A collaboration between ANZHNCS members Professor Camile Farah from the Australian Centre for Oral Oncology Research & Education and Dr Charbel Darido from the Peter MacCallum Cancer Centre, has been successful in securing $2.2 million in funding from the Genomics Health Futures Mission for their work “Evaluating clinically relevant biomarkers to improve early detection and treatment of head and neck cancer”.

The project is a collaboration between the two teams and their colleagues at Genomics for Life, Icon Cancer Centre, and CSIRO to continue their collaborative work into the genomic profile of head and neck cancers, and is administered through the University of Melbourne.

Over the last 30 years, improvements in survival rates if head and neck cancer patients have remained modest and have been hampered by late detection of the disease. This project will undertake genomic sequencing of patient samples to identify signatures of malignancy and premalignancy that will be validated in unique laboratory models of the human disease. The project will discover novel clinically relevant biomarkers which will allow earlier detection of head and neck cancer and ultimately lead to better treatment options for patients.

Funded through the Federal Government’s $20 billion Medical Research Future Fund, the project aims to improve health outcomes for Australian patients with cancer, by improving early detection and mapping the molecular blueprint of oral cancer and precursor lesions.

Through the Genomics Health Futures Mission, 17 researcher groups received a share of $46.5 million for genomics research to support health clinicians to identify genetic disorders and diagnose rare diseases faster, positioning Australia as a global leader in this area, as highlighted by the Minister of Health media release. Media release

Investigators: M Abdul-Razak, H Chung, E Wong, C Palme, M Veness, D Farlow, H Coleman and Gary Morgan
Information provided by ANZHNCS Member: Dr Muzib Abdul-Razak, Westmead Hospital

Funded by the Garnett Passe and Rodney Williams Memorial Foundation
Investigators: EH Ooi, D Hussey, CM Woods, NH Dharmawardana
Information provided by ANZHNCS Member: A/Prof Eng H. Ooi, Flinders University

This project resulted in 2 publications

Mayne GC, Woods CM, Dharmawardana N, Wang T, Krishnan S, Hodge JC, Foreman A, Boase S, Carney AS, Sigston EAW, Watson DI, Ooi EH, Hussey DJ. Cross validated serum small extracellular vesicle microRNAs for the detection of oropharyngeal squamous cell carcinoma. J Transl Med. 2020 Jul 10;18(1):280. doi: 10.1186/s12967-020-02446-1. PMID: 32650803; PMCID: PMC7350687.

Dharmawardana N, Ooi EH, Woods C, Hussey D. Circulating microRNAs in head and neck cancer: a scoping review of methods. Clin Exp Metastasis. 2019 Jun;36(3):291-302. doi: 10.1007/s10585-019-09961-6. Epub 2019 Mar 14. PMID: 30877500.

Conclusion: We developed a novel method, StaVarSel, that was able to identify a panel of miRNAs, present in small extracellular vesicles derived from blood serum, that robustly cross validated as a biomarker for the detection of HPV + OPSCC. This approach could be used to derive diagnostic biomarkers of other head and neck cancers.

Funded by the ANZHNCS foundation
Investigators: EH Ooi, R Yazbek, CM Woods, NH Dharmawardana
Information provided by ANZHNCS Member: A/Prof Eng H. Ooi, Flinders University

This grant funded project resulted in the following publications

Dharmawardana N, Woods C, Watson DI, Yazbeck R, Ooi EH. A review of breath analysis techniques in head and neck cancer. Oral Oncol. 2020 May;104:104654. doi: 10.1016/j.oraloncology.2020.104654. Epub 2020 Mar 19. PMID: 32200303.

Dharmawardana N, Goddard T, Woods C, Watson DI, Ooi EH, Yazbeck R. Development of a non-invasive exhaled breath test for the diagnosis of head and neck cancer. Br J Cancer. 2020 Dec;123(12):1775-1781. doi: 10.1038/s41416-020-01051-9. Epub 2020 Sep 9. PMID: 32901136; PMCID: PMC7722848.

“A breath test for cancer” is possible

Conclusion: Breath analysis for non-invasive diagnosis of HNSCC appears to be practical and accurate. Future studies should be conducted in a primary care setting to determine the applicability of breath analysis for early identification of HNSCC.

Funded by the GPRWMF academic surgeon scientist research scholarship program
Investigators: N. Dharmawardana, R. Yazbeck, E.H. Ooi.
Information provided by ANZHNCS Member: A/Prof Eng H. Ooi, Flinders University

This grant funded project resulted in the following publications

Dharmawardana N, Goddard T, Woods C, Watson DI, Butler R, Ooi EH, Yazbeck R. Breath methane to hydrogen ratio as a surrogate marker of intestinal dysbiosis in head and neck cancer. Sci Rep. 2020 Sep 14;10(1):15010. doi: 10.1038/s41598-020-72115-2. PMID: 32929151; PMCID: PMC7490703.

Conclusion: These findings suggest a modified carbohydrate fermentation profile in HNSCC patients that is tumour stage and smoking status dependent.

Partly funded by the Faculty of Health Sciences seeding grant, Flinders University
Investigators: Mistyka Schar, C.M. Woods, T. Omari, T. Athanasiadis, C. Cock, E.H. Ooi
Information provided by ANZHNCS Member: A/Prof Eng H. Ooi, Flinders University

Pharyngeal Augmentation for Dysphagia (swallowing difficulty)(PAD therapy) tested the effects of injecting hyaluronic acid (HA) or abdominal fat as a filler to the tongue base to enhance pharyngeal pressures during swallowing. This is the first study to investigate the biomechanical impact on swallowing of PAD therapy for the management of moderate-severe dysphagia following Head and Neck Cancer (HNC) treatment in a small case series.

PAD therapy demonstrated safety and resulted in improvements in self-reported dysphagia symptoms and subtle biomechanical changes suggestive of improved bolus transit on high-resolution pharyngeal video-manometry. Increased filler volumes may be required to determine the full effect of tongue base augmentation on swallowing.

Investigators: Jae Park, Anna Megow, Adam Swalling, Sam Boase, S. Kao, JC Hodge, Suren Krishnan, E.H. Ooi
Information provided by ANZHNCS Member: A/Prof Eng H. Ooi, Flinders University

This was published:

Park J, Megow A, Swalling A, Hodge JC, Foreman A, Boase S, Valentine R, Krishnan S, Ooi EH. Prognosis of oral squamous cell carcinoma with perineural invasion: A comparative study of classification types. Clin Otolaryngol. 2020 Jan;45(1):99-105. doi: 10.1111/coa.13472. Epub 2019 Nov 19. PMID: 31677332.

Conclusions: The presence of multifocal and Extra-Tumoral PNI in OSCC is associated with poor clinical outcomes. Patients with multifocal PNI were associated with worse Disease Free Survival even with adjuvant therapy.

Funding applied for.
Investigators: Jane Bickford, Sebastian Doeltgen, C.M. Woods, E.H. Ooi
Information provided by ANZHNCS Member: Dr Jane Bickford, Flinders University and A/Prof Eng H. Ooi, Flinders University

Three honours projects have examined the clinical usefulness, reliability and effectiveness of hand-held tools e.g. infrared thermography, VapoMeter, MoistureMeter-D, Indurometer/Fibrometer and surface tape measurements to objectively measure the lymphatic system (i.e. volume/dimension, fluid, tissue)  of the head and neck in both clinical and non-clinical populations.

A protocol was developed for use in a busy clinical setting and designed to examine internal and external head and neck lymphoedema (HNL). In the clinical study, 28 participants recovering from head and cancer treatment were evaluated for internal HNL and 24 participants had measures taken using the handheld tools (14 with HNL). In the non-clinical study, 22 participants were measured.

There is evidence of protocol utility and device reliability for clinical and non-clinical populations, but we did not find strong evidence of the effectiveness of these tools in detecting HNL. Validation in a larger sample is warranted.

Chief Investigator: Courtenay Henrys, Year 3 MBBS. BAppSci (Human Movement Studies)

Research Supervisor: Dr Roger Grigg MBBS FRACS

Contact Person (ie. Dept Secretary etc.): Dr Roger Grigg

Information provided by ANZHNCS Member: Dr Roger Grigg

This resulted in the publication:

Henrys CE, Grigg R. Use of fine-needle aspiration cytology in the diagnosis of parotid neoplasms. ANZ J Surg. 2015 Nov;85(11):838-42. doi: 10.1111/ans.12939. Epub 2014 Nov 26. PMID: 25424665.

Conclusion: FNAC is a useful tool in the evaluation of parotid masses but should be used with caution in identifying neoplastic subtypes.

Titles:

1. N. Beech, M. Batstone, S. Porceddu – the impact of preradiotherapy dental extractions on the development of osteoradionecrosis and quality of life
2. M. Batstone, O. Ellis – Frozen sections and their influence on surgical margins in oral cavity cancer
3. Gore S, Clark J, Batstone M, Crombie A – chemoradiotherapyvs surgery and adjuvant xrt for the management of oral cavity cancer
4. Farah C, Batstone M + others – narrow band imaging and molecular margin analysis in head and neck
5. Batstone M, Subramaniam S, Sharp D – the cost effectiveness of free flap monitoring

Chief Investigators

1. Nick Beech nicholasbeech@gmail.com
2. Martin Batstone martin.batstone@health.qld.gov.au
3. Jonathon Clarke jcjc@tpg.co
4. Martin BAtstone martin.batstone@health.qld.gov.au
5. Camile Farah c.farah@uq.edu.au
6. Shiva Subramaniam shivasubramaniam@gmail.com

Contact Person (ie. Dept Secretary etc.:
Ms Pauline Haley (07) 3646 7681
Email: pauline.haley@health.qld.gov.au

Information provided by ANZHNCS Member:  Dr Martin Batstone

The projects have resulted in the following key publications:

Beech NM, Porceddu S, Batstone MD.  Radiotherapy-associated dental extractions and osteoradionecrosis.  Head and Neck, 2017 Jan;39(1)128-132.

Beech N, Porceddu S, Batstone MD.  Preradiotherapy Dental extractions and health related quality of life.   Oral Surg, Oral Med, Oral Pathol, Oral Radio.2016 Dec;122(6):672-679.

Ellis O, David M, Park D, Batstone MD.  High volume surgeons deliver larger margins in oral cavity cancer. J Oral and Maxillofac Surg. 2016 Jul;54(5) 579-83.

Gore S, Crombie A, Batstone MD, Clark J.  Concurrent chemoradiotherapy compared with surgery and adjuvant radiotherapy for oral cavity squamous cell carcinoma.  Head and Neck 2014. Feb 15.

Farah CS, Dalley AJ,  Nguyen P,  Batstone M,  Kordbacheh F, Perry-Keene, J, Fielding D.  Improved surgical margin definition by Narrow Band Imaging for resection of oral squamous cell carcinoma:  A prospective gene expression profiling study.  Head and Neck. Dec 2016 Jun; 38(6):832-9.

Subramaniam S, Sharp D, Jardim C, Batstone MD.  Cost-effectiveness of monitoring free flaps.  Br J Oral and Maxillofac Surg 2016 Jun; 54(5):579-83.

Titles:

1. 1.HPV in oropharynx
2. Epidemiology of H&N Cancers
3. Identification of molecular and immuno diagnostic cancer markers in Northern Territory population

Chief Investigator: Dr Mahiban Thomas

Contact Person (ie. Dept Secretary etc.): Dr Mahiban Thomas

Information provided by ANZHNCS Member:  Dr Mahiban Thomas, Darwin Hospital

Chief Investigator: Dr Iain Ward

Contact Person (ie. Dept Secretary etc.): Dr Iain Ward

Information provided by ANZHNCS Member:  Dr Iain Ward, The Canterbury Regional Cancer and Haematology Service

Titles:

1. Sample Saliva Test to Diagnose Head and Neck Cancer at an Early Stage –  with Chamindie Punyadeera
2. Defining the role of HPV in causation of Oral Cavity Cancers in Non-Smokers

Chief Investigator: Dr Chris Perry

Contact Person (ie. Dept Secretary etc.):  Dr Chris Perry

Information provided by ANZHNCS Member:  Dr Chris Perry, Brisbane ENT

Titles:

a)  Further studies regarding biomarkers for non- smoking, non-drinking patients who develop oral squamous cell carcinomas. PhD project

S. Belobrov,  D. Wiesenfeld, M. McCullough,

b)  Oral yeasts’ carriage and biofilm forming ability and exfoliative cytology in oral cancer patients. PhD project

A. Al Nuami, D. Wiesenfeld, M.McCullough

c) Molecular Oncogenesis of Oral Cavity and Oropharyngeal Squamous Cell Carcinoma PhD Project

K Koo,T Iseli, D Wiesenfeld, A Burgess

d) A role for panendoscopy? Second primary tumours in early stage squamous cell carcinoma of the oral tongue

K Koo, R Harris, D Wiesenfeld, T Iseli

Chief Investigators: Dr Tim Iseli, Michael McCullough

Contact Person (ie. Dept Secretary etc.):  Dr Tim Iseli, Michael McCullough

Information provided by ANZHNCS Member:  Dr Tim Iseli, Michael McCullough, Dr David Wiesenfeld, Royal Melbourne Hospital

The research projects have resulted in multiple significant publications as listed below:

Udovicich C, Daniell J, Wiesenfeld D, Bressel M, Rowe D, Vital D, Cavanagh K, Lekgabe E, Wong T, Magarey MJR, Iseli TA, Fua T, Rischin D, McDowell L. Contralateral neck failure in oral tongue cancer: outcomes from two centers using predefined treatment criteria. Head Neck 2021 https://doi.org/10.1002/hed.26671

Koo K, Mouradov, Angel CM, Iseli TA, Wiesenfeld D, McCullough MJ, Burgess AW, Sieber OM. Genomic signature of oral squamous cell carcinomas from non-smoking non-drinking patients Cancers 2021;13(5) 1029 https://doi.org/10.1016/j.ijom.2020.06.011

Shaw LM, Iseli TA, Wiesenfeld D, Ramakrishnan A, Granger CL. Postoperative pulmonary complications following major head and neck cancer surgery Int J Oral Maxillofacial Surg 2021;50(3):302-308.

Daniell J, Udovicich C, Rowe D, McDowell L, Vital D, Bressel M, Magarey MJR, Iseli TA, Wong T, Lekgabe E, Cavanagh K, Fua T, Rischin D, Wiesenfeld D. Impact of histological oral tongue cancer margins on locoregional recurrence: A multi-centre retrospective analsysis Oral Oncol 2020 https://doi.org/10.1016/j.oraloncology.2020.105004

Shepherd SJ, Creber N, Mansour K, Wiesenfeld D, Iseli TA, Amott D. Relationship between age, comorbidities and complications in head and neck cancer patients undergoing curative surgery ANZ J Surg 2019: https://doi.org/10.1111/ans.15611

Tang N, Tao P, Liew J, Iseli TA, Wiesenfeld D, MacGill K, Ramakrishnan A. Palatal fistulas complicating osseomyocutaneous reconstruction of oncological maxillectomy defects Eur J Plastic Surg 2019;42:577-582

Pun A, King JA, Phal PM, Iseli TA. Giant psudomeningocele of the greater wing of sphenoid. ANZ J Surg 2018:https://doi.org/10.1111/ans.13267

Koo K, Angel C, Kershaw N, Mouradov D, Chueh A, Wiesenfeld D, Iseli TA, McCullough M, Sieber O, Burgess AW. Characterization of NOTCH1 mutations in oral cavity squamous cell carcinomas Cancer Research 2017 DOI: 10.1158/1538-7445

Subramaniam S, Natri A, King J, Iseli T Endoscopic resection of the pterygoid plates following incomplete transoral resection of an odontogenic myxoma Oral Maxillofacial Surg 2017: https://doi.org/10.1016/j.bjoms.2016.08.004

Breik O, Sim F, Wong T, Nastri A, Iseli TA, Wiesenfeld D. Survival outcomes of mucosal melanoma in the head and neck: case series and review of current treatment guidelines. J Oral Maxillofac Surg in press (DOI: http://dx.doi.org/10.1016/j.joms.2016.03.008)

Translational Research Activities

Cancer Biology

1. Individualising care in head and neck cancer using genetic markers of cancer progression to guide drug target selection in a mouse model
2. Tissue microarray analysis of oropharyngeal SCC tumour specimens
3. Defining the role of HPV in the causation of oral cavity cancers in non-smokers / Viral oncogenesis in oral squamous cell carcinoma.
4. Studying the factors involved in the perineural spread of cutaneous squamous cell carcinomas of the head and neck
5. Perineural spread of cutaneous malignancy in a live mouse model and ganglion tumour coculture model
6. Optimising intratumoural treatment of HNSCC mouse models with a novel drug EBC-46
7. The role of LoxL2 in perineural invasion of cutaneous squamous cell carcinoma
8. Studies on squamous carcinoma formation and the development of novel therapies

Rhinosinusitis

9. High throughput screening of bioactive extracts for anti-inflammatory properties and the development of an in-situ nasal gelling drug delivery system for the treatment of chronic rhinosinusitis

Imaging

10.Evaluation of accuracy of 3T MRI in evaluation of head and neck perineural invasion

 Epidemiology

11. Head and Neck Cancer Study

 Clinical Trials

12. Phase I dose-escalation study to determine the safety and tolerability of an intratumoural injection of EBC-46 in patients with refractory cutaneous or subcutaneous tumours
13. A pilot study of an old drug with a new use – prochlorperazine to improve anti-EGFR therapy in squamous cell carcinoma of the mucosa
14. Phase I/II open-label clinical trial of autologous EBV-specific T cell therapy as consolidative treatment following chemotherapy for metastatic EBV-associated NPC

Surgical Trial

15. Primary trans-oral surgical management of early tonsillar squamous cell carcinoma followed by risk-adapted radiotherapy
16. Drop Neck Study Assessment of need for neck dissection in cutaneous metastatic disease to the parotid:

Diagnostics

17. A simple saliva test to diagnose head and neck cancer at an early stage
18. A saliva-based method for the detection of HPV-associated oral cancers
19. Salivary glycoproteins as biomarkers for head and neck squamous cell carcinoma
20. To develop a method to detect circulating tumour cells (CTC’s) in metastatic head and neck squamous cell carcinoma
21. Identification of breath biomarkers from head and neck SCC

Information provided by Andrew Wetzig, Research Coordinator, Queensland Head and Neck Cancer Centre; ANZHNCS Member A/Prof Ben Panizza, PA Hospital, Brisbane, Qld

Professor Camile Farah, Perth, Western Australia

Research Project Titles:

1. Genomic sequencing of head and neck cancers and precancers
2. Exomic and transcriptomic profile of early onset oral cancers
3. DNA damage repair pathways in oral leukoplakia
4. Single cell sequencing of oral carcinoma and dysplasia
5. Role of HPV in oral leukoplakia
6. Predictive molecular signature of epithelial dysplasia
7. Malignant transformation of oral potentially malignant disorders
8. Optical fluorescence imaging of oral potentially malignant disorders
9. Correlation of confocal laser endomicroscopy with histology
10. Confocal laser endomicroscopy for head and neck cancer delineation

Chief Investigators: Professor Camile Farah, Dr Simon Fox, Dr Kate Shearston

Collaborators: Dr Chady Sader (Western ENT and St John of God Hospital), Dr Charbel Darido (Peter MacCallum Cancer Centre), Prof Alistair Forrest (Harry Perkins Institute of Medical Research), Dr Jenny Grew (Australian Clinical Labs), Dr Omar Kujan (UWA), Associate Professor Carol Tran (CQ University)

Contact Person (ie. Dept Secretary etc.):  Professor Camile Farah

Information provided by ANZHNCS Member:  Professor Camile Farah, Australian Centre for Oral Oncology Research & Education.

Research themes and projects

The work of our group is based mainly on two independent but inter-related themes namely Genomic Pathology and Optical Imaging. The ultimate objective of our research is to bring together the findings from these distinct areas into one clinical focus of Molecular Imaging to improve outcomes for patients suffering from head and neck cancers and precancerous lesions.

Theme 1. Genomic Pathology

This research theme is interested in uncovering molecular biomarkers of head and neck cancers and precancers that can be used to either diagnose these conditions or predict the likely outcome of their presence.

1. Genomic sequencing of head and neck cancers and precancers
2. Exomic and transcriptomic profile of early onset oral cancers
3. DNA damage repair pathways in oral leukoplakia
4. Single cell sequencing of oral carcinoma and dysplasia
5. Malignant transformation of oral potentially malignant disorders

Selected published papers supporting this theme:

1: Bai Y, Boath J, White GR, Kariyawasam UGIU, Farah CS, Darido C. The Balance

between Differentiation and Terminal Differentiation Maintains Oral Epithelial

Homeostasis. Cancers (Basel). 2021 Oct 13;13(20):5123. doi:

10.3390/cancers13205123. PMID: 34680271; PMCID: PMC8534139.

2: Idrees M, Farah CS, Shearston K, Kujan O. A machine-learning algorithm for

the reliable identification of oral lichen planus. J Oral Pathol Med. 2021

Oct;50(9):946-953. doi: 10.1111/jop.13226. Epub 2021 Aug 11. PMID: 34358361.

3: Kordbacheh F, Farah CS. Molecular Pathways and Druggable Targets in Head and

Neck Squamous Cell Carcinoma. Cancers (Basel). 2021 Jul 9;13(14):3453. doi:

10.3390/cancers13143453. PMID: 34298667; PMCID: PMC8307423.

4: Farah CS. Molecular landscape of head and neck cancer and implications for

therapy. Ann Transl Med. 2021 May;9(10):915. doi: 10.21037/atm-20-6264. PMID:

34164549; PMCID: PMC8184465.

5: Farah CS, Fox S, Shearston K, Newman L, Babic S, Vacher M. Lichenoid

dysplasia is not a distinct pathological entity. Oral Oncol. 2021

Aug;119:105362. doi: 10.1016/j.oraloncology.2021.105362. Epub 2021 May 29. PMID:

34062399.

6: Zolghadr F, Tse N, Loka D, Joun G, Meppat S, Wan V, Zoellner H, Xaymardan M,

Farah CS, Lyons JG, Hau E, Patrick E, Seyedasli N. A Wnt-mediated phenotype

switch along the epithelial-mesenchymal axis defines resistance and invasion

downstream of ionising radiation in oral squamous cell carcinoma. Br J Cancer.

2021 Jun;124(12):1921-1933. doi: 10.1038/s41416-021-01352-7. Epub 2021 Mar 30.

PMID: 33785878; PMCID: PMC8184921.

7: Idrees M, Farah CS, Khurram SA, Firth N, Soluk-Tekkesin M, Kujan O. Observer

agreement in the diagnosis of oral lichen planus using the proposed criteria of

the American Academy of Oral and Maxillofacial Pathology. J Oral Pathol Med.

2021 May;50(5):520-527. doi: 10.1111/jop.13170. Epub 2021 Apr 8. PMID: 33730381.

8: Farah CS. Molecular, genomic and mutational landscape of oral leukoplakia.

Oral Dis. 2021 May;27(4):803-812. doi: 10.1111/odi.13608. Epub 2020 Sep 9. PMID:

33448555.

9: Kujan O, Idrees M, Anand N, Soh B, Wong E, Farah CS. Efficacy of oral brush

cytology cell block immunocytochemistry in the diagnosis of oral leukoplakia and

oral squamous cell carcinoma. J Oral Pathol Med. 2021 May;50(5):451-458. doi:

10.1111/jop.13153. Epub 2021 Jan 12. PMID: 33368584.

10: Chitturi Suryaprakash RT, Kujan O, Shearston K, Farah CS. Three-Dimensional

Cell Culture Models to Investigate Oral Carcinogenesis: A Scoping Review. Int J

Mol Sci. 2020 Dec 14;21(24):9520. doi: 10.3390/ijms21249520. PMID: 33327663;

PMCID: PMC7765087.

11: Kujan O, van Schaijik B, Farah CS. Immune Checkpoint Inhibitors in Oral

Cavity Squamous Cell Carcinoma and Oral Potentially Malignant Disorders: A

Systematic Review. Cancers (Basel). 2020 Jul 17;12(7):1937. doi:

10.3390/cancers12071937. PMID: 32708945; PMCID: PMC7409293.

12: Celentano A, Glurich I, Borgnakke WS, Farah CS. World Workshop on Oral

Medicine VII: Prognostic biomarkers in oral leukoplakia and proliferative

verrucous leukoplakia-A systematic review of retrospective studies. Oral Dis.

2021 May;27(4):848-880. doi: 10.1111/odi.13363. Epub 2020 May 12. PMID:

32306449.

13: Idrees M, Kujan O, Shearston K, Farah CS. Oral lichen planus has a very low

malignant transformation rate: A systematic review and meta-analysis using

strict diagnostic and inclusion criteria. J Oral Pathol Med. 2021

Mar;50(3):287-298. doi: 10.1111/jop.12996. Epub 2020 Feb 8. PMID: 31981238.

14: Farah CS, Jessri M, Bennett NC, Dalley AJ, Shearston KD, Fox SA. Exome

sequencing of oral leukoplakia and oral squamous cell carcinoma implicates DNA

damage repair gene defects in malignant transformation. Oral Oncol. 2019

Sep;96:42-50. doi: 10.1016/j.oraloncology.2019.07.005. Epub 2019 Jul 9. PMID:

31422212.

15: Farah CS, Fox SA. Dysplastic oral leukoplakia is molecularly distinct from

leukoplakia without dysplasia. Oral Dis. 2019 Oct;25(7):1715-1723. doi:

10.1111/odi.13156. Epub 2019 Jul 26. PMID: 31295760.

16: Webster JD, Batstone M, Farah CS. Missed opportunities for oral cancer

screening in Australia. J Oral Pathol Med. 2019 Aug;48(7):595-603. doi:

10.1111/jop.12915. Epub 2019 Jul 3. PMID: 31188491.

17: Pollaers K, Massingham I, Friedland PL, Farah CS. The economic burden of

oral squamous cell carcinoma in Australia. J Oral Pathol Med. 2019

Aug;48(7):588-594. doi: 10.1111/jop.12907. Epub 2019 Jun 27. PMID: 31177557.

18: Kujan O, Huang G, Ravindran A, Vijayan M, Farah CS. CDK4, CDK6, cyclin D1

and Notch1 immunocytochemical expression of oral brush liquid-based cytology for

the diagnosis of oral leukoplakia and oral cancer. J Oral Pathol Med. 2019

Aug;48(7):566-573. doi: 10.1111/jop.12902. Epub 2019 Jun 26. PMID: 31172614.

19: Kujan O, Huang G, Ravindran A, Vijayan M, Farah CS. The role of cyclin-

dependent kinases in oral potentially malignant disorders and oral squamous cell

carcinoma. J Oral Pathol Med. 2019 Aug;48(7):560-565. doi: 10.1111/jop.12903.

Epub 2019 Jun 27. PMID: 31172620.

20: Shearston K, Fateh B, Tai S, Hove D, Farah CS. Oral lichenoid dysplasia and

not oral lichen planus undergoes malignant transformation at high rates. J Oral

Pathol Med. 2019 Aug;48(7):538-545. doi: 10.1111/jop.12904. Epub 2019 Jun 22.

PMID: 31172588.

21: Min Ang X, Chi Khang Au P, Kwok K, Yeon Park K, Kujan O, Frydrych AM, Farah

1. Quality of life in patients with oral leukoplakia. J Oral Pathol Med. 2019

Aug;48(7):574-580. doi: 10.1111/jop.12897. Epub 2019 Jun 26. PMID: 31172584.

22: Shearston K, Fateh B, Tai S, Hove D, Farah CS. Malignant transformation rate

of oral leukoplakia in an Australian population. J Oral Pathol Med. 2019

Aug;48(7):530-537. doi: 10.1111/jop.12899. Epub 2019 Jun 21. PMID: 31172563.

23: Villa A, Celentano A, Glurich I, Borgnakke WS, Jensen SB, Peterson DE, Delli

K, Ojeda D, Vissink A, Farah CS. World Workshop on Oral Medicine VII: Prognostic

biomarkers in oral leukoplakia: A systematic review of longitudinal studies.

Oral Dis. 2019 Jun;25 Suppl 1(Suppl 1):64-78. doi: 10.1111/odi.13087. PMID:

31140698; PMCID: PMC6544170.

24: Pentenero M, Bowers LM, Jayasinghe R, Yap T, Cheong SC, Kerr AR, Farah CS,

Alevizos I. World Workshop on Oral Medicine VII: Clinical evidence of

differential expression of lncRNAs in oral squamous cell carcinoma: A scoping

review. Oral Dis. 2019 Jun;25 Suppl 1(Suppl 1):88-101. doi: 10.1111/odi.13076.

PMID: 31140697; PMCID: PMC6544174.

25: Pentenero M, Bowers L, Jayasinghe R, Cheong SC, Farah CS, Kerr AR, Alevizos

1. World Workshop on Oral Medicine VII: Functional pathways involving

differentially expressed lncRNAs in oral squamous cell carcinoma. Oral Dis. 2019

Jun;25 Suppl 1:79-87. doi: 10.1111/odi.13051. PMID: 31140691.

26: Alsarraf A, Kujan O, Farah CS. Liquid-based oral brush cytology in the

diagnosis of oral leukoplakia using a modified Bethesda Cytology system. J Oral

Pathol Med. 2018 Oct;47(9):887-894. doi: 10.1111/jop.12759. Epub 2018 Jul 19.

PMID: 29957892.

27: Pollaers K, Hinton-Bayre A, Friedland PL, Farah CS. AJCC 8th Edition oral

cavity squamous cell carcinoma staging – Is it an improvement on the AJCC 7th

Edition? Oral Oncol. 2018 Jul;82:23-28. doi: 10.1016/j.oraloncology.2018.04.018.

Epub 2018 May 10. PMID: 29909897.

28: Fox SA, Farah CS. Mass spectrometry in the palm of your hand: Future

applications of in vivo tissue analysis. Oral Dis. 2019 Apr;25(3):639-642. doi:

10.1111/odi.12897. Epub 2018 Jun 11. PMID: 29782691.

29: Fox SA, Currie SS, Dalley AJ, Farah CS. Transcriptome changes induced

in vitro by alcohol-containing mouthwashes in normal and dysplastic oral

keratinocytes. J Oral Pathol Med. 2018 May;47(5):511-518. doi:

10.1111/jop.12704. Epub 2018 Mar 22. PMID: 29504154.

30: El-Sakka H, Kujan O, Farah CS. Assessing miRNAs profile expression as a risk

stratification biomarker in oral potentially malignant disorders: A systematic

review. Oral Oncol. 2018 Feb;77:57-82. doi: 10.1016/j.oraloncology.2017.11.021.

Epub 2017 Dec 22. PMID: 29362128.

31: H Alsarraf A, Kujan O, Farah CS. The utility of oral brush cytology in the

early detection of oral cancer and oral potentially malignant disorders: A

systematic review. J Oral Pathol Med. 2018 Feb;47(2):104-116. doi:

10.1111/jop.12660. Epub 2017 Dec 7. PMID: 29130527.

32: Jessri M, Dalley AJ, Farah CS. Deficient double-strand break repair in oral

squamous cell carcinoma cell lines. J Oral Pathol Med. 2017 Oct;46(9):695-702.

doi: 10.1111/jop.12576. Epub 2017 May 17. PMID: 28383762.

33: Kujan O, Shearston K, Farah CS. The role of hypoxia in oral cancer and

potentially malignant disorders: a review. J Oral Pathol Med. 2017

Apr;46(4):246-252. doi: 10.1111/jop.12488. Epub 2016 Aug 25. PMID: 27560394.

34: Dalley AJ, Abdul Majeed AA, Pitty LP, Major AG, Farah CS. LGR5 expression in

oral epithelial dysplasia and oral squamous cell carcinoma. Oral Surg Oral Med

Oral Pathol Oral Radiol. 2015 Apr;119(4):436-40.e1. doi:

10.1016/j.oooo.2014.11.014. Epub 2014 Dec 5. PMID: 25592865.

35: Jessri M, Dalley AJ, Farah CS. MutSα and MutLα immunoexpression analysis in

diagnostic grading of oral epithelial dysplasia and squamous cell carcinoma.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Jan;119(1):74-82. doi:

10.1016/j.oooo.2014.06.017. Epub 2014 Sep 28. PMID: 25446502.

36: Jessri M, Dalley AJ, Farah CS. hMSH6: a potential diagnostic marker for oral

carcinoma in situ. J Clin Pathol. 2015 Jan;68(1):86-90. doi:

10.1136/jclinpath-2014-202411. Epub 2014 Oct 28. PMID: 25352643.

37: Dalley AJ, Pitty LP, Major AG, Abdulmajeed AA, Farah CS. Expression of ABCG2

and Bmi-1 in oral potentially malignant lesions and oral squamous cell

carcinoma. Cancer Med. 2014 Apr;3(2):273-83. doi: 10.1002/cam4.182. Epub 2014

Jan 11. PMID: 24415717; PMCID: PMC3987077.

38: Jessri M, Farah CS. Next generation sequencing and its application in

deciphering head and neck cancer. Oral Oncol. 2014 Apr;50(4):247-53. doi:

10.1016/j.oraloncology.2013.12.017. Epub 2014 Jan 15. PMID: 24440145.

39: Dost F, Lê Cao K, Ford PJ, Ades C, Farah CS. Malignant transformation of

oral epithelial dysplasia: a real-world evaluation of histopathologic grading.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Mar;117(3):343-52. doi:

10.1016/j.oooo.2013.09.017. Epub 2013 Oct 17. PMID: 24388536.

40: Abdulmajeed AA, Farah CS. Gene expression profiling for the purposes of

biomarker discovery in oral potentially malignant lesions: a systematic review.

Clin Med Insights Oncol. 2013 Oct 31;7:279-90. doi: 10.4137/CMO.S12950. PMID:

24250244; PMCID: PMC3825664.

41: Abdulmajeed AA, Farah CS. Can immunohistochemistry serve as an alternative

to subjective histopathological diagnosis of oral epithelial dysplasia? Biomark

Cancer. 2013 Oct 10;5:49-60. doi: 10.4137/BIC.S12951. PMID: 24179398; PMCID:

PMC3798313.

42: Dost F, Lê Cao KA, Ford PJ, Farah CS. A retrospective analysis of clinical

features of oral malignant and potentially malignant disorders with and without

oral epithelial dysplasia. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013

Dec;116(6):725-33. doi: 10.1016/j.oooo.2013.08.005. Epub 2013 Oct 18. PMID:

24144993.

Theme 2. Optical Imaging

This research theme is interested in understanding how optical imaging modalities can help with diagnosis and treatment of head and neck cancers and precancers, and provide better outcomes for patients with these conditions.

1. Optical fluorescence imaging of oral potentially malignant disorders
2. Narrow Band Imaging and molecular margins
3. Correlation of confocal laser endomicroscopy with histology
4. Confocal laser endomicroscopy for head and neck cancer surgical delineation
5. Comparative histopathology, machine learning and artificial intelligence

Selected published papers supporting this theme:

1: Guida A, Ionna F, Farah CS. Narrow-band imaging features of oral lichenoid

conditions: A multicentre retrospective study. Oral Dis. 2021 May 13. doi:

10.1111/odi.13915. Epub ahead of print. PMID: 33982367.

2: Karnowski K, Li Q, Poudyal A, Villiger M, Farah CS, Sampson DD. Influence of

tissue fixation on depth-resolved birefringence of oral cavity tissue samples. J

Biomed Opt. 2020 Sep;25(9):096003. doi: 10.1117/1.JBO.25.9.096003. PMID:

32914607; PMCID: PMC7481436.

3: Tiwari L, Kujan O, Farah CS. Clinico-pathological correlation of optical

fluorescence imaging in oral mucosal lesions. Oral Dis. 2020 Mar 21. doi:

10.1111/odi.13334. Epub ahead of print. PMID: 32198955.

4: Farah CS, Dost F, Do L. Usefulness of optical fluorescence imaging in

identification and triaging of oral potentially malignant disorders: A study of

VELscope in the LESIONS programme. J Oral Pathol Med. 2019 Aug;48(7):581-587.

doi: 10.1111/jop.12896. Epub 2019 Jun 21. PMID: 31172574.

5: Walther J, Li Q, Villiger M, Farah CS, Koch E, Karnowski K, Sampson DD.

Depth-resolved birefringence imaging of collagen fiber organization in the human

oral mucosa <i>in vivo</i>. Biomed Opt Express. 2019 Mar 22;10(4):1942-1956.

doi: 10.1364/BOE.10.001942. PMID: 31086712; PMCID: PMC6484997.

6: Tiwari L, Kujan O, Farah CS. Optical fluorescence imaging in oral cancer and

potentially malignant disorders: A systematic review. Oral Dis. 2020

Apr;26(3):491-510. doi: 10.1111/odi.13071. Epub 2019 Mar 26. PMID: 30810255.

7: Farah CS. Narrow Band Imaging-guided resection of oral cavity cancer

decreases local recurrence and increases survival. Oral Dis. 2018

Mar;24(1-2):89-97. doi: 10.1111/odi.12745. PMID: 29480612.

8: Farah CS, Fox SA, Dalley AJ. Integrated miRNA-mRNA spatial signature for oral

squamous cell carcinoma: a prospective profiling study of Narrow Band Imaging

guided resection. Sci Rep. 2018 Jan 16;8(1):823. doi:

10.1038/s41598-018-19341-x. PMID: 29339786; PMCID: PMC5770416.

9: Boppart SA, Brown JQ, Farah CS, Kho E, Marcu L, Saunders CM, Sterenborg HJCM.

Label-free optical imaging technologies for rapid translation and use during

intraoperative surgical and tumor margin assessment. J Biomed Opt. 2017

Dec;23(2):1-10. doi: 10.1117/1.JBO.23.2.021104. PMID: 29288572; PMCID:

PMC5747261.

10: Farah CS, Kordbacheh F, John K, Bennett N, Fox SA. Molecular classification

of autofluorescence excision margins in oral potentially malignant disorders.

Oral Dis. 2018 Jul;24(5):732-740. doi: 10.1111/odi.12818. Epub 2018 Mar 13.

PMID: 29243374.

11: Farah CS. Focus On: Oral Cancer Screening Devices. Dent Today. 2017

Apr;36(4):16. PMID: 29235309.

12: Lalla Y, Matias MA, Farah CS. Assessment of oral mucosal lesions with

autofluorescence imaging and reflectance spectroscopy. J Am Dent Assoc. 2016

Aug;147(8):650-60. doi: 10.1016/j.adaj.2016.03.013. Epub 2016 Apr 23. PMID:

27117325.

13: Dost F, Do L, Farah CS. Knowledge of oral cancer risk factors amongst high-

risk Australians: findings from the LESIONS programme. Aust Dent J. 2016

Dec;61(4):432-439. doi: 10.1111/adj.12408. PMID: 26780197.

14: Kordbacheh F, Bhatia N, Farah CS. Patterns of differentially expressed genes

in oral mucosal lesions visualised under autofluorescence (VELscope(™) ). Oral

Dis. 2016 May;22(4):285-96. doi: 10.1111/odi.12438. Epub 2016 Feb 9. PMID:

26749103.

15: Vu A, Farah CS. Narrow band imaging: clinical applications in oral and

oropharyngeal cancer. Oral Dis. 2016 Jul;22(5):383-90. doi: 10.1111/odi.12430.

Epub 2016 Jan 25. PMID: 26713751.

16: Dost F, Do L, Farah CS. Lesion Evaluation, Screening and Identification of

Oral Neoplasia Study: an assessment of high-risk Australian populations.

Community Dent Oral Epidemiol. 2016 Feb;44(1):64-75. doi: 10.1111/cdoe.12191.

Epub 2015 Aug 11. PMID: 26259637.

17: Lalla Y, Matias M, Farah CS. Oral mucosal disease in an Australian urban

Indigenous community using autofluorescence imaging and reflectance

spectroscopy. Aust Dent J. 2015 Jun;60(2):216-24. doi: 10.1111/adj.12320. Epub

2015 May 20. PMID: 25990387.

18: Allen K, Farah CS. Screening and referral of oral mucosal pathology: a

check-up of Australian dentists. Aust Dent J. 2015 Mar;60(1):52-8. doi:

10.1111/adj.12261. PMID: 25721278.

19: Vu AN, Matias M, Farah CS. Diagnostic accuracy of Narrow Band Imaging for

the detection of oral potentially malignant disorders. Oral Dis. 2015

May;21(4):519-29. doi: 10.1111/odi.12315. PMID: 25619340.

20: Farah CS, Dalley AJ, Nguyen P, Batstone M, Kordbacheh F, Perry-Keene J,

Fielding D. Improved surgical margin definition by narrow band imaging for

resection of oral squamous cell carcinoma: A prospective gene expression

profiling study. Head Neck. 2016 Jun;38(6):832-9. doi: 10.1002/hed.23989. Epub

2015 Jun 26. PMID: 25545703.

21: Allen K, Ford PJ, Farah CS. Oral mucosal screening and referral attitudes of

Australian oral health therapists and dental hygienists in Queensland. Int J

Dent Hyg. 2015 Aug;13(3):206-12. doi: 10.1111/idh.12103. Epub 2014 Aug 26. PMID:

25155987.

22: Allen K, Farah CS. Dental prosthetist experience with oral mucosal screening

and referral. Quintessence Int. 2014 Nov-Dec;45(10):891-7. doi:

10.3290/j.qi.a32512. PMID: 25126631.

23: Bhatia N, Matias MA, Farah CS. Assessment of a decision making protocol to

improve the efficacy of VELscope™ in general dental practice: a prospective

evaluation. Oral Oncol. 2014 Oct;50(10):1012-9. doi:

10.1016/j.oraloncology.2014.07.002. Epub 2014 Aug 2. PMID: 25096826.

24: Vu AN, Farah CS. Efficacy of narrow band imaging for detection and

surveillance of potentially malignant and malignant lesions in the oral cavity

and oropharynx: a systematic review. Oral Oncol. 2014 May;50(5):413-20. doi:

10.1016/j.oraloncology.2014.02.002. Epub 2014 Mar 4. PMID: 24618128.

25: Do LG, Spencer AJ, Dost F, Farah CS. Oral mucosal lesions: findings from the

Australian National Survey of Adult Oral Health. Aust Dent J. 2014

Mar;59(1):114-20. doi: 10.1111/adj.12143. Epub 2014 Feb 4. PMID: 24494603.

26: Bhatia N, Lalla Y, Vu AN, Farah CS. Advances in optical adjunctive AIDS for

visualisation and detection of oral malignant and potentially malignant lesions.

Int J Dent. 2013;2013:194029. doi: 10.1155/2013/194029. Epub 2013 Sep 2. PMID:

24078812; PMCID: PMC3775423.

27: Farah CS, Bhatia N, John K, Lee BW. Minimum intervention dentistry in oral

medicine. Aust Dent J. 2013 Jun;58 Suppl 1:85-94. doi: 10.1111/adj.12054. PMID:

23721342.

28: Nguyen P, Bashirzadeh F, Hodge R, Agnew J, Farah CS, Duhig E, Clarke B,

Perry-Keene J, Botros D, Masters IB, Fielding D. High specificity of combined

narrow band imaging and autofluorescence mucosal assessment of patients with

head and neck cancer. Head Neck. 2013 May;35(5):619-25. doi: 10.1002/hed.22999.

Epub 2012 Jun 28. PMID: 22740333.

29: Farah CS, McIntosh L, Georgiou A, McCullough MJ. Efficacy of tissue

autofluorescence imaging (VELScope) in the visualization of oral mucosal

lesions. Head Neck. 2012 Jun;34(6):856-62. doi: 10.1002/hed.21834. Epub 2011 Aug

4. PMID: 21818819.

30: McIntosh L, McCullough MJ, Farah CS. The assessment of diffused light

illumination and acetic acid rinse (Microlux/DL) in the visualisation of oral

mucosal lesions. Oral Oncol. 2009 Dec;45(12):e227-31. doi:

10.1016/j.oraloncology.2009.08.001. Epub 2009 Oct 1. PMID: 19800285.

31: McCullough MJ, Farah CS. The assessment of the DNA content of oral cytology

via virtual microscopy for the early detection of epithelial dysplasia and

neoplasia in oral mucosal lesions. Oral Oncol. 2009 Sep;45(9):e114-5. doi:

10.1016/j.oraloncology.2009.06.009. Epub 2009 Aug 8. PMID: 19665920.

32: Farah CS, McCullough MJ. A pilot case control study on the efficacy of

acetic acid wash and chemiluminescent illumination (ViziLite) in the

visualisation of oral mucosal white lesions. Oral Oncol. 2007 Sep;43(8):820-4.

doi: 10.1016/j.oraloncology.2006.10.005. Epub 2006 Dec 13. PMID: 17169603.

33: Vuchkova J, Maybury T, Farah CS. Digital interactive learning of oral

radiographic anatomy. Eur J Dent Educ. 2012 Feb;16(1):e79-87. doi:

10.1111/j.1600-0579.2011.00679.x. Epub 2011 Feb 17. PMID: 22251358.

34: Vuchkova J, Maybury TS, Farah CS. Testing the educational potential of 3D

visualization software in oral radiographic interpretation. J Dent Educ. 2011

Nov;75(11):1417-25. PMID: 22058390.

35: Allen K, Farah CS. Patient perspectives of diagnostic delay for suspicious

oral mucosal lesions. Aust Dent J. 2015 Sep;60(3):397-403. doi:

10.1111/adj.12246. PMID: 25345336.

36: Farah CS. A keratinised lump on the lateral surface of the tongue. Aust J

Gen Pract. 2020 Apr;49(4):206-207. doi: 10.31128/AJGP-10-19-5103. PMID:

32233345.

37: Farah CS. Concurrent chronic hyperplastic candidosis and oral lichenoid

lesion as adverse events of secukinumab therapy. Aust Dent J. 2021

Sep;66(3):340-345. doi: 10.1111/adj.12833. Epub 2021 Mar 5. PMID: 33547810.