarring and faster recovery
  • Speech pathologists and voice therapists assist with communication and swallowing issues
  • Occupational therapists help patients with daily activities and addressing concerns related to lifestyle and well-being
  • Physical therapists work to prevent or address complications and restore functionality to the shoulder joint, neck and face
  • Nutritionists aim to optimize patients’ nutrition status, manage side effects, reduce complications and improve quality of life during and after treatment
  • Social workers and psychologists address practical and psychosocial challenges throughout the continuum of care
  • Patient navigators help overcome barriers to care and assist with care coordination
  • Palliative care experts work with the care team to improve quality of life and address treatment side effects or other issues

This approach assures the most thorough assessment and treatment plan. We believe in an integrative approach to the whole person.

Program Information

Approach to Treatment

You will be cared for by a comprehensive team of specialists that combines leading experts with the latest technological and research advances. Our multidisciplinary team works together to create a personalized treatment plan that supports all of your medical, nutritional and emotional needs. At the GW Cancer Center’s Head and Neck Cancer Program, you will have access to:

  • A multidisciplinary treatment team of world-renowned experts in head and neck surgery, reconstructive surgery, medical oncology, radiation oncology and radiology
  • Experts in dermatology and cutaneous oncology for skin cancers involving the head and neck
  • Clinical trials
  • Advanced radiation oncology techniques including external beam radiation therapy (EBRT), intensity modulated radiation therapy (IMRT) and surface mold computer-optimized high-dose-rate bracytherapy (SMBT)
  • Radiation-sparing techniques like chemotherapy and minimally invasive surgery
Head and Neck Cancer Information for Patients

Cancers of the head and neck are typically categorized by the area of the body in which they start, typically inside the mouth, the nose and the throat. Head and neck cancers make up approximately 4% of all cancers in the United States, and rates are on the rise. Areas where head and neck cancers can arise include:

  • Oral cavity including the lips, the front of the tongue, the lining inside the cheeks and lips, the bottom of the mouth under the tongue, the hard palate and small area of the gum behind the wisdom teeth
  • Throat, or pharynx, starting behind the nose and leading to the esophagus
  • Voicebox, or larynx, which contains the vocal cords and epiglottis which prevents food from entering air passages
  • Paranasal sinuses and nasal cavity including the small hollow spaces in the bones of the head surrounding the nose as well as the hollow space inside the nose
  • Salivary glands

Adapted from the National Cancer Institute’s Head and Neck Cancers Fact Sheet

The GW Cancer Center’s Head and Neck Cancer Program also sees patients with thyroid cancer, certain types of skin cancer and cranial or facial tumors. We also specialize in treating patients with human papillomavirus-associated (HPV) cancers. Learn more about specific cancer types and conditions.

Research and Clinical Trials

The GW Cancer Center offers a variety of clinical trials. Patients with skin cancer can also enroll in our blood, tissue and database collection studies for melanoma, squamous cell carcinoma, Merkel cell carcinoma and cutaneous T-cell lymphoma. 

Diagnostic and Treatment Options

Some of the procedures we offer for diagnosing and treating head and neck cancers include:

  • Thyroid and parathyroid surgery
  • Minimally invasive laser techniques which can avoid the need for extensive surgical exposure and complicated reconstructive procedures
  • Craniofacial trauma and reconstruction, including local, regional and free microvascular flaps (one of the most advanced surgical options available that uses tissue from other parts of a patients' body to rehabilite damage caused by the removal of head and neck tumors)
  • Trans-oral robotic surgery (TORS) which allows surgeons to operate through the patient's mouth instead of a long incision through the throat and jaw, avoiding facial disfigurement and a tracheotomy
  • Sialendoscopy, a technique used to examine the openings of the salivary glands and remove any salivary stones or debris that may be present
  • Flex® Robotic System, which allows surgeons to access anatomical locations that were previously difficult or impossible to reach without invasive surgical interventions, equipment that is only available regionally at the GW Hospital
  • Sentinel lymph node biopsy for melanoma, a specialized procedure to see if melanoma cells have spread to sentinel nodes closest to the primary tumor

Page last updated: January 2020

Title Description
A Phase II/III Randomized Study of Maintenance Nivolumab Versus Observation in Patients with Locally Advanced, Intermediate Risk HPV Positive OPCA

Primary objective:
To assess the efficacy of concurrent definitive therapy followed by nivolumab compared with concurrent definitive therapy followed by observation in terms of progression-free survival (PFS). (Phase II) II. To assess the efficacy of concurrent definitive therapy followed by nivolumab compared with concurrent definitive therapy followed by observation in terms of overall survival (OS). (Phase III)

Secondary objectives:

  1. To further assess the efficacy of nivolumab compared with observation in terms of:
    • The relationship of baseline PD-L1 expression to clinical outcome.
    • To evaluate the association of 12 week post therapy fludeoxyglucose F-18 (FDG) positron emission tomography (PET)/computed tomography (CT) with PFS and OS.
    • To establish the prognostic value of standardized uptake value (SUV)max of primary tumor or neck nodal metastasis of baseline FDG PET/CT for OS (and/or PFS).
    • To correlate SUVmax of primary tumor or nodal metastasis of baseline FDG PET/CT with PD-L1 expression (positive vs. negative).
    • To compare the PET based therapy response assessment (Hopkins criteria) to the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 assessment at 12 week post chemoradiation therapy, for patients who have a PET/CT scan at 12 weeks.

Inclusion Criteria:

  1. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  2. Patients must have oropharynx cancer (AJCC 8) that is p16-positive by immunohistochemistry with smoking status: >= 10 pack-years, stage T1-2N2-N3 or T3-4N0-3 (less than 10 pack-years is considered a non-smoker) OR < 10 pack-years, stage T4N0-N3 or T1-3N2-3.
  3. Patients must not have known hypersensitivity to nivolumab or compounds of similar chemical or biologic composition.
  4. Patients with a history of allergic reactions attributed to platinum-based chemotherapy agents are excluded.
  5. Patients must not have had prior systemic therapy, radiation treatment or surgery for p16 positive oropharyngeal squamous cell carcinoma (OPSCC).
  6. Patients must not have received previous irradiation for head and neck tumor, skull base, or brain tumors.
  7. Patients must not receive investigational agents within 4 weeks of enrollment or at any time while on study.
  8. Patients with evidence of distant metastases or leptomeningeal disease (LMD) are excluded.
  9. Patients with uncontrolled inter-current illnesses which in the opinion of the investigator will interfere with the ability to undergo therapy including chemotherapy are excluded.
  10. Patients with a history of prior or second malignancy are excluded, with the exception of curatively treated non-melanoma skin cancer, or curatively treated cervical cancer; additionally, patients curatively treated for malignancy who remain disease-free at > 2 years of follow up, are not excluded.
  11. Absolute neutrophil count (ANC) >= 1500/mm^3 (must be obtained =< 2 weeks prior to randomization).
  12. Hemoglobin (Hgb) >= 8.0 g/dL (must be obtained =< 2 weeks prior to randomization).
  13. Platelet count >= 100,000/mm^3 (must be obtained =< 2 weeks prior to randomization).
  14. Creatinine clearance of >= 60 ml/min (must be obtained =< 2 weeks prior to randomization). Creatinine clearance may be measured or calculated. If calculating, creatinine clearance, use the Cockcroft-Gault formula.
  15. Total bilirubin within 1.5 times the normal limits (must be obtained =< 2 weeks prior to randomization).
  16. Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) or serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) within 2.0 times the normal limits (must be obtained =< 2 weeks prior to randomization).
  17. Alkaline phosphatase within 1.5 times the normal limits (must be obtained =< 2 weeks prior to randomization).
  18. Women must not be pregnant or breast-feeding as chemotherapy, radiation, and immunotherapy may have possible teratogenicity effects; in addition, complications from pregnancy may interfere with the ability of patients to have an uninterrupted therapy.
  19. All women of childbearing potential must have a blood test or urine study within 2 weeks prior to randomization to rule out pregnancy.
  20. A woman of childbearing potential is any female, regardless of sexual orientation or whether they have undergone tubal ligation, who meets the following criteria: 1) has achieved menarche at some point, 2) has not undergone a hysterectomy or bilateral oophorectomy or 3) has not been naturally postmenopausal (amenorrhea following cancer therapy does not rule out childbearing potential) for at least 24 consecutive months.
  21. Women of childbearing potential (WOCBP) and males who are sexually active with WOCBP must use an accepted and effective method of contraception or abstain from sexual intercourse for at least one week prior to the start of treatment, and continue for 5 months after the last dose of protocol treatment for women of childbearing potential and 7 months after the last dose of protocol treatment for males who are sexually active with WOCBP.
  22. Patients must have measurable disease as defined.
  23. Patients must have tumor measurements with CT of neck and CT of chest within 4 weeks prior to Step 1 randomization.
GW Head and Neck Cancer Program
2300 M Street, NW 4th Floor
Washington , DC
United States

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