A consortium of head and neck cancer research groups have agreed diagnostic criteria that will aid better collaborative working.
The consortium of 21 research groups, which was led by Professor Hisham Mehanna at University of Birmingham, have published a four-part series in The Lancet Oncology detailing recommendations for conducting studies in head and neck cancer and standardising clinical practice. These agreed standards should help to advance research by making global collaborations more feasible, analysis across studies easier and sequential studies possible.
These recommendations should enable trials to speak to each other in a more logical and sequential way. There are so many subgroups in head and neck cancer now that we need better quality research, better powered studies, better and wider collaboration, can only do that if you have standardised methodology. Standardised end points will enable us to answer questions faster because we’d be able to work together.
The first paper agrees upon terminology and diagnostic features for identifying extranodal extensions in head and neck cancers, important since detection of these features indicates poor prognosis. The consensus recommendations reported in this paper, endorsed by 19 organisations representing 34 countries, are a crucial development towards standardised diagnosis and reporting of histology detected extranodal extension, which should lead to more accurate data collection and analysis.
The second proposes a new classification system for diagnosis of extranodal extensions using imaging. This classification system still needs validation but shows promise in aiding diagnosis and could help guide treatment selection. The researchers also created an online educational resource for grading imaging detected extranodal extensions.
The Head and Neck Cancer International Group assessed endpoint definitions from trials in patients with recurrent or metastatic head and neck cancer published between 2008 and 2021 and identified considerable variation. The third paper highlights an urgent need for increased rigour in reporting and harmonisation of endpoints.
The final paper looks at endpoints in trials intended to cure head and neck cancer. Last, researchers investigate endpoint use in curative-intent trials. Reviewing 92 trials showed huge variation in all the core components of endpoint reporting, including definitions of common terms, such as overall survival and progression-free survival. Again, the researchers call for harmonisation and engagement of all stakeholders to ensure the transparent reporting of endpoint details.
The Lancet Onology series is accompanied by a podcast that features Professor Hisham Mehanna talking about this work.
Deputy Pro-Vice Chancellor (interdisciplinary research)
Staff profile of Professor Hisham Mehanna, InHANSE, Department of Cancer and Genomic Sciences, College of Medicine and Health, University of Birmingham
