Christopher F Perry

University of Queensland | UQ · School of Medicine

Background Recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) generally has a poor prognosis for patients with limited treatment options. While incorporating immune checkpoint inhibitors (ICIs) has now become the standard of care, the efficacy is variable, with only a subset of patients responding. The complexity of the tumor mi...

Immune checkpoint inhibitor (ICI) therapy has had limited success (<30%) in treating metastatic recurrent Head and Neck Oropharyngeal Squamous Cell Carcinomas (OPSCCs). We postulate that spatial determinants in the tumor play a critical role in cancer therapy outcomes. Here, we describe the case of a male patient diagnosed with p16+ OPSCC and exten...

Vaccines have been hailed as one of the most remarkable medical advancements in human history, and their potential for treating cancer by generating or expanding anti-tumor T cells has garnered significant interest in recent years. However, the limited efficacy of therapeutic cancer vaccines in clinical trials can be partially attributed to the ina...

Immune checkpoint inhibitor (ICI) modality has had a limited success (<20%) in treating metastatic recurrent Head & Neck Oropharyngeal Squamous cell carcinomas (OPSCCs). To improve response rates to ICIs, tailored approaches capable to capture the tumor complexity and dynamics of each patient's disease are needed. Here, we performed advanced analys...

Head and neck squamous cell carcinoma (HNSCC) represents a heterogeneous group of tumors. While significant progress has been made using multimodal treatment, the 5‐year survival remains at 50%. Developing effective therapies, such as immunotherapy, will likely lead to better treatment of primary and metastatic disease. However, not all HNSCC tumor...

The development of cancer vaccines has been intensively pursued over the past 50 years with modest success. However, recent advancements in the fields of genetics, molecular biology, biochemistry, and immunology have renewed interest in these immunotherapies and allowed the development of promising cancer vaccine candidates. Numerous clinical trial...

Background Head and neck squamous cell carcinoma, and in particular hypopharyngeal squamous cell carcinoma, has long been associated with disfiguring treatment options, significant morbidity and limited long‐term survival outcomes. Total pharyngolaryngectomy (TPL) with free flap reconstruction followed by post‐operative radiation therapy or chemora...

Now is an exciting era of development in immunotherapy checkpoint inhibitors and their effect on the treatment of NPC. While the general prognosis of R/M disease is poor, immunotherapy offers some promise in a malignancy associated with EBV and characterized by a peritumoural immune infiltrate. Our study aims to review past and on‐going clinical tr...

Purpose A randomised controlled trial was conducted to evaluate the effectiveness of a nurse-delivered Head and Neck Cancer Survivor Self-Management Care Plan (HNCP) for patients who had completed treatment for head and neck cancer (HNC). Methods Ten oncology nurses were trained to deliver the HNCP. The HNCP consisted of one face-to-face hour-long...

Oral cavity Squamous Cell Carcinoma (OCSCC) is a common form of head and neck cancer throughout the developed and developing world. However, the etiology of OCSCC is still unclear. Here, we explored the extent to which tobacco use, Human Papillomavirus (HPV) infection and genetic and transcriptomic changes contributed to the oncogenesis of OCSCC. I...

Waterfall plot of significant mutations identified by MuTect, MuTect2 or VarScan2. Mutations are ranked accordingly to significance assigned by MutSigCV analysis. Clinical traits are matched to the samples and displayed as a heat map. Tumor purity and ploidy values predicted from BubbleTree are included. (EPS)

Consensus WGCNA network analysis between TCGA HNSC-OCSCC and BNE PAH OCSCC RNA-seq data. (A) Module preservation z-score of modules detected in consensus gene network. Higher z-score indicates higher module preservation/similarity (>10 z-score). (B) Correlation of modules detected in consensus gene network with clinical trait measurements is shown...

BubbleTree Tumor purity estimates for samples 1–10. The BubbleTree graph is presented with the R score (copy number ratio) on the x-axis and the HDS (heterozygous-deviation score; |Beta allele frequency– 0.5|) on the y-axis. The proximity of the bubbles (somatic copy number alterations), or leaves, to the tree branches indicates the integer allele-...

BubbleTree Tumor purity estimates for samples 11–20. The BubbleTree graph is presented with the R score (copy number ratio) on the x-axis and the HDS (heterozygous-deviation score; |Beta allele frequency– 0.5|) on the y-axis. The proximity of the bubbles (somatic copy number alterations), or leaves, to the tree branches indicates the integer allele...

BubbleTree Tumor purity estimates for samples 21–25. The BubbleTree graph is presented with the R score (copy number ratio) on the x-axis and the HDS (heterozygous-deviation score; |Beta allele frequency– 0.5|) on the y-axis. The proximity of the bubbles (somatic copy number alterations), or leaves, to the tree branches indicates the integer allele...

Differential gene testing between smoking groups. Differential gene expression testing between the smoking groups (Current versus Ex; Current versus Never; Ex vs Never) using LIMMA-voom. Genes were considered statistically significanct if they met the fold-change threshold of > 1.25 or < -1.25 and Benjamini and Hochberg (BH) adjusted p-value of < 0...

Normalized read counts of HPV16 E7 gene. Reads from RNA-seq data (33 samples) were aligned to the human reference genome concatenated with HPV16 (NC_001526.4) genome and represented as normalized read counts per million for the HPV16 E7 oncogene. (EPS)

Background Early diagnosis of head and neck squamous cell carcinoma (HNSCCs) is an appealing way to increase survival rates in these patients as well as to improve quality of life post-surgery. Angiogenesis is a hallmark of tumor initiation and progression. We have investigated a panel of angiogenic factors in saliva samples collected from HNSCC pa...

Background: Metastasis in HNC patients is reflected by measurable levels of circulating tumor cells (CTCs) in the peripheral blood of cancer patients. CTCs represent cancer cells from the primary and metastatic sites, thereby providing a comprehensive representation of the tumor burden of an individual patient. For patients without CTCs at presenta...

Human papillomavirus (HPV), a virus vital to the etiology of cervical cancer, is strongly associated with the development of head and neck cancer. Therefore, it is pivotal to develop a noninvasive and cost-effective approach for detecting oral HPV. Accumulating evidence suggested the usefulness of salivary oral rinse as a diagnostic fluid to detect...

Distant metastasis (DM) from head and neck cancers (HNC) portends a poor patient prognosis. Despite its important biological role, little is known about the cells which seed these DM. Circulating tumour cells (CTCs) represent a transient cancer cell population, which circulate in HNC patients' peripheral blood and seed at distant sites. Capture and...

Background: Recurrent respiratory papillomatosis is a rare but morbid disease caused by human papillomavirus (HPV) types 6 and 11. Infection is preventable through HPV vaccination. Following an extensive quadrivalent HPV vaccination program (females 12-26 years in 2007-2009) in Australia, we established a method to monitor incidence and demographi...

Head and neck squamous cell carcinomas (HNSCC) are a heterogeneous group of tumours that originate predominantly from the oral cavity, pharynx and larynx. Our aim was to determine whether salivary miRNA expression levels can diagnose these cancer subtypes. Saliva samples were collected from healthy controls (n=113, smoker and non-smokers), HPV-posi...

Background Cytokeratin (CK) intermediate filaments are demonstrated to have enormous potential in regulating cellular motility and cancer progression. There are more than 20 divergent CKs that have been identified, of which CK 8, 17, 18 and 19 are reported to be elevated in the tumour biopsies of head and neck cancer squamous cell carcinoma (HNSCC)...

Introduction To estimate and monitor national incidence of Juvenile onset Recurrent Respiratory Papillomatosis (JoRRP) in Australia following the extensive quadrivalent HPV vaccine catch up program (females aged 12–26 years in 2007–2009, which included women of child bearing age) and to assess demographics and risk factors of incident cases. Metho...

Background Blockade of the PD-1/PD-L1 immune checkpoint pathway is emerging as a promising immunotherapeutic approach for the management and treatment of head and neck cancer patients who do not respond to 1st/2nd line therapy. However, as checkpoint inhibitors are cost intensive, identifying patients who would most likely benefit from anti PD-L1 t...

Background Head and neck squamous cell carcinoma (HNSCC) is a heterogeneous group of tumours with a typical 5 year survival rate of <40 %. DNA methylation in tumour-suppressor genes often occurs at an early stage of tumorigenesis, hence DNA methylation can be used as an early tumour biomarker. Saliva is an ideal diagnostic medium to detect early HN...

Objective: To analyse predictive factors affecting outcome after treatment with hyperbaric oxygen (HBOT) in patients with idiopathic sudden sensorineural hearing loss (ISSHL). Methods: This is a retrospective audit of outcome in 77 consecutive patients referred for consideration of HBOT for ISSHL for either adjunctive treatment or after failure...

Background: Human papilloma virus-16 (HPV-16) infection is a major risk factor for a subset of head and neck squamous cell carcinoma (HNSCC), in particular oropharyngeal squamous cell carcinoma (OPSCC). Current techniques for assessing the HPV-16 status in HNSCC include the detection of HPV-16 DNA and p16(INK4a) expression in tumor tissues. When t...

Objectives: Head and neck squamous cell carcinoma (HNSCC) is a heterogeneous tumour type which necessitates multiple in vitro models to attain an appreciation of its multiple subtypes. The phenomenon of epithelial-mesenchymal transition (EMT) is important to the development of a metastatic cancer cell phenotype being relevant to the ability of canc...

Head and neck cancer patients often present with advanced metastatic disease resulting in a poor 5-year survival. Therefore, there is a need for non-invasive diagnostic tools that could complement conventional imaging to inform clinicians of patient outcomes and treatment responses. A liquid biopsy addresses this unmet clinical need; a simple perip...

In Reply The focus of much current research has been the role of human papilloma virus (HPV) in oropharyngeal cancer, especially as a separate risk factor, or even disease process, compared with smoking-related cancer of the oropharynx. Our data1 support previous research showing that oral cavity cancer is slightly more prevalent than oropharyngeal...

Oral and oropharyngeal cancers (OPC) are the most common types of head and neck cancers (HNC), accounting for 263,900 new cases and 128,000 deaths worldwide (1). These cancer subtypes are highly curable if detected early. The most common treatments include surgery, radiation therapy, chemotherapy or a combination of these treatments. Tobacco smokin...

Background The ability to identify high risk head and neck cancer (HNC) patients with disseminated disease prior to presenting with clinically detectable metastases holds remarkable potential. A fraction of circulating tumour cells (CTCs) are invasive cancer cells which mediate metastasis by intravasation, survival and extravasation from the blood...

The prevalence of ear disease and hearing loss is greater for Indigenous children than for their non-Indigenous counterparts. In 2009, we established a mobile ear-screening service in South Burnett, in which an Indigenous Health Worker (IHW) assesses children at school and shares results by telemedicine with ear, nose and throat (ENT) specialists,...

Over 50,000 new cases of head and neck cancer are diagnosed each year in the United States. The majority of these are squamous cell carcinoma (HNSCC), associated with human papillomavirus infection and carcinogenic behaviors such as tobacco use and alcohol consumption. Although these are more common, there are several other causes that this book ad...

There is a general lack of public awareness on the daunting statistics of head and neck squamous cell carcinoma (HNSCC) when compared with other mainstay cancers such as breast and prostate cancers. HNSCC includes malignancies in five major anatomical sites, namely, oral cavity, oropharynx, nasopharynx, hypopharynx and larynx. HNSCC is diverse in n...

Minimally invasive techniques are required for the identification of head and neck cancer (HNC) patients who are at an increased risk of metastasis, or are not responding to therapy. An approach utilised in other solid cancers is the identification and enumeration of circulating tumour cells (CTCs) in the peripheral blood of patients. Low numbers o...

Importance The relatively high and possibly rising incidence of mouth squamous cell carcinoma in nonsmokers, especially women, without obvious cause has been noted by previous authors. Is chronic dental trauma and irritation a carcinogen, and what is its importance compared with human papillomavirus (HPV) oropharyngeal cancer in nonsmokers?Objecti...

With an increasing recognition of the link between oral and systemic disease, attention has turned to saliva as an alternative diagnostic medium for a diverse array of health conditions [1]. Compared with blood, saliva collection is non-invasive, easy sampling with multiple sampling opportunities, does not need pre-processing and is ideal for 3 rd...

Head and neck squamous cell carcinoma (HNSCC) is the 6th most common cancer with 650000 new cases p/a worldwide. HNSCC causes high morbidity with a five-year survival rate of less than 60%, which has not improved due to the lack of early detection 1. Metastatic disease remains one of the leading causes of death in HNSCC patients.This review article...

Background: Few cancers pose greater challenges than head and neck (H&N) cancer. Residual effects following treatment include body image changes, pain, fatigue and difficulties with appetite, swallowing and speech. Depression is a common comorbidity. There is limited evidence about ways to assist patients to achieve optimal adjustment after comple...

In 2009, we established a mobile ear-screening service for children in a remote community approximately 350 km north-west of Brisbane. We compared pre-implementation health service utilisation data (2006-2008) with data for the following three years. The study included only children in schools that had participated in screening since the start of t...

A mobile ear-screening service was established in an Aboriginal community in central Queensland. Telemedicine allowed ear nose and throat (ENT) specialists at the tertiary children's hospital in Brisbane to assess children at a distance using pre-recorded information comprising video-otoscopic images and the results of tympanometry and audiometry....

Paediatric cochlear implantation (PCI) requires complex case evaluation and counselling, surgical intervention, and habilitation. Outcomes vary and many cases have sub-optimal outcomes as a result of a broad spectrum of adverse influences. To systematically review the literature to identify research papers that indicate a demonstrated outcome or pr...

The increasing prevalence and earlier onset of chronic health conditions amongst Aboriginal and Torres Strait Islander people has become a concerning and significant problem. Telehealth may be a useful application for the early detection, monitoring, and treatment of chronic diseases such as ear disease and vision impairment. This study evaluates w...

In Australia, three to five children die each year because of otitis media complications, and 15 children will suffer permanent hearing loss each year as a result of otitis media. Extracranial complications occur most commonly, and include mastoiditis, cholesteatoma and otitis media with perforation. Intracranial complications are less common, and...

We describe a previously unreported case of ethmoid silent sinus syndrome. Case report and review of the world literature regarding silent sinus syndrome. A 33-year-old woman developed medial displacement of the left orbital contents in the absence of trauma, surgery or other significant pathology. Imaging showed opacification of the left ethmoid s...

A 6-week-old boy presented with failure to thrive, pulmonary stenosis and stridor, which had worsened since birth. He also had undescended testes. On examination, he was noted to have facial asymmetry and his left eyelid did not close fully. He was noted to have a broad nose with a pit in the skin of his nose at the junction of the nasal bones and...

Juvenile nasopharyngeal angiofibroma (JNA) is a rare tumour occurring almost exclusively in young adult males. Although histologically benign, it can be locally aggressive with a significant recurrence rate. The finding of activating beta-catenin gene mutations in the stromal cells indicates these are the neoplastic cells and supports the associati...

Lymphoblastoid cell lines (LCLs) and fibroblasts provide conveniently derived non-neuronal samples in which to investigate the aetiology of schizophrenia (SZ) using gene expression profiling. This assumes that heritable mechanisms associated with risk of SZ have systemic effects and result in changes to gene expression in all tissues. The broad aim...

We compared the accuracy of ear, nose and throat (ENT) assessments made by a specialist in the conventional face-to-face (FTF) manner with assessments made using pre-recorded information, i.e. history and video recording of the ears, nose, face and throat. 58 patients, mainly of indigenous background, agreed to participate in the study (median age...

A newborn presented with acute airway obstruction secondary to a compound odontoma of the hard palate/nasal floor. This is the first case recorded in the literature. We review the pathology of compound odontomas and discuss the management of this rare and interesting case.

For many years, the term 'specific cough' has been used as a clinical cough descriptor in children to signify the likelihood of an underlying disease causing the cough. In this case study, we describe a child with specific cough caused by a rare carcinoma, a mucoepidermoid carcinoma of the bronchus. The cough only totally resolved after the primary...

To determine whether isotretinoin (or 13-cis-retinoic acid) decreases the risk of second primary cancers in patients previously treated for cure of head and neck squamous cell carcinoma. Randomized, double-blind, placebo-controlled trial. Two head and neck multidisciplinary cancer clinics in university teaching hospitals taking cases from 4 to 5 mi...

Multipotent stem cells are thought to be responsible for the generation of new neurons in the adult brain. Neurogenesis also occurs in an accessible part of the nervous system, the olfactory mucosa. We show here that cells from human olfactory mucosa generate neurospheres that are multipotent in vitro and when transplanted into the chicken embryo....

This is an overview of the cellular biology of upper nasal mucosal cells that have special characteristics that enable them to be used to diagnose and study congenital neurological diseases and to aid neural repair. After mapping the distribution of neural cells in the upper nose, the authors' investigations moved to the use of olfactory neurones t...

The efficacy of fine-needle aspiration cytology (FNAC) in the diagnosis of parotid tumours remains a controversial subject. Studies within small departments utilizing experienced pathologists have shown FNAC to have high sensitivity and specificity for parotid tumours. The present study was performed to assess the accuracy and utility of FNAC of pa...

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Meningo-encephalocoeles of the skull base may present as spontaneous cerebrospinal fluid rhinorrhoea or acute meningitis. Previous approaches to midline skull base lesions have been either intracranial, via a craniotomy, or by transfacial or endoscopic extracranial approaches. This paper presents an alternative approach to lateral sphenoid sinus en...

To improve the success of culturing olfactory neurons from human nasal mucosa by investigating the intranasal distribution of the olfactory epithelium and devising new techniques for growing human olfactory epithelium in vitro. Ninety-seven biopsy specimens were obtained from 33 individuals, aged 21 to 74 years, collected from 6 regions of the nasa...

Tonsillar surgery has been performed from as early as 3000 BC, with recurrent tonsillitis the main indication for its use.[1] Celsus described the technique of tonsillectomy in De Medicina in AD 10 thus: 'cut the outer lining with a fingernail and then pull the tonsil out' - a technique not dissimilar to the blunt dissection technique favoured by m...

• Forty-one patients undergoing surgery between 1977 and 1985 for malignant tumors of the paranasal sinuses abutting or eroding the orbital walls were studied for the need to remove the orbital contents. All patients had preliminary computed tomographic scans to delineate the extent of orbital invasion. All were treated with preoperative radiothera...

Total glossectomy is a procedure based on sound oncologic principles, and its usefulness may not be fully appreciated. Given the dimensions of the tongue and the need to obtain a wide margin of resection, this procedure may be indicated in selected T3 lesions and recurrences after irradiation. The procedure offers excellent palliation of pain, and...

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