Head & Neck and Thyroid Cancer Program

Welcome to the Head and Neck and Thyroid Cancer Program at Washington University.

Our program is uniquely structured to provide the best care available to patients with cancers of the head and neck and thyroid. We apply a comprehensive multidisciplinary approach to the evaluation, diagnosis, treatment, and long-term follow-up care of patients with cancers of the head and neck and thyroid. All patients are offered the opportunity to participate in clinical trials that seek to improve upon the outcomes of current standard treatments. Excellence in provision of clinical care and clinical trial research are our overarching goals.

Head and Neck and Thyroid Cancers

Head and neck cancers, the sixth most common cancer type, arise in the oral cavity, tongue, larynx, hypopharynx, nasopharynx, paranasal sinuses, salivary glands, and skin. Thyroid cancers, the ninth most common cancer type, include differentiated, anaplastic, and medullary cancers. Most patients with newly diagnosed cancers of the head and neck and thyroid are cured with current standard therapy; however, the acute and chronic side effects of treatment can be substantial. For these patients, our clinical trial research is focused on decreasing the side effects of treatment and further increasing the rate of cure. Patients with recurrent or metastatic cancers of the head and neck and thyroid are usually treated with palliative intent. For these patients, our clinical trial research is focused on prolonging survival, increasing the rate of cancer response, and decreasing the side effects of treatment.

Our Treatment Approach

Last year, our program cared for over 600 new patients with cancers of the head and neck and thyroid. Patients with cancers of the head and neck and thyroid are cared for by a multidisciplinary team of physicians and other health care providers who are specialists in medical oncology, radiation oncology, otolaryngology, endocrine surgery, pathology, dental care, and speech and swallow functions. Each new patient is seen and evaluated by this multidisciplinary team, and their cancer diagnosis is then discussed in detail at our weekly tumor board meetings, one for head and neck cancer and one for thyroid cancer. The result is a comprehensive treatment plan developed by a team of specialists that provides the optimal treatment approach tailored to the patient, and yields excellence in outcomes for our patients. Feedback from our patients has confirmed to us that this multidisciplinary team approach to evaluation and treatment is what they most want us to deliver for them.

The Head & Neck Tumor Center at Washington University School of Medicine in St. Louis and Barnes-Jewish Hospital, a member of BJC HealthCare, is a collaborative, multispecialty practice of Washington University physicians and researchers whose mission is to provide cutting-edge care for patients with head and neck cancers as well as benign tumors and masses of the head and neck. Among the first of its kind in the country, the Head & Neck Tumor Center emphasizes individualized, patient-centered care with complementary research programs that have the potential to transform patients’ treatment and improve their outcomes. Based at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, the center is co-led by three Washington University physicians: Sidharth V. Puram, MD, PhD, an associate professor of otolaryngology, head & neck surgery; Douglas R. Adkins, MD, a professor of medicine in the oncology division in the Department of Medicine; and Wade L. Thorstad, MD, a professor of radiation oncology in the Department of Radiation Oncology. The Head & Neck Tumor Center employs patient navigators to provide support and guidance to patients as they manage the complexities of the treatment regimens for these tumors.

Treatment Team

• The multidisciplinary team for head and neck cancer also includes six otolaryngology surgeons (led by Sidharth Puram, MD, PhD, FACS, Chief, Head and Neck Surgery) and four head and neck radiation oncologists (led by Wade Thorstad, MD, Chief, Head and Neck Cancer Service).
• The multidisciplinary team for thyroid cancer also includes three endocrine surgeons (led by William Gillanders, MD, Vice Chair for Research, Surgery), six otolaryngology surgeons (led my Sidharth Puram, MD, PhD, FACS, Chief, Head and Neck Surgery), three radiation oncologists (led by Stephanie Markovina, MD, PhD), three nuclear medicine radiologists (led by Farrokh Dehdashti, MD), and two endocrinologists (led by Sina Jasim, MD, MPH).

Research and Clinical Trials

The primary goal of the clinical trial research program is to develop improved therapeutics for patients with newly diagnosed and recurrent or metastatic cancers of the head and neck and thyroid. A collaboration between physicians from medical oncology, otolaryngology, radiation oncology, pathology, and endocrine surgery work together to develop and implement hypothesis-driven clinical trials to offer our patients with cancer.

The results of these clinical trials have been published in high-impact cancer journals, including Lancet, Lancet Oncology, JAMA Oncology, Journal of Clinical Oncology, Annals of Oncology, Cell, Cell Reports, Science Immunology, Cell Death and Disease, Clinical Cancer Research, International Journal of Radiation Oncology, Biology, and Physics (IJROBP), Thyroid, iScience, Laryngology, JAMA Otolaryngology, Head and Neck Surgery, and Cancer.  

Clinical Trial Highlights

• “Open-Label, Randomized Phase 2 Trial of Ramucirumab in Combination with Pembrolizumab versus Pembrolizumab Alone as First-Line Treatment of PD-L1 Positive, Recurrent or Metastatic Head and Neck Squamous-Cell Carcinoma”
  • The primary hypothesis of this clinical trial is that the objective response rate with ramucirumab in combination with pembrolizumab will be significantly higher than with pembrolizumab alone as First-Line Treatment of PD-L1 Positive, Recurrent or Metastatic Head and Neck Squamous-Cell Carcinoma.
• “Non-Randomized Phase 2 Trial of Three Schedules of CUE-101 Administered Before Surgery or Definitive Chemoradiation Therapy in HLA-A*0201 Positive Patients with Locally Advanced, HPV16-Positive Oropharyngeal Squamous-Cell Carcinoma”
  • The primary hypothesis of this clinical trial is that the three schedules of CUE-101 administration will be safe and tolerable, and will generate antigen-specific T cell responses in tumor and blood.
• “Palbociclib and Cetuximab versus Cetuximab Monotherapy for Patients with CDKN2A-altered, HPV-unrelated Head and Neck Squamous Cell Carcinoma who Experienced Disease Progression on a PD-1/L1 Inhibitor: A Multicenter, Open-Label, Randomized Phase 3 Trial”
  • The primary hypothesis of this clinical trial is that the overall survival of patients with CDKN2A-altered, HPV-unrelated recurrent or metastatic HNSCC that progressed on a prior PD-(L)1 inhibitor-containing regimen will be longer with palbociclib and cetuximab versus with cetuximab monotherapy.