Prognostic significance of human papillomavirus in recurrent or metastatic head and neck cancer: an analysis of Eastern Cooperative Oncology Group trials

Argiris, Athanassios; Li, S.; Ghebremichael, Musie; Egloff, Ann Marie; Wang, L.; Forastiere, Arlene A.; Burtness, Barbara; Mehra, Ranee

doi:10.1093/annonc/mdu167

Cited by 96 publications

(83 citation statements)

References 27 publications

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“…These HPV-positive HNC have also been observed to have a different subset of clinicopathological characteristics and preferably good response to treatment modalities [26][27][28][29][30]. A few Indian studies have also reported the incidence of HPV in various head and neck cancer across different parts of India [16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Human Papilloma Virus in Oral Cavity Cancer and Relation to Change in Quality of Life Following Treatment—a Pilot Study from Northern India

Singh

Kushwaha

Anand

et al. 2016

Indian J Surg Oncol

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Human papilloma virus (HPV)-associated head and neck cancer (HNC) has generated significant amount of research interest in recent times with focus shifted to oral cavity squamous cell cancer (OCSCC) after oropharyngeal cancer. Due to high incidence of OCSCC and anecdotal reports on association of HPV infection from northern region of India, this study was conceived to investigate HPV infection and establish its association with lifestyle habits such as tobacco, alcohol consumption, oro-genital sex, number of sexual contacts, and change in quality of life posttreatment. A total of 43 primary OCSCC biopsy specimens were collected. These samples were analyzed for HPV DNA genotyping which was done by using 13 high-risk HPV real-time PCR kits. Quality of life was assessed using University of Washington questionnaire for HNC patients, which was administered pretreatment and 3-months posttreatment. HPV presence was confirmed in only three patients (7.0 %). HPV positivity did not find any statistical correlation with age, gender, residence, addiction habit, stage, tumor size, nodal status, tumor grade, and number of sexual contacts. There was no significant (p > 0.05) difference in the average percent change in QOL parameters from pretreatment to posttreatment when correlated with HPV status.

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Section: Discussionmentioning

confidence: 99%

“…Patients with HPV-positive HNC in general tend to be younger (<50 years) at time of diagnosis [24,25] and generally have a better survival and favorable prognosis compared to HPV-negative patients [26][27][28][29][30].…”

Section: Introductionmentioning

confidence: 99%

Human Papilloma Virus in Oral Cavity Cancer and Relation to Change in Quality of Life Following Treatment—a Pilot Study from Northern India

Singh

Kushwaha

Anand

et al. 2016

Indian J Surg Oncol

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“…33 An archival analysis from 2 ECOG trials (E1395 39 and E3301 40 ), which included 129 patients with recurrent or metastatic H&N squamous cell carcinoma, showed that both HPV status (12.9 vs 6.7 months for HPV-positive vs HPV-negative; P=.014) and p16-positive disease (11.9 vs 6.7 months for p16-positive vs p16-negative; P=.027) were associated with greater median survival. 41 These studies provide substantial evidence that there is a clinically relevant prognostic difference in recurrent or metastatic disease.…”

Section: Hpv and Treatment Of Oropharyngeal Cancermentioning

confidence: 99%

NCCN Guidelines Insights: Head and Neck Cancers, Version 2.2017

Adelstein¹,

Gillison²,

Pfister³

et al. 2017

J Natl Compr Canc Netw

286

241

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The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Head and Neck Cancers provide treatment recommendations for cancers of the lip, oral cavity, pharynx, larynx, ethmoid and maxillary sinuses, and salivary glands. Recommendations are also provided for occult primary of the head and neck (H&N), and separate algorithms have been developed by the panel for very advanced H&N cancers. These NCCN Guidelines Insights summarize the panel's discussion and most recent recommendations regarding the increase in human papillomavirus-associated oropharyngeal cancer and the availability of immunotherapy agents for treatment of patients with recurrent or metastatic H&N cancer.

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“…Given the different aetiology, natural history [24–26], biomolecular signature [11,27], and treatment responsiveness, it is now accepted that HPV-positive and HPV-negative OPSCCs are distinct diseases to be studied separately in trials. Consequently, a number of clinical trials are underway to investigate strategies for the de-intensification of treatment in patients with HPV-associated OPSCC in order to minimise morbidity while maintaining excellent outcomes.…”

Section: Introductionmentioning

confidence: 99%

Treatment de-intensification strategies for head and neck cancer

Kelly

Husain

Burtness

2016

European Journal of Cancer

101

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Increasingly, squamous cell carcinoma of the oropharynx (OPSCC) is attributable to transformation resulting from high-risk human papillomavirus (HPV) infection. Such cancers are significantly more responsive to treatment than traditional tobacco- and alcohol-associated squamous cell cancers of the head and neck. Conventional management with definitive chemoradiation, surgery and adjuvant radiation, or radiation given with altered fractionation schemes, while effective, incurs long-term morbidity that escalates with treatment intensity and significantly impairs quality of life. Recent trials have suggested that less intensive treatment regimens may achieve similar efficacy with decreased toxicity. In this article, we review the primary strategies used for de-escalation of treatment, which include the reduction of radiation dose, substitution and/or elimination of concurrent radiosensitising chemotherapy, and the use of minimally invasive surgery. We discuss the rationale behind these approaches and the preliminary data demonstrating the success of de-escalation, as well as potential considerations raised by treatment de-intensification in HPV-associated OPSCC.

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Prognostic significance of human papillomavirus in recurrent or metastatic head and neck cancer: an analysis of Eastern Cooperative Oncology Group trials

Cited by 96 publications

References 27 publications

Human Papilloma Virus in Oral Cavity Cancer and Relation to Change in Quality of Life Following Treatment—a Pilot Study from Northern India

Human Papilloma Virus in Oral Cavity Cancer and Relation to Change in Quality of Life Following Treatment—a Pilot Study from Northern India

NCCN Guidelines Insights: Head and Neck Cancers, Version 2.2017

Treatment de-intensification strategies for head and neck cancer

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