De-Escalation Strategies in HPV-Associated Oropharynx Cancer —Are we Putting the Cart Before the Horse?

Let's get to the punchline because it is a big one: Radiation therapy plus cetuximab led to inferior overall survival (OS) in human papilloma virus (HPV)-positive oropharyngeal squamous cell carcinoma (SCC). It is in light of the recently published results from Radiation Therapy Oncology Group (RTOG) 1016 and De-ESCALaTE HPV that we scope this issue's Oncology Scan to discuss the populist view that has prevailed among the head and neck cancer community for some time now: treatment de-intensification in HPV-positive oropharyngeal SCC (OPSCC).
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Tags: Feature Source Type: research

Related Links:

In conclusion, HPV-DNA prevalence was significantly lower in our HNSCC patients than worldwide 32–36% estimates (p ≤ 0.001). Although infrequent, oropharyngeal cancer increased over years and showed 21% HPV-DNA positivity, which is close to the worldwide 36–46% estimates (p = 0.16). Besides age, smoking, tumor stage, and treatment, HPV/p16 status was an important determinant of patients’ survival. The HPV and/or p16 positivity patients had a better OS than HPV/p16 double-negative patients (p = 0.05). Thus, HPV/p16 status helps improve prognosis by distinguishing between the more favorab...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Article Source Type: research
Authors: Boguñá N, Capdevila L, Jané-Salas E Abstract Over the last few decades, the human papillomavirus (HPV) infection has emerged as a new epidemic and become a health issue due to its involvement in several cancers affecting the cervix, the anogenital region and the oropharynx. In this review, we aim to understand and explain the distinctive features of HPV-related oropharyngeal squamous cell carcinoma based on its epidemiological data, risk factors, specific topography, HPV subtypes most frequently involved, HPV-status diagnosis, clinical behaviour, prognosis, treatment, and preventive me...
Source: Medicina Clinica - Category: General Medicine Tags: Med Clin (Barc) Source Type: research
Authors: Aboagye E, Agyemang-Yeboah F, Duduyemi BM, Obirikorang C Abstract Fewer studies have been done over the years to establish the association of human papillomavirus (HPV) with head and neck squamous cell carcinoma (HNSSC) within the subregions of sub-Saharan Africa, and thus this study was designed to investigate the presence of HPV in HNSCC at a tertiary hospital in Ghana, providing additional evidence on the need to explore similar studies in other subregions. A retrospective cross-sectional study was employed to investigate the presence of the DNA of HPV genotypes in HNSCC archived tissue. A total of 100 ...
Source: The Scientific World Journal - Category: Science Tags: ScientificWorldJournal Source Type: research
Santosh K. Ghosh1*, Thomas S. McCormick1,2 and Aaron Weinberg1* 1Biological Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, United States 2Dermatology, School of Medicine, Case Western Reserve University, Cleveland, OH, United States Human beta-defensins (hBDs, −1, 2, 3) are a family of epithelial cell derived antimicrobial peptides (AMPs) that protect mucosal membranes from microbial challenges. In addition to their antimicrobial activities, they possess other functions; e.g., cell activation, proliferation, regulation of cytokine/chemokine production, migration, diffe...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
The objective of this review article is to discuss the current role of surgery as the primary treatment modality in patients with head and neck squamous cell carcinoma (HNSCC). Recent findings HNSCC represents one of the cancer locations where the primary treatment modality is the most under discussion. Indeed, the respective roles of primary surgical resection followed, as necessary, by adjuvant radiotherapy or definitive chemoradiotherapy remain controversial. The results of organ preservation trials and the drastic rise in the incidence of human papillomavirus-induced oropharyngeal tumors, which are known to be highl...
Source: Current Opinion in Oncology - Category: Cancer & Oncology Tags: HEAD AND NECK: Edited by Joël Guigay Source Type: research
This retrospective cohort study assesses the performance of the traditional pathologic risk stratification system for surgically resected human papillomavirus –associated oropharyngeal squamous cell carcinoma and proposes an alternate composite risk stratification system.
Source: JAMA Otolaryngology - Head and Neck Surgery - Category: ENT & OMF Source Type: research
Conclusions In the span of a very short time—less than a decade—robotic head and neck surgery has transformed the management of the head and neck cancer, and it seems clear that the future of treatment for these cancers lies in a multimodal approach in which TORS is likely to play an important role. Nevertheless, it is important to keep in mind that the current indications for TORS are limited and long-term data on the safety and oncological outcomes are needed to better understand the true role of TORS in treatment of head and neck cancer. Nonetheless, the emergence of ever more advanced robotic instruments i...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Conclusion Most head and neck pathologies show a broad cellular heterogeneity making it difficult to achieve an accurate diagnosis and efficient treatment (Graf and Zavodszky, 2017; Lo Nigro et al., 2017). Single cell analysis of circadian omics (Lande-Diner et al., 2015; Abraham et al., 2018), may be a crucial tool needed in the future to fully understand the circadian control of head and neck diseases. It becomes more obvious that there is only a small genetic component but a largely unknown epigenetics and/or environmental component for most of the head and neck pathologies (Moosavi and Motevalizadeh Ardekani, 2016; He...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Opinion statementOropharyngeal squamous cell carcinoma (OPSCC) incidence rates have been steadily increasing over the past several decades, and this has been largely attributed to human papillomavirus (HPV)-related OPSCC. The rise of HPV-related OPSCC and the observed distinct survival advantage it offers compared to HPV-unrelated OPSCC have resulted in the development of a new staging system specifically for OPSCC in the eighth edition of the AJCC Staging Manual for head and neck cancer. The observations on HPV-related OPSCC and its prognostic implications have coincided with increasing utilization of transoral surgical a...
Source: Current Treatment Options in Oncology - Category: Cancer & Oncology Source Type: research
Oral human papillomavirus (HPV) infection has rapidly become the primary causative factor driving the epidemic of HPV-related oropharyngeal squamous cell carcinoma (OPSCC). Oral infections with high-risk HPV types, most notably HPV 16, are responsible for 60% to 70% of OPSCC cases in the United States. Determining HPV infection status in patients with newly diagnosed OPSCC, most often with p16 immunostaining as a surrogate marker, is important for risk stratification and prognostication. Over the last decade, there has been increasing interest in noninvasive biomarkers for cancer, including from blood and saliva. Oral rins...
Source: JAMA Otolaryngology - Head and Neck Surgery - Category: ENT & OMF Source Type: research
More News: Biology | Cancer | Cancer & Oncology | Carcinoma | Erbitux | Head and Neck Cancer | Human Papillomavirus (HPV) | Oropharyngeal Cancer | PET Scan | Physics | Radiation Therapy | Radiology | Skin Cancer | Squamous Cell Carcinoma