Human papillomavirus predicts the outcome following concomitant chemoradiotherapy in patients with head and neck squamous cell carcinomas

Abstract

We investigated the prevalence of human papillomavirus (HPV) in a clinical series of 72 patients with head and neck squamous cell carcinoma (HNSCC) using a retrospective and prospective study design. The majority of patients were smokers and/or drinkers and were treated with concomitant chemoradiotherapy (CCR). Furthermore, we assessed the impact of HPV positivity on the response to CCR. Paraffin-embedded samples from HNSCC patients (n=72) were evaluated for the presence of HPV DNA using both GP5+/GP6+ consensus PCR and type-specific E6/E7 PCR to detect HPV types 6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 67 and 68. The type-specific E6/E7 PCR demonstrated that 20 out of 69 HNSCC patients (29%) presented with high-risk (HR) HPV types and that 5 of the 69 HNSCC patients (7%) presented with low-risk (LR) HPV types. Using the GP5+/GP6+ PCR, we observed that the rate of response was statistically lower in the HPV+ group (P=0.02). Concerning patient outcomes in terms of recurrence and survival, we observed that the prognosis was poorer for HPV+ patients. We showed for the first time that patients with HPV+ HNSCC present with a worse prognosis after CCR. This observation highlights the need for prospective studies with large numbers of patients and a detailed history of tobacco and alcohol consumption before validating HPV as a marker of prognosis following CCR.

Classical risk factors, but not HPV status, predict survival after chemoradiotherapy in advanced head and neck cancer patients

“…DNA was purified using the QIAamp DNA Mini Kit (Qiagen, Benelux, Belgium) according to the manufacturer’s recommended protocol. All DNA extracts were tested for the presence of 18 different HPV genotypes using TaqMan-based real-time PCR, as described previously (Depuydt et al 2006 , 2007 ; Duray et al 2013 ).…”

“…The development of cancers related to HPV infections has significantly complicated the profile of head and neck cancer patients, notably in terms of prognosis and response to treatment. The management of such patients is particularly complex in Europe, where many individuals are heavy smokers and/or drinkers (Duray et al 2012 ; Duray et al 2013 ). Indeed, while non-smoking and nondrinking oropharyngeal patients exhibit an improved response to therapy and a better outcome, tobacco and alcohol consumers with non-oropharyngeal cancers are associated with a heterogeneous prognosis (Ang et al 2010 ; Isayeva et al 2012 ).…”

Langerhans cell number is a strong and independent prognostic factor for head and neck squamous cell carcinomas

“…DNA was extracted using the QIAamp DNA Mini Kit (Qiagen, Benelux, Belgium) as previously described [20].…”

“…Detection of HPV by polymerase chain reaction (PCR) amplification HPV DNA detection was performed using PCR with GP5+/GP6+ primers (synthesized by Eurogentec, Liege, Belgium) that amplify a consensus region located within the L1 region of the HPV genome as previously described [20].…”

“…All of the DNA extracts were tested for the presence of 18 different HPV genotypes using TaqMan-based real-time PCR that targeted type-specific sequences of the viral genes as previously described [20].…”