Massachusetts General Hospital | Cancer Center

Biography

Dr. Rocco's clinical practice at the MEEI and MGH focuses on the treatment of patients with head and neck cancer and general Otolaryngology problems including sinus disease. Dr. Rocco is committed to providing compassionate, state-of-the-art care for his patients.

Dr. Rocco joined the MEEI as a member of the division of Head and Neck Surgery in 1999, with a joint appointment in Surgical Oncology at the MGH. He completed his residency in Otolaryngology-Head and Neck Surgery at Johns Hopkins Hospital where he received outstanding resident award for his graduating year. Dr. Rocco attended the Mount Sinai School of Medicine through the NIH Medical Scientist Training Program earning M.D. and Ph.D. degrees. At Mount Sinai he was elected to Alpha Omega Alpha and received the basic science achievement award for his Ph.D. thesis.

Dr. Rocco is Assistant Professor of Otology and Laryngology at Harvard Medical School, Senior Surgeon at the MEEI, Director of Head and Neck Oncology Research and the beneficiary of the Danny Miller Chair in Head and Neck Surgery. In addition to his clinical practice, Dr. Rocco directs a basic and clinical science research laboratory devoted to understanding and treating head and neck squamous cell carcinoma.

ResearchWe have found that pre-treatment tumor expression of the anti-apoptotic protein Bcl2 can be combined with tumor HPV status to identify groups of patients having different risks of recurrence and death following concurrent chemoradiation, a standard of care for advanced OPSCC. Bcl2 and HPV are not associated with each other, and they provide independent estimates of risk of recurrence and death. This is a particularly important advance with respect to the growing subset of OPSCC that are HPV-associated. Although HPV-associated OPSCC are known to respond better to treatment than do tumors associated with the traditional risk factors of smoking and drinking, treatment fails for a significant fraction of patients with HPV-associated tumors. We report that pre-treatment tumor Bcl2 expression in HPV-associated tumors distinguished a subgroup that is almost always cured after concurrent chemoradiation Bcl2-negative, 3% recurrence) from one with a substantial risk of failure (Bcl2-positive, 24% recurrence). The association of Bcl2 expression with increased risk of recurrence also holds for HPV-negative tumors. Furthermore, the association that we found between Bcl2 expression and failure through distant metastasis both suggests presently available therapies that might improve outcome in some groups of patients and provides additional support for developing therapies based on inhibiting Bcl2 function.

Publications1. Nichols AC, Finkelstein DM, Faquin WC, Westra WH, Mroz EA, Kneuertz P, , Begum S, Michaud WA, Busse PM, Clark JR, and Rocco JW. Bcl2 and HPV16 as Predictors of Outcome following Concurrent Chemoradiation for Advanced Oropharyngeal Cancer. Clin Cancer Res. 2010 Apr 1;16(7):2138-46. Epub 2010 Mar 16. PMID: 20233885.

2. Mroz AE and Rocco JW. Functional p53 status as a biomarker for chemotherapy response in oral-cavity cancer. J Clin Oncol. 2010 Feb 10;28(5):715-7. Epub 2010 Jan 4. PMID: 20048171.

3.Michaud WA, Nichols AC, Mroz EA, Faquin WC, Clark JR, Begum S, Westra WH, Wada H, Busse PM, Ellisen LW, Rocco JW. Bcl-2 Blocks Cisplatin-Induced Apoptosis and Predicts Poor Outcome Following Chemoradiation Treatment in Advanced Oropharyngeal Squamous Cell Carcinoma. Clin Cancer Res. 2009 Mar 1;15(5):1645-54. Epub 2009 Feb 24. PMID: 19240170

4.Nichols AC, Faquin WC, Westra WH, Mroz EA, Begum S, Clark JR, Rocco JW. HPV-16 infection predicts treatment outcome in oropharyngeal squamous cell carcinoma. Otolaryngol Head Neck Surg. 2009 Feb;140(2):228-34.

5.Rocco JW, Leong CO, Kupperwasser N, De Young MP, Ellisen LW. P63 mediates survival in squamous cell carcinoma by suppression of p73-dependent apoptosis. Cancer Cell. 2006 Jan;9(1):45-56. PMID: 16413471.

6.Nichols AC, Kneuertz PJ, Mroz EA, Deschler DG, Lin DT, Emerick KS, Clark JR, Busse PW, Rocco JW. Surgical Salvage of the Oropharynx After Failure of Organ Sparing Therapy. Head Neck. 2010 Jul 22.

7. Mroz EA., Baird A., Michaud WA., Rocco JW. The co-repressor CtBP regulates expression of the p16 tumor suppressor and senescence. Cancer Res. 2008 Aug 1;68(15):6049-53. PMID: 18676825.

Genetic diversity within tumors predicts outcome in head and neck cancer

A new measure of the heterogeneity – the variety of genetic mutations – of cells within a tumor appears to predict treatment outcomes of patients with the most common type of head and neck cancer.