2025 Contemporary Multidisciplinary Care of the Head and Neck Cancer Patient CME

Podcast Transcript

Paul C. Bryson, MD, MBA: Thanks for joining us for another episode of Head and Neck Innovations. I'm your host, Paul Bryson, Director of the Cleveland Clinic Voice Center. You can follow me on X, formerly Twitter, @PaulCBryson, and you can get the latest updates from Cleveland Clinic Otolaryngology-Head and Neck Surgery by following us on LinkedIn at Cleveland Clinic Otolaryngology - Head and Neck Surgery, and Instagram at Cleveland Clinic Otolaryngology. 

Today I'm joined by Dr. Brandon Prendes, surgeon in the Cleveland Clinic's head and neck department and staff member of both the section of head and neck surgery and the section of facial plastic and reconstructive surgery. Welcome to Head and Neck Innovations, or should I say welcome back?

Brandon Prendes, MD: Thanks so much for having me, Paul. Pleasure to be here today.

Paul C. Bryson, MD, MBA: Yeah, no, I'm excited to talk about the upcoming course you're going to tell us a little bit more about. But before we dive into that, for our listeners, do you mind sharing a little bit about your background, certainly where you're from and where you trained, and then just some of your... Really, you have a really broad portfolio of activities here at Cleveland Clinic, but do you mind telling the listener about your background?

Brandon Prendes, MD: Sure, so I am a Cleveland native. I grew up on the west side of Cleveland, and then after I graduated high school, I went to University of Michigan for undergraduate, and then to Philadelphia at University of Pennsylvania for my medical school training, and then out to the West Coast to University of California San Francisco for residency. And then was lucky enough to come back to Cleveland to do my fellowship in advanced head and neck cancer surgery and reconstruction with a lot of the people I still work with here in the head and neck cancer and reconstructive group.

That was a one-year fellowship, and then I've been on staff since. Going into my 10th year now with us. And then my roles here, as you asked about, I take care of benign and malignant tumors of the head and neck, so parotid tumors, both cancerous and benign, and then all the different head and neck cancers that we deal with, so tongue and larynx and oropharynx cancer, thyroid. And then I also do a lot of reconstructive surgery, so free flap reconstruction for those various tumors.

And then now for the last couple years I've been the fellowship director, so it's nice I get to now be in charge of the fellowship that I did 10 years ago and train and recruit the up-and-coming residents who want to get advanced training in head and neck and reconstruction. That's really exciting, and part of why we put on these courses is to continue educating people and move the care of head and neck cancer patients forward.

Paul C. Bryson, MD, MBA: It's been really fun to work with you and to really see your career grow. You've always had a real diverse set of interests and skills that you can offer patients, and the fellowship is really... It's been fun to watch that grow over the years, too. There's so much educational opportunity for the fellows when they do come here to train, so congratulations on all that you've been doing and continue to do.

Let's dive in. This is the 2025 Contemporary Multidisciplinary Care of the Head and Neck Cancer Patient course that's coming up. Again, it's been great to see this just grow and expand over the years. Can you tell us a little bit about certainly when is it, and then what's the audience? Who's coming?

Brandon Prendes, MD: Sure, so this year it'll be on a Thursday. It's November 20th, and it's a one day all day course. This year, so we've had this course for a few years now. It took a little break during the COVID, early COVID years, but it's back on for at least a few years now. And then we've had great attendance and really exciting guests that we invite from around the country.

This year I was lucky enough to be co-director along with one of my partners, Danielle Bottalico, who also is a former fellow here. She was hired on after her fellowship here, and we've been lucky enough to direct the course and plan it out. We have some really exciting guests this year. Our first guest is Neil Gross, who's coming from MD Anderson. He is a very accomplished head and neck surgeon, a leader in a lot of clinical trials, and had a New England Journal of Medicine publication on immunotherapy for a squamous cell cancer of the skin that is resectable skin cancers and using immunotherapy to treat those before surgery. He'll be lecturing to us, and we're really excited about that.

And then another one of my friends from University of California San Francisco training, I did residency with her, Marika Russell, is coming from Mass eye and ear. She's kind of a national thyroid expert on thyroid surgery. She'll be giving a couple different lectures about thyroid cancer management and decision-making regarding advanced thyroid cancer.

Really excited to have both of those guests. I think you asked who should attend. It's really directed at anyone who takes care of head and neck cancer, whether it be physicians, both surgeons, radiation oncologists, medical oncologists, and then also advanced practice providers who are so important for the multidisciplinary and holistic care of these patients. Nurse practitioners, physician assistants, and then also oral surgeons, speech and language pathologists, physical therapists, occupational therapists. Basically, anyone who's involved with the care of these patients would be important members that we intend to direct these lectures towards.

Paul C. Bryson, MD, MBA: The program's usually, and I'm sure it will be continue to be, excellent and diverse. Like you said, anybody who looks after and cares for patients with head and neck cancer, I mean, it's usually always something off there that you can take home and put it into your practice and try to make your systems and processes better.

Brandon Prendes, MD: Yeah, I mean, it's a huge team that we rely on to take care of these patients now, so it's nice to be able to interact with people from lots of different training backgrounds and really talk about ways to make care more efficient and more taking into account all the individual patient's needs.

Really, having all these members of our treating team both give lectures and attend the course makes it more interactive and dynamic and a much more impactful course.

Paul C. Bryson, MD, MBA: You mentioned some of the innovations that are changing the paradigm in head and neck oncologic surgery and reconstruction. Can you speak a little bit more about some of these advances? I understand it's not just surgical innovation. You mentioned immunotherapy, and I'm sure there'll be some topics on this.

Can you just give a little brief appetizer, if you will, on some of the advances in immunotherapy and how head and neck cancer diagnosis and treatment has been impacted?

Brandon Prendes, MD: Sure, so yeah, I think it's a really exciting time for head and neck cancer treatment. We've traditionally relied on surgery or radiation with chemotherapy as the approaches to head and neck cancer, but over the past few years, we've done more and more surgical innovation with minimally invasive surgeries like robotic transoral surgeries to try to de-intensify patient treatment.

This year with this course we're focusing a lot of our discussions on, as you mentioned, things like immunotherapy or targeted therapy that really is individualized therapy for the patients trying to minimize the effect of surgery on people. We have sessions on skin cancer this year, mucosal head neck cancer, so the tongue cancers and the throat cancers and the larynx cancers, and then also on thyroid cancer. On each of those sections, we have new and exciting therapy approaches that involve not only immunotherapy, but then surgery and radiation for patients to try to give them better outcomes.

In one instance for skin cancer, as I mentioned before with Dr. Gross's clinical trial with cutaneous squamous cell carcinoma, we're looking at giving patients upfront immunotherapy, most of which the patients will have a response to. And then you can lessen the extent of surgery that you give to patients and spare important structures, but particularly on things like the face where the skin cancers are near the nose or the eye or the ear, things like that, that are particularly morbid for patients to have be part of their surgical resection. That's exciting and a way we can offer patients less invasive surgeries with a good outcome with a chance of cure.

And then for things like mucosal head and neck cancer, we just had a very exciting international study come out, the KEYNOTE-689 trial. That was one of the first phase three positive trials in head and neck mucosal cancer in recent years that could change the way we manage patients with advanced mucosal head and neck cancers. And so we'll hear a lecture about that. But the idea would be giving patients upfront immunotherapy to charge their immune system before you take out their cancer with surgery, and then have them get additional immunotherapy after treatment. The hope and the indication from that trial is that that can improve patients' outcome long-term, lessen the chance of metastasis, lessen the chance of recurrences.

And then for things like thyroid cancer, previously almost untreatable aggressive thyroid cancers, these anaplastic thyroid cancers that we've dreaded to have to manage patients with those in the past because they were almost uniformly fatal, we now have options for patients with certain mutations in those cancers. Again, giving them immunotherapy or targeted therapy up front, and then doing surgery once we've lessen the burden of disease so that their surgeries aren't so involved and actually have a chance to resect all the disease. That's really changed the management of those anaplastic thyroid cancer patients and given a lot of people who wouldn't have had hope for cure.

All these things are really exciting, and we're trying to boil them down into one day where we cover a bunch of different things, but I think it'll make for a really impactful, exciting day learning all these new treatment approaches.

Paul C. Bryson, MD, MBA: Well, I really appreciate your time today. Let me know for any of our listeners in the area that might be able to attend the course, I'd highly recommend it.

For more information on our contemporary update of management strategies for head and neck cancer, please visit clevelandclinicmeded.com/live/courses/headandneck. And to connect directly with a specialist or submit a referral call (216) 4448-500. That's (216) 4448-500. Or for our listeners who might have a patient with known cancer to refer to us, I would encourage you to check out our Cancer Answer Line through the Taussig Cancer Center. It is a great resource for putting together those multidisciplinary appointments that are so critical to the patient's journey through their disease process and treatment.

Dr. Prendes, thanks for joining Head and Neck Innovations. Good luck with the course.

Brandon Prendes, MD: Thanks so much for having me, Paul. I hope our listeners can attend. We're really excited about this. Thank you.

Paul C. Bryson, MD, MBA: Thanks for listening to Head and Neck Innovations. You can find additional podcast episodes on our website clevelandclinic.org/podcasts. Or you can subscribe to the podcast on iTunes, Google Play, Spotify, BuzzSprout, or wherever you listen to podcasts. Don't forget, you can access realtime updates from Cleveland Clinic experts in otolaryngology – head and neck surgery on our Consult QD website at consultqd.clevelandclinic.org/headandneck. Thank you for listening and join us again next time.