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HNCIG Newsletter, December 2021

In this Issue

Harmonizing Clinical Trial Endpoints


ESMO Updates

ESTRO Updates

ASCO Updates

Nasopharyngeal Carcinoma

and more

From the HNCIG Board

Dr. Hisham Mehanna, Chair

Dr. Sandro Porceddu, Secretary

As we are writing this to you, there appears to be another wave of COVID – this time the Omicron variant.

In these difficult times, one may wonder whether there is sufficient time and energy for doing research or clinical trials. However, it is exactly in those times that, we need to remember that it is those trials and studies that move the outcomes of our patients forward and result in significant benefit to them. And so as difficult as it maybe during COVID 19, this continued progress is important for our patients and their families.

As research and clinical trials become more challenging to do, the added advantage and benefit of Head and Neck CIG becomes more evident. The ability to run trials across different countries and jurisdictions and to follow harmonised protocols is a unique opportunity, and one that we must make best use of.

With that in mind, the TACTIC – HNC study has just launched, in collaboration with Savana Med. It is the first multinational study utilising artificial intelligence in head and neck cancer in the world. Through the use of novel artificial intelligence technology, we will be able to interrogate electronic patient medical records of thousands of head and neck cancer patients and extract data that will enable us to develop dynamic risk stratification algorithms to better stratify and monitor our patients, both before and after treatment. This, we hope, will be the first of many studies exploring artificial intelligence in the quest to help improve the management of patients with head and neck cancer.

In addition, the different committees of HNCIG have been busy working on a multitude of different initiatives, from harmonisation of endpoints, to harmonisation of database design and definitions, to initiating collaboratives on rare cancers and carcinoma of unknown origin, to setting up a young investigators and trainee research collaborative.

To make all this great effort as successful as possible, we need YOUR participation and engagement. So please get involved!



Dr. Pablo Parente
Dr. Sujith Baliga

The Database subcommittee have finalized a data dictionary following input from the other HNCIG subcommittees and we have developed a minimum dataset which defines the essential clinical and demographic data that should be collected. Our plan is to present this to the various international cooperative groups to gain their endorsement. We hope with international consensus will make data sharing much easier and seamless in the future and allow us to expedite head and neck cancer research to improve patient care.


Guidelines & Protocols

Dr. Sue Yom
Dr. Juliette Thariat

The HNCIG G&P subcommittee is busy working on a project to harmonise clinical trials endpoints in head and neck cancer clinical trials. You can read more about the process on page 4 which highlights this two-step project which is being led internally by theHNCIG G&P subcommittee.

The initial phase includes a comprehensive literature review of global variations in end point definitions used in previously published and ongoing clinical studies. We have divided into two working parties, one focussing on studies in curative or locoregional

treatment and one dedicated to those focussed on recurrent and metastatic trials. An exciting aspect of this study is the use of a novel machine learning application to semi-automate the article screening process (Research Screener, The second stage of the project will involve a Delphi method to achieve consensus of endpoint definition through the HNCIG members. We hope to report substantial progress at our next update!

We are also very pleased to welcome our new members Dr Annette Lim and Dr Christopher Le Tourneau to the HNCIG G&P subcommittee who have brought a lot of experience and enthusiasm into the endpoints project!


Young Investigators

Dr Christina Henson and
Dr Lachlan McDowell

The HNCIG YI subcommittee is in full swing - we have welcomed several new members from the global head and neck cancer community including Dr Sharon Poh and Dr Natascha Putri from Singapore, Dr Pedro De Marchi from LACOG, Dr Francesca Caparotti and Dr Pierluigi Bonomo from the EORTC YI group, Dr Anna Lee and Dr Trisha Wise-Draper from USA/NRG, Dr Camilla Kjær Lønkvist from DAHANCA and Dr Sweet Ping Ng and Dr Rahul Ladwa from Australia.

The YI subcommittee has developed a survey on patterns of care in oligometastatic disease, led by Dr Monali Swain and Dr Petr Szturz in collaboration with Dr Sarbani Ghosh-Laskar from Tata Memorial Centre.

This survey will hopefully be circulated early next year.

The YI is also working hard to improve the visibility of the HNCIG through Twitter - and have appointed Social Media Ambassadors to assist at international and national meetings.

We are also working towards HNCIG in-person events at IFHNOS and other international meetings next year!

A big thank you to all those who have contributed this edition of the newsletter!

Stay tuned!


Harmonizing Clinical Trials Endpoints

Dr Annette Lim, Dr Lachlan McDowell and Dr Sue Yom

The HNCIG G&P subcommittee have commenced a project to harmonise clinical trial endpoint definitions, given the use of time-to-event endpoints as surrogates for the gold standard of overall survival (OS). Previous studies have indicated heterogeneity of endpoint definitions with regards to multiple parameters including the timing and method of assessment, the events that define failure, and censuring of data (1,2).Crucially, the variety of surrogate time-to-event endpoint definitions have implicationson the interpretation of data and subsequent regulatory approval, in the modern era of more standardised surveillance methods to detect relapse (3), new effective therapies including immunotherapy which can improve OS in the metastatic setting (4), and clinicopathological entities such as HPV-related oropharyngeal disease which is associated with improved survival and different patterns of relapse (5).

In order to harmonise endpoints, the subcommittee has performed a comprehensive literature review of Medline, Embase and, which has identified ~5000mucosal HNSCC studies from 2008 onwards. Members will accept studies for review ifthe following inclusion criteria are met (see Figure 1); i) Phase 3 trial OR ii) potentially practice changing based on the consensus of 3 members, AND iii) endpoints are defined in available protocols +/- publications, AND iv) are in English. Following retrieval ofprotocols+/-publications, study and endpoint data will be extracted. The events used todefine surrogate survival endpoints will be collated. Endpoints will be then circulated to the wider representative HNCIG for voting on what is considered i) the most significant endpoint/s, ii) the key events that should be used to define that endpoint and iii) harmonisation/condensation of endpoint terminology via a DELPHI survey method.

The project establishes a repository of HNSCC trial protocols for further analyses and amethod for interrogating surrogate time-to-event endpoints in other head and neckcancers.

As one of several groups with interest in this challenging area, the HNCIG shared its process and methodology with the U.S. Food and Drug Administration Oncology Center of Excellence at their recent Public Virtual Workshop on Clinical Trial Endpoint Development for Locally Advanced Head and Neck Squamous Cell Carcinoma, held November 3, 2021. As a global stakeholder group, the HNCIG will continue to work in concert with the FDA and other parties to assist in the definition and harmonisation of these endpoints.


1. Le Tourneau C, Michiels S, Gan HK, et al: Reporting of time-to-event end points and tracking of failures in randomized trials of radiotherapy with or without any concomitant anticancer agent for locally advancedhead and neck cancer. J Clin Oncol 27:5965-71, 2009

2. Michiels S, Le Maitre A, Buyse M, et al: Surrogate endpoints for overall survival in locally advanced head and neck cancer: meta-analyses of individual patient data. Lancet Oncol 10:341-50, 2009

3. Mehanna H, Wong WL, McConkey CC, et al: PET-CT Surveillance versus Neck Dissection in Advanced Head and Neck Cancer. N Engl J Med 374:1444-54, 2016

4. Burtness B, Harrington KJ, Greil R, et al: Pembrolizumab alone or with chemotherapy versus cetuximab with chemotherapy for recurrent or metastatic squamous cell carcinoma of the head and neck (KEYNOTE-048): a randomised, open-label, phase 3 study. Lancet 394:1915-1928, 2019

5. Gillison ML, D'Souza G, Westra W, et al: Distinct risk factor profiles for human papillomavirus type 16-positive and human papillomavirus type 16-negative head and neck cancers. J Natl Cancer Inst 100:407-20,2008



Dr Sujith Baliga and

Dr Miren Taberna

This is a unique collaborative study between the Head and Neck Cancer International Group (HNCIG) and Savana.

The first of its kind for head and neck cancer study, HNC-TACTIC is a multi-language, multi-center, retrospective, real-world evidence study analyzing Electronic Health Records (EHRs).

The study aims to describe patients with head and neck squamous cell carcinoma(HNSCC) in a real-world setting :

The primary objective is to develop two predictive models based on

dynamic risk stratification for:

  • Defining the risk of recurrence or progression following a primary curative treatment in HNSCC patients with early and locally advanced disease

  • Identifying patients’ features that predict long-term survival after immunotherapy in recurrent and metastatic patients.

You can join the study now!

View the study briefing and concept sheet here:


The global search for a new HNCIG logo is over!

Following a Twitter campaign to find a new, fit-for-purpose logo for the HNCIG, many high-quality submissions were received from across the globe.

Following a short-list of the best submissions by the HNCIG executive, the successful logo

was chosen by the HNCIG board earlier this year.

Our new logo was designed by Steve Smith, a graphic designer from Leicestershire, England. He studied graphic design at York university and over the last 30 years has run his own small company with a small professional workforce.

Steve was inspired to submit a logo after reading about the research projects undertaken by the HNCIG, the groups' advanced outlook to combat adversity and the incredible intellectual talent within HNCIG!

The HNCIG and their member organisations would like to extend their gratitude to Steve for his generosity in developing a re-invigorated logo for the HNCIG!



Dr. Petr Szturz

This year’s ESMO congress was held as a virtual meeting on September 16-21, 2021. With about 100 abstracts focusing on head and neck cancer, the conference provided a valuable insight for clinicians and other healthcare stakeholders. Two late-breaking abstracts were presented. The first one (LBA35) reported on the results of the phase IIIREACH trial randomly assigning 707 patients with locoregionally advanced squamous head and neck carcinoma to either avelumab/cetuximab/radiotherapy or standard cisplatin-based chemoradiotherapy in fit and bioradiotherapy with cetuximab in unfit patients. The primary endpoint of a progression-free survival benefit in the experiment alarm with avelumab was not met, albeit a favorable trend was seen in the unfit cohort. The latter abstract (LBA36) related to Check Mate 651, a phase III study enrolling 947patients in the recurrent and/or metastatic setting. The primary objective was to compare overall survival between patients treated with the EXTREME regimen and those receiving an immunotherapy doublet (nivolumab plus ipilimumab) in the first line. Despite a trend for improved survival in patients with higher tumor expression of programmed death ligand-1 (PD-L1), the trial did not meet its primary endpoint. Taken together, these negative results underline the importance of reliable predictive biomarkers for future clinical research.



Dr Francesca Caparrotti

Results of the long term follow-up (FU) of the JCOG0701 randomized controlled trial, comparing accelerated fractionation (2.4 Gy/fraction) to standard fractionation for T1/T2glottic cancer, were presented. After a median FU of 7 years, progression-free survival(PFS), overall survival (OS), and larynx progression-free survival (LPFS) were comparable in the two groups, while there was a lower incidence of late adverse events in the accelerated fractionation group (p=0.055).

Local control in head and neck squamous cell carcinoma (HNSCC) after the introduction in 2013 of geometric margins in the Danish Head and Neck Cancer Group (DAHANCA)consensuses guidelines was compared to the outcome of HNSCC patients treated applying the former guidelines. The median FU was 48 months. The 3-year local failure rate was 15% and 11% in 2010-2012 and 2013-2015, respectively (p=0.03).

Results of the phase I study evaluating NBTXR3 (hafnium oxide nanoparticles injected intratumorally and activated by radiotherapy) plus intensity modulated radiation therapy(IMRT) for cisplatin-ineligible locally advanced HNSCC patients were discussed. In the 31patients evaluable for efficacy, the objective response rate (ORR) of the primary lesion was 83.9% and the complete response rate by imaging (CRR) 67.7%, at a median time of7.8 months after NBTXR3 injection. Recruitment is ongoing and updated efficacy and safety results will be further presented.


Upcoming 2022 Meetings!

AHNS/ASCO/ASTRO/SITC HNC Symposium - Phoenix 24-26 Feb

ICHNO/ECHNO -Brussels March 3-5

ESTRO Annual meeting - Copenhagen 6-10 May

ASCO Annual Meeting Chicago 3-7 June

IFHNOS World Congress - Rome 1-4 September

ESMO Annual Meeting - Paris 9-13 September

ASTRO Annual meeting - San Antonio 23-26 October



Dr Trisha Wise-Draper
Dr James Bates

The American Society of Clinical Oncology (ASCO) earlier this year in June highlighted several interesting studies in head and neck cancer. These included promising approaches with immune checkpoint blockade neoadjuvantly in head and necks quamous cell carcinoma (HNSCC) as well as in combination with chemotherapy in recurrent and metastatic nasopharyngeal cancer (NPC).

In the neoadjuvant setting, the PD-1 antibody, pembrolizumab, given one to three weeks prior to surgery, resulted in a high rate of pathologic response (PR) defined as greatert han 20% treatment effect (tumor necrosis, keratinous debris and histiocytic formation)in nearly 40% of patients in a study by Wise-Draper and colleagues. Importantly, PR correlated with a significant improvement in both disease-free survival (DFS) and overall survival compared to those that did not achieve a PR. One-year DFS was significantly higher in those with intermediate risk features who also received adjuvant pembrolizumab concurrent with standard of care radiation compared to historical controls in RTOG 9501 (97% [95% CI 91-100%] vs 69% [95% CI 59-78%]). Uppaluri et al. showed that an additional dose of neoadjuvant pembrolizumab up to 2 cycles was safe and enhanced pTR-2 (≥50% treatment effect) pathological response to 42% in resectable human papillomavirus negative HNSCC. These study results are promising for future neoadjuvant approaches in HNSCC as well as using PR as a surrogate for survival.

Two studies in nasopharyngeal cancer were presented at ASCO combining PD-1antibodies (toripalimab or camrelizumab) with gemcitabine and cisplatin in recurrent and metastatic disease. The Jupiter-02 study demonstrated a prolonged median progression free survival (PFS) with the addition of toripalimab (11.7mo) compared to chemotherapyalone (8 mo). Similar results were seen in a similar study performed in China with camrelizumab and chemotherapy with a PFS of 10.8 mo compared to 6.9 mo in those receiving chemotherapy alone. These promising results are practice changing for this group of patients.

Also presented at ASCO were several studies evaluating de-intensification of therapy in HPV-associated oropharyngeal cancer. An update to the now fully published ECOG 3311confirmed continued excellent outcomes in patients with intermediate risk factors after TORS who receive either 50 Gy or 60 Gy of adjuvant RT. Early results from the 30 ROC study at Memorial Sloan Kettering Cancer Center were also presented showing that inpatients with no hypoxia on an F-MISO PET scan after resection of their primary tumor,30 Gy with bolus cisplatin was associated with a 1-year local control of 94%.

In the space of definitive chemo RT for HPV-negative patients, where outcomes still have room for improvement, the recently completed TRYHARD study (RTOG 3501) evaluating standard chemo RT +/- lapatinib, an EGFR/HER2 inhibitor showed no benefit to the addition of lapatinib. While we continue to make incredible progress as a field personalizing treatment for patients with HPV-associated disease, novel approaches are still needed for patients with HPV-negative disease.


Updates in Nasopharyngeal Carcinoma

Dr Sharon Poh
Dr Melvin Chua

The established treatment of nasopharyngeal carcinoma has remained unchanged for along time; however, in recent years, there have been some exciting developments, especially within the locally advanced, relapsed/recurrent and metastatic sphere.

The benefit of induction chemotherapy before definitive chemoradiation in locally advanced (Stage III to IVA excepting cT3N0) non-metastatic NPC has been established with the publication of a number of large Phase III trials showing significant benefits. Regiments used are cisplatin based, and include GP, TPF, PF and others. The latest MAC-NPC meta-analysis (published in abstract form at time of writing) further reinforces this, demonstrating that the addition of induction chemotherapy or adjuvant chemotherapy to radical concurrent chemoradiation improves disease control probability and survival over chemoradiation alone.

At the recent ASCO 2021 meeting, abstracts were also presented investigating the role of capecitabine as adjuvant treatment after CRT compared to CRT alone. Ma et al. looked at metronomic capecitabine (650 mg/m2 twice daily for 1 year) in Stage III to IVA (excludingT3-4N0 and T3N1) NPC, and showed that there was significant improvement in the 3-yearsurvival data. On the other hand, Miao et al. used a dose of 1000 mg/m2 bi-daily for 14days every 21-day cycle for 8 cycles, and also showed significant 3-year survival results.

Capecitabine also makes its appearance again in the recurrent/metastatic setting. Liu etal. carried out a study investigating the role of maintenance capecitabine in the metastatic setting (1,250 mg/m2/day on days 1-14 every 21 days for up to 24 months) or BSC alone. After a median follow-up of 33.1 months, median PFS was 35.2 months in the capecitabine maintenance group vs 9.1 months in the BSC group, though OS data was immature at time of presentation. The role of immunotherapy in recurrent/metastatic NPC as first line treatment was also reinforced with the recent Phase III trials, JUPITER-02(using anti PD-1 monoclonal antibody toripalimab) and CAPTAIN (using anti PD-1monoclonal antibody camrelizumab) studies.

There are a number of upcoming trials for which we are eagerly awaiting results. TheNRG-HN001 (NRG Oncology, NCI) trial is still currently recruiting, and aims to investigate adjuvant chemotherapy treatment after standard CCRT in locally advanced NPC, based on plasma EBV results post CCRT. Those with undetectable levels are randomized to either standard adjuvant cisplatin and fluorouracil chemotherapy or observation; while those with detectable levels are randomized to either standard cisplatin and fluorouracil chemotherapy versus gemcitabine and paclitaxel. In the immunotherapy space, another trial with ongoing recruitment is the NEO-SPACE trial (Chinese University of HK, NCC Singapore). This is a non-randomized, phase 2 trial looking at neoadjuvant pembrolizumab in combination with gemcitabine-cisplatin for 2 cycles, followed by concurrent pembrolizumab-cisplatin-radiation, followed by maintainence pembrolizumab monotherapy in previously untreated stage IVA NPC.


Fellowships in Head and Neck Oncology

Princess Margaret Radiation Medicine Program

The Radiation Medicine Program Head and Neck Site Group at the Princess Margaret Cancer Center offers one year clinical and research fellowships in Head and Neck Radiation Oncology through the University of Toronto. Candidates will have successfully completed their training and national specialty examinations in Radiation Oncology prior to commencement of the fellowship position. Our program sees more than 800new patients a year providing fellows significant clinical exposure and training in the management of a wide range of head and neck malignancies including opportunities for research. Three fellowship positions are offered annually for a period of one year commencing in July each year. Applications are due June 30th the year prior to enrollment. Limited positions may also be available commencing in January with applications due the previous January. The selection process is competitive and based on professional and academic merit.

For more information and application procedures please email:

John Waldron MD, MSc, FRCPC Radiation Oncology

Head and Neck Site Group Leader

Princess Margaret Cancer Center, Toronto, Canada


From a previous fellow...

I was fortunate enough to secure a fellowship at the Princess Margaret Hospital focussing on head and neck radiation oncology and late effects in adult patients treated with radiotherapy in 2015.I had decid ed on pursuing a fellowship at Princess Margaret based on its international reputation for head and neck cancer research and in facilitating the clinical development of many Australian head and neck radiation, medical and surgical oncologists before me. From an Australian summer to landing in Toronto in late December (one of its coolest ever years I am told) was quite an experience, but Princess Margaret is conveniently located in Downtown Toronto with very accessible and convenient residential accommodation and public transport. The fellowship did not disappoint, with many internationally recognised head and neck experts more than willing to provide academic and clinical mentoring throughout my fellowship. PMH has a large fellowship program which in 2015 included about 20radiation oncology fellows from across the globe which has led to many long lasting friendships. For those wanting to travel, Toronto is the perfect base to explore the natural beauty of Ontario with easy access to the remainder of Canada and the US. Fellowships are great time for personal and professional growth - and Toronto is a brilliant place for both!

Dr Lachlan McDowell

To highlight fellowship opportunities or provide contact details for your fellowshipprogram on the HNCIG website or newsletter please contact

Lachlan McDowell -

Christina Henson -


Hellenic Cooperative Oncology Group


Dr Amanda Psyrri

The ΗeLLENIC COOPERATIVE ONCOLOGY GROUP (HeCOG) is a national academic group that consists of leading physicians and other scientists, members of the Oncology community. HeCOG was founded in 1990.

The main objectives of the HECOG are:

  • The study and development of novel anticancer drugs.

  • The promotion of clinical and basic research both in Greece and internationally, in collaboration with respective scientific organizations.

  • The organisation of scientific educational events with the aim of informing and educating physicians and other scientists.

HeCOG studies have been published in over 700 peer-reviewed papers in high-impact journals, including New England Journal of Medicine, Journal of Clinical Oncology, Lancet Oncology, JNCI, Nature Genetics, and Clinical Cancer Research.

Over the years, the Head and Neck Cancer Group (HNCG) has conducted randomized phase II/III studies in nasopharyngeal cancer and locally advanced head and neck squamous cell cancer. In the past years, multidisciplinary specialties have been collaborating with the group. In addition, HeCOG HNCG has contributed to MACH-NC and MARCH Collaborative Groups meta-analyses. HECOG is a founding member of HNCIG.

At present, HeCOG HNCG is conducting window-of-opportunity immunotherapy and translational biomarker studies in Head and Neck Cancer. In addition, HeCOG HNCG is currently running an international head and neck cancer registry with COVID-19 (HERODOTUS: Head and Neck cancers international CODVID-19 collabOraTion): NCT#04632173). Furthermore, HeCOGHNC Group is participating in a phase III GORTEC Nivolumab postoperative study.


Japan Clinical Oncology Group


Dr Takuma Onoe

Japan Clinical Oncology Group (JCOG) is a nationwide cooperative group for oncology research established in 1990. Currently, it is the biggest academic oncology group in Japan and consists of 16 subgroups. The JCOG-Head and Neck Cancer Study Group (JCOG-HNCSG) is a comparatively newer subgroup derived from the Gastrointestinal Oncology Study Group in 2011.Furthermore, JCOG-HNCSG is composed of more than 505 investigators at 33 institutions.

JCOG-HNCSG has conducted five clinical trials aiming for a minimally invasive approach and better quality of life/treatment outcomes using a multidisciplinary approach thus far. The result of JCOG0706 (phase II trial of chemoradiotherapy (CRT) with S-1 + cisplatin) was published in Cancer Science in 2015, and JCOG1008 (phase II/III trial of postoperative CRT with 3-weeklycisplatin vs weekly cisplatin) was presented at ASCO2020 and received as “practice-changing.”

JCOG1212 (RADPLAT–MSC: dose finding and confirmatory trial of super selective intra-arterial infusion of cisplatin and concomitant radiotherapy for patients with locally advanced maxillarysinus cancer) is a trial of a novel therapeutic strategy for this relatively rare cancer and has just completed enrolment in November 2021.

Presently, we are recruiting patients for two trials. JCOG1601 (RESPOND: randomized phase III study to evaluate the value of omission of prophylactic neck dissection for stage I/II tongue cancer) is a simple but influential study that will answer this big clinical question in head and neck surgery. JCOG1912 (NEW BRIDGE: novel approach of prophylactic radiation to reduce toxicities, comparing 2-step-40 with SIB-56 IMRT techniques for locally advanced squamous cell carcinoma of the head and neck) is an intergroup phase III trial in collaboration with Radiation Therapy Study Group that will shed light on late side effects and quality of life.

Collaborating with global investigators, we aim to achieve a new standard therapy by conducting high-quality clinical trials for patients with head and neck cancer worldwide.


The Latin American Cooperative Oncology Group

(LACOG) Head and Neck Group

Dr Luiz Kowalski and Dr Pedro De Marchi

The Latin American Cooperative Oncology Group (LACOG) was founded 10 years ago by Latin American oncologists who wanted to improve collaborative clinical research. The main objective of the group is to create a network for investigators to promote innovative studies for the Latin American population, that are also of global interest. Our current network has more than 420members, working in over 200 research sites and hospitals where they conduct epidemiological studies and gather real world data on the patients’ characteristics, treatments and outcomes.

The group also carries out clinical research on new drugs, for various pathologies, many of which are conducted in partnership with different collaborative groups around the world. LACOG has 29studies currently ongoing and has 8 groups dedicated to different types of tumors: breast, gynecological, genitourinary, lung, neurological, head and neck, gastrointestinal and radiation.

LACOG office is located at Tecnopuc – Scientific and Technological Park at PUCRS - in Porto Alegre, Brazil, and it is responsible for assisting the investigators regarding study concepts, developing protocols, managing and monitoring data, pharmacovigilance and statistical analyses. Currently, LACOG team counts 24 employees; among them are physicians, biomedical scientists, pharmacists, statisticians, IT and administrative analysts and professionals of communication.

LACOG Head and Neck Group

The LACOG Head and Neck Group works jointly with the Brazilian Head and Neck Cancer Group(GBCP) to carry out activities to support research, the continuing development of healthcare professionals and to raise awareness of the disease in patients and the community. The group's social media focuses on raising people’s awareness of these types of tumors, as well as patientcare. We held livestreams on Instagram and created a YouTube channel, both were dedicated to discussing topics in the area, with the constant support of healthcare workers and support staff, using clear language so that non-specialist professionals and the lay public would both be able to understand as well.

The group also launched a fundraising campaign, in partnership with Projeto Cura, to collect donations that would make it possible to support pilot clinical research studies. The aim was to involve the community by making them aware of the importance of early diagnosis and treatment. In 2020, we carried out our activities online, due to the COVID-19 pandemic, but we had excellent numbers and reach for our events. We ended the year with the following meetings, held in parallel: The First Multidisciplinary Support Forum: an event dedicated to the support and rehabilitation of patients with head and neck cancer; the Third GBCP Annual Symposium 2020:dedicated to the latest updates in this specialist area; and the Second Forum for Patients with Head and Neck Cancer: at which, the main issues in treating the disease, the side effects, the sequelae and access to treatment, were all discussed. The group had four studies published in international journals and launched a Head and Neck Oncology Manual.


HNCIG Portfolio Open Trials

HNCIG-1: Post-operative Adjuvant Treatment for HPV-positive Tumours (PATHOS)

HNCIG-2: EORTC 1420: Study Assessing The “Best of” Radiotherapy vs the “Best of” Surgery in Patients With Oropharyngeal Carcinoma (Best Of).

HNCIG-3: CompARE: Phase III randomised controlled trial Comparing Alternative Regimens for escalating treatment of intermediate and high-risk oropharyngeal cancer.

HNCIG-5: NRG HN001: Individualized Treatment in Treating Patients With Stage II-IVBNasopharyngeal Cancer Based on EBV DNA.

HNCIG Developed Guidelines

Porceddu SV, Daniels C, Yom SS, Liu H, Waldron J, Gregoire V, Moore A, Veness M, Yao M, Johansen J,Mehanna H, Rischin D, Le QT. Head and Neck Cancer International Group (HNCIG) Consensus Guidelines for the Delivery of Postoperative Radiation Therapy in Complex Cutaneous Squamous Cell Carcinoma of the Head and Neck (cSCCHN). Int J Radiat Oncol Biol Phys. 2020 Jul 15;107(4):641-651

HNCIG Members in Steering committee/Involved in Consensus review

Carsuzaa F, Lapeyre M, Gregoire V, Maingon P, Beddok A, Marcy PY, Salleron J, Coutte A, Racadot S,Pointreau Y, Graff P, Beadle B, Benezery K, Biau J, Calugaru V, Castelli J, Chua M, Di Rito A, Dore M,Ghadjar P, Huguet F, Jardel P, Johansen J, Kimple R, Krengli M, Laskar S, Mcdowell L, Nichols A, TribiusS, Valduvieco I, Hu C, Liem X, Moya-Plana A, D'onofrio I, Parvathaneni U, Takiar V, Orlandi E, Psyrri A,Shenouda G, Sher D, Steuer C, Shan Sun X, Tao Y, Thomson D, Tsai MH, Vulquin N, Gorphe P, Mehanna H,Yom SS, Bourhis J, Thariat J. Recommendations for postoperative radiotherapy in head & necksquamous cell carcinoma in the presence of flaps: A GORTEC internationally-reviewed HNCIG-endorsed consensus. Radiother Oncol. 2021 May 11;160:140-147.

Mehanna H, Hardman JC, Shenson JA, Abou-Foul AK, Topf MC, AlFalasi M, Chan JYK, Chaturvedi P,Chow VLY, Dietz A, Fagan JJ, Godballe C, Golusiński W, Homma A, Hosal S, Iyer NG, Kerawala C, KohYW, Konney A, Kowalski LP, Kraus D, Kuriakose MA, Kyrodimos E, Lai SY, Leemans CR, Lennon P, LicitraL, Lou PJ, Lyons B, Mirghani H, Nichols AC, Paleri V, Panizza BJ, Parente Arias P, Patel MR, Piazza C,Rischin D, Sanabria A, Takes RP, Thomson DJ, Uppaluri R, Wang Y, Yom SS, Zhu YM, Porceddu SV, deAlmeida JR, Simon C, Holsinger FC. Recommendations for head and neck surgical oncology practice in asetting of acute severe resource constraint during the COVID-19 pandemic: an international consensus. Lancet Oncol. 2020 Jul;21(7):e350-e359. doi: 10.1016/S1470-2045(20)30334-X. Epub 2020 Jun 11.

Grégoire V, Evans M, Le QT, Bourhis J, Budach V, Chen A, Eisbruch A, Feng M, Giralt J, Gupta T, HamoirM, Helito JK, Hu C, Hunter K, Johansen J, Kaanders J, Laskar SG, Lee A, Maingon P, Mäkitie A, Micciche'F, Nicolai P, O'Sullivan B, Poitevin A, Porceddu S, Składowski K, Tribius S, Waldron J, Wee J, Yao M, YomSS, Zimmermann F, Grau C. Delineation of the primary tumour Clinical Target Volumes (CTV-P) in laryngeal, hypopharyngeal, oropharyngeal and oral cavity squamous cell carcinoma: AIRO, CACA,DAHANCA, EORTC, GEORCC, GORTEC, HKNPCSG, HNCIG, IAG-KHT, LPRHHT, NCIC CTG, NCRI, NRG Oncology, PHNS, SBRT, SOMERA, SRO, SSHNO, TROG consensus guidelines. Radiother Oncol. 2018Jan;126(1):3-24

HNCIG Endorsed guideline

Thomson DJ, Palma D, Guckenberger M, Balermpas P, Beitler JJ, Blanchard P, Brizel D, Budach W,Caudell J, Corry J, Corvo R, Evans M, Garden AS, Giralt J, Gregoire V, Harari PM, Harrington K,Hitchcock YJ, Johansen J, Kaanders J, Koyfman S, Langendijk JA, Le QT, Lee N, Margalit D, Mierzwa M,Porceddu S, Soong YL, Sun Y, Thariat J, Waldron J, Yom SS. Practice Recommendations for Risk-Adapted Head and Neck Cancer Radiation Therapy During the COVID-19 Pandemic: An ASTRO-ESTRO Consensus Statement. Int J Radiat Oncol Biol Phys. 2020 Jul 15;107(4):618-627. doi:10.1016/j.ijrobp.2020.04.016. Epub 2020 Apr 14.

HNCIG acknowledged in guideline development

Ng WT, Soong YL, Ahn YC, Al Hussain H, Choi HCW, Corry J, Grégoire V, Harrington KJ, Hu CS, Jensen K, Kwong DL, Langendijk JA, Le QT, Lee NY, Lin JC, Lu TX, Mendenhall WM, O'Sullivan B, Ozyar E, Pan JJ, Peters LJ, Poh SS, Rosenthal DI, Sanguineti G, Tao Y, Wee JT, Yom SS, Chua MLK, Lee AWM. International Recommendations on Reirradiation by Intensity Modulated Radiation Therapy for Locally Recurrent Nasopharyngeal Carcinoma. Int J Radiat Oncol Biol Phys. 2021 Jul 1;110(3):682-695.



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