The incidence of human papillomaviruspositive oropharyngeal cancer (HPV/OPSCC) is rapidly increasing, which will represent a major public health burden for decades to come. Although HPV/OPSCC is generally associated with a better prognosis than HPV-negative OPS-CC, the survival rate of individuals with higher-risk clinical and pathologic features remains unchanged. Emerging evidence suggests that HPV/OPSCC is pathologically and molecularly distinct from HPV-negative OPSCC. This review focuses on summarizing treatment strategies for HPV/OPSCC by reviewing the peer-reviewed literature and noting ongoing and planned clinical trials in this disease. We also discuss the potential of designing targeted therapy based on the recent genomic findings of HPV/OPSCC.Keywords HPV/OPSCC Á Chemotherapy Á Radiation
HPV-Related Head and Neck Cancer (HNC) and Related-Deaths on the RiseThe incidence of oropharyngeal squamous cell carcinoma (OPSCC), a site for head and neck cancer (HNC), is rising in developed countries including the US and Europe. In the past 2 decades, reports indicate that up to 70-80 % of OPSCC (the most common type of head and neck SCC in year 2010 [1]) in these developed countries are HPVpositive [2]. In fact, the number of HPV-positive OPSCC (hereafter named as HPV/OPSCC) is expected to continue to rise (due to oral sex, multiple sex partners, and premarital sex), while that of HPV-negative OPSCC has been decreasing since 1991 (which parallels the drop in smoking in the US). In fact, the total annual cases of HPV/OPSCC alone are predicted to outnumber that of all cervical cancer cases in the US by 2020 [1].HPV/OPSCC patients are treated with standard chemoradiation therapy or surgery with a generally high response rate [3]. However, treatment is often complicated by morbidities and the positive prognostic benefit of HPV can be mitigated by negative prognostic factors, such as smoking and lymph node metastases [4,5]. Recurrence, metastasis, and second primary cancer still account for the majority of deaths from HPV/OPSCC. The appreciable number of deaths from recurrence or treatment failure (*15 to 18/100, even with the most aggressive current treatment [6,7]), coupled with a dramatic surge in total number of HPV/OPSCC suggests that the total number of deaths from both HPV-positive and HPV-negative OPSCCs will be comparable. More strikingly, a recent study revealed that the highest-risk HPV/OPSCC patients had a 3-year overall survival of only 70.8 %, while the overall survival for the highest-risk HPV-negative OPSCC was 46 % [8] (original data can be found in Fig.