Around the world,head and neck cancers are increasing in prevalence — mostly associated with a rise in disease associated with human papilloma virus. When a patient’s head or neck is damaged, they can have difficulty talking or eating for years. Currently, patients have limited options. There are immunotherapies, but fewer than 30 percent of people respond well to them.
Among all cancers, survivors of head and neck cancer have the second highest suicide rate. “The head and neck are what we use to eat and speak,” Assistant Professor and Principal Investigator Dechen Lin said. “You can imagine the trauma that happens after surgery, radiation or chemotherapy. They create a lot of side effects.”
Lin is working on a study to use diet and medications to create some new inroads into understanding and treating these types of cancers. He has recently received a grant from the National Institute of Dental and Craniofacial Research to begin the work.
Avoiding eggs, shellfish and meat?
Lin’s work focuses on a special metabolic feature — an essential amino acid called methionine that is very high in head and neck cancer patients compared to healthy people. Lin has found that this high level of methionine can have a “huge impact on cancer cells surviving and thriving,” Lin said. Blocking the pathway means that tumor cells are killed — that’s what the work in mice shows, so far.
Methionine can also activate epigenetic changes, through an enzyme called EZH2 — and that’s another target of the work. Drugs already exist that inhibit the enzyme for certain lymphomas and leukemias. Lin wants to use these already-approved drugs for head and neck cancer patients.
He’s also planning to test a dietary intervention in the coming years — since methionine is high in certain foods like eggs, shellfish and meat. If patients skip those items, the idea is that their cancers won’t grow as quickly. Lin has assembled a team at Keck with a surgical oncologist and a pathologist and is writing the protocol to eventually identify the patients who might benefit from this modified diet.
Lin says that any dietary intervention would supplement other forms of treatments. Patients would still receive their routine treatments — surgery, radiation therapy or chemotherapy. “However, after all these standard treatments, we’re going to look at their molecular profiles, and we’re going to say these patients may benefit from dietary intervention,” he says. “Our hope is that with our methionine-based intervention, we could see a prolonged survival period or less recurrence of disease and better outcomes.”
Lin’s lab is focused on oral and esophageal cancers, and is working to build up organoids — tiny chunks of tissue from individual patients that could help determine how the patient would respond to different drugs before treatment.
Treating cancers through research requires a special approach, Lin said. “As a PhD, I definitely enjoy all the nitty gritty stuff, like the molecular interactions or epigenetic regulation.” he said. “New technologies are coming out at a mind-blowing pace.” But, as a cancer scientist, he’s driven by a mission to treat patients with urgency. “There’s a gap right between how much we’re researching versus how much clinical progress is made.”
Author: Katherine Gammon
Source: https://dentistry.usc.edu/
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