Solving Dilemmas in Clinical Practice

A Michigan State University surgeon is teaming up with a Lansing-area dental benefits firm on a clinical trial to create a simple, cost-effective saliva test to detect oral cancer, a breakthrough that would drastically improve screening and result in fewer people dying of the world’s sixth most common cancer.
Barry Wenig, a professor in the College of Human Medicine’s Department of Surgery and lead investigator on the project, is working with Delta Dental of Michigan’s Research and Data Institute to compile study data and recruit dentists. The study will enroll 100-120 patients with white lesions or growths in their mouths and tonsil areas to test as part of the clinical trial.
Wenig and his team will be looking for certain biomarkers previously identified by researchers at UCLA; the biomarkers have been shown in studies to confirm the presence of oral cancer. By creating a simple saliva test which could identify the biomarker’s presence, physicians and dentists would know which patients need treatment and which ones could avoid needless and invasive biopsies.
"Most white lesions are benign, so a majority of people who develop them are getting biopsies that are not needed," Wenig said. "Conversely, a simple test would allow us to identify those patients with malignant lesions and get them into treatment quicker."
Oral cancer has a poor survival rate linked to late detection, Wenig said: Only 60 percent of patients live beyond five years after diagnosis. Among black males, the survival rate is less than 38 percent.
"The key challenge to reduce the mortality and morbidity of oral cancer is to develop strategies to identify and detect the disease when it is at a very early stage," he said.
In addition to Delta Dental’s Research and Data Institute, which works with researchers from leading universities to monitor advances in science, Wenig is collaborating with PeriRx, a Pennsylvania company that will sponsor upcoming trials with the Food and Drug Administration.
"The results of this trial could be life changing for many people," said Jed Jacobson, chief science officer at Delta Dental and a licensed dentist. "It is a tremendous opportunity for the dental community to participate in what could be a groundbreaking research project."
Wenig and members of his team recently returned from southern California, where they met with UCLA colleagues, who are working to develop saliva diagnostic tests for other cancers as well.
"These tests are as noninvasive as it gets; patients simply need to spit into a cup," Wenig said. "The ease of the test will greatly expand our ability to effectively screen for the cancerous lesions.
"Right now, there are no early screenings available for most head and neck cancers."
The test also has the potential to accelerate health care savings, he added, since the number of biopsies can be dramatically reduced.