De-Escalation Strategies for Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma—Where Are We Now?

Silver, Jennifer A; Turkdogan, Sena; Roy, Catherine F.; Subramaniam, Thavakumar; Henry, Mélissa; Sadeghi, N.

doi:10.3390/curroncol29050295

Cited by 14 publications

(14 citation statements)

References 76 publications

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“…Many completed or ongoing clinical trials are attempting to change the standard treatments for HPV-positive OPSCC and reduce the treatment-related secondary effects [ 4 , 12 , 13 ]. Patients can be offered a plethora of potential treatments.…”

Section: Discussionmentioning

confidence: 99%

“…With improved prognosis for most OPSCC cases, goals are shared between maintaining the excellent overall survival and disease-free survival, and quality of life (QOL) [ 11 ]. Recent reviews have summarized ongoing or recently completed clinical trials attempting to de-escalate standard therapies for HPV-associated OPSCC patients to minimize or lessen treatment-related side effects [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Patient-Reported Outcome Measures of Psychosocial Quality of Life in Oropharyngeal Cancer Patients: A Scoping Review

Silver

Schwartz

Roy

et al. 2023

JCM

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Background: Oropharyngeal squamous cell carcinoma (OPSCC) patients are burdened by the effect of the disease process and treatment toxicities on organs important in everyday activities, such as breathing, speaking, eating, and drinking. There is a rise in OPSCC due to human papilloma virus (HPV)-associated OPSCC, affecting younger and healthier patients and with a better overall prognosis. Emphasis must be shared between oncologic outcomes and the effects on quality of life. While there have been efforts to study global and physical quality of life, the impact on psychosocial quality of life has not yet been specifically reviewed. Methods: A scoping review methodology was employed to explore the emotional, social, and mental quality of life in OPSCC patients and determine the impact of HPV status or treatment modalities. Results: Eighty-seven full-text articles were evaluated for eligibility. Fifteen articles met final inclusion criteria. The majority of the studies were conducted in the United States (n = 10) and study methodology was divided between cross-sectional (n = 6), prospective (n = 5), and retrospective studies (n = 4). Four psychosocial quality of life themes were explored: the impact on mental health and emotional wellbeing, social wellbeing and function, stress, and relationship and sexual behavior. Eighteen different patient-reported outcome measures were used, including both general head and neck oncology questionnaires and symptom-specific surveys. Conclusion: There is a paucity of research regarding the effect of OPSCC on patients’ psychosocial quality of life. Learning more about this component of quality of life can guide outreach programs and multidisciplinary involvement in improving patient care.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patient-Reported Outcome Measures of Psychosocial Quality of Life in Oropharyngeal Cancer Patients: A Scoping Review

Silver

Schwartz

Roy

et al. 2023

JCM

Self Cite

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“…However, as shown in the hazard ratios from these meta-analyses, in the subgroup of HPV-positive HNSCC patients, cancer progression occurs in over 40% of these patients. Their identification is particularly important due to the ongoing clinical trials regarding the possibility of de-escalation of anticancer treatment in HPV-positive patients with OPSCC [ 6 ]. Therefore, there is an urgent need to indicate new prognostic and/or predictive factors, allowing for the identification of a subgroup of patients with HPV infection that benefit from the de-escalation of treatment.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Significance of STING Immunoexpression in Relation to HPV16 Infection in Patients with Squamous Cell Carcinomas of Oral Cavity and Oropharynx

et al. 2022

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Infection with HPV16 in cancers of the oral cavity (OCSCC) and oropharynx (OPSCC) is, today, an important etiological and prognostic factor. Patients with HPV-positive OPSCC have a better prognosis than uninfected patients. However, in over 40% of these patients, cancer progression is noticed. Their identification is particularly important due to the ongoing clinical trials regarding the possibility of de-escalation of anticancer treatment in patients with HPV-positive OPSCC. Some studies suggest that there is possibility to differentiate prognosis of HPV16-positive patients by STING (Stimulator of Interferon Genes) immunoexpression. The aim of the present study was to analyze the influence of STING immunoexpression on overall (OS) and disease-free survival (DFS) of patients with HPV16-positive and -negative OCSCC and OPSCC. The study was performed in a group of 87 patients with OCSCC and OPSCC for which in our earlier study active HPV16 infection was assessed by P16 expression followed by HPV DNA detection. To analyze STING immunoexpression in tumor area (THS) and in adjacent stromal tissues (SHS) H score (HS) was applied. In the subgroup with HPV16, active infection patients with tumors with THS had significantly better DFS (p = 0.047) than those without THS. In this subgroup, TSH did not significantly influence OS, and SHS did not significantly correlate with OS and DFS. In the subgroup of patients without active HPV16 infection, THS and SHS also did not significantly influence patients’ survival. Presented results indicated prognostic potential of tumor STING immunoexpression in patients with active HPV16 infection in cancers of oral cavity and oropharynx.

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“…14 Within patients with surgically treated HPV(+)OPSCC, lymphocyte count has not been completely investigated as a prognostic factor. For HPV (+)OPSCC patients treated with surgical therapy and postoperative de-escalation of adjuvant treatment, 15 lymphocyte count must be explored as a prognostic indicator to better stratify patients for de-escalated adjuvant therapy. This study aims to explore the impact of absolute lymphocyte count (ALC) prior to, during, and after treatment on oncologic outcomes in patients with HPV(+) OPSCC.…”

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confidence: 99%

“…A median (IQR) of 9 days passed between the baseline blood draw to the date of surgery. A median (IQR) of 25(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31) days passed from the date of surgery to the date of blood draw for the postoperative ALC nadir. A median (IQR) of 78 (68-106) days passed from the date of surgery to the date of blood draw for the post-RT time…”

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confidence: 99%

Low postoperative lymphocyte count increases risk of progression in human papillomavirus associated oropharyngeal cancer

et al. 2022

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Background: We aim to explore the prognostic role of absolute lymphocyte count (ALC) before, during, and after treatment on oncologic outcomes in human papillomavirus associated oropharyngeal cancer (HPV(+)OPSCC). Methods: Retrospective cohort at a tertiary center, 2006-2018. Multivariable Cox regressions were used to determine the effect of ALC on risk of progression. Univariate linear regression was performed to determine clinical factors associated with lower ALC. Results: All 197 patients underwent primary surgery. Mean (SD) ALC nadirs (Â10 9 cells/L) were: baseline (N = 149): 1.69 (0.56); postoperative (N = 126): 1.58 (0.59); post-RT (N = 141): 0.68 (0.35) and long-term (N = 105): 0.88 (0.37). Lower baseline ALC nadir was associated with worse overall survival (HR 3.85, 95%CI:1.03-14.29, p = 0.04). Lower postoperative ALC nadir was associated with higher risk of progression (HR 2.63, 95%CI: 1.04-6.67, p = 0.04).Conclusions: Lower baseline ALC is associated with worse survival, whereas lower postoperative ALC is associated with increased risk of progression in surgically treated HPV(+)OPSCC.

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De-Escalation Strategies for Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma—Where Are We Now?

Cited by 14 publications

References 76 publications

Patient-Reported Outcome Measures of Psychosocial Quality of Life in Oropharyngeal Cancer Patients: A Scoping Review

Patient-Reported Outcome Measures of Psychosocial Quality of Life in Oropharyngeal Cancer Patients: A Scoping Review

Prognostic Significance of STING Immunoexpression in Relation to HPV16 Infection in Patients with Squamous Cell Carcinomas of Oral Cavity and Oropharynx

Low postoperative lymphocyte count increases risk of progression in human papillomavirus associated oropharyngeal cancer

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