HPV status linked to outcome in patients with head, neck cancer

Patients with head and neck squamous cell carcinoma whose tumors are HPV positive may have higher treatment response rates and survive longer than those with HPV-negative tumors.

Researchers from Johns Hopkins in Baltimore, Dana-Farber Cancer Institute in Boston and other institutions analyzed 96 patients with stage 3 or stage 4 head and neck squamous cell carcinoma of the oropharynx or larynx who participated in the Eastern Cooperative Oncology Group phase-2 trial. During the phase-2 trial, all patients received two cycles of induction chemotherapy with paclitaxel and carboplatin followed by weekly paclitaxel and standard fractionation radiation therapy, according to researchers.

Response rates were higher in patients with HPV-positive tumors following induction chemotherapy (82% vs. 55%; P=.01) and chemoradiation (84% vs. 57%; P=.007), compared with patients with HPV-negative tumors.

Overall survival improved in patients with HPV-positive tumors after a median follow-up of 39.1 months (two-year overall survival, 95% vs. 62% in those with HPV-negative tumors; P=.005). Progression rates and death from any cause were also lower in those with HPV-positive tumors. – by Stacey L. Adams

J Natl Cancer Inst. 2008;100:261-269.

This is not a new piece of information, but it certainly confirms the suggestions that have already been in the literature stating that patients whose tumors express HPV have a better prognosis. It’s certainly important to see that confirmed in a prospective study. Looking to the future, there’s this area of personalized medicine where we do more than just look under the microscope and say, “It’s cancer.” Instead, we look at a wide variety of molecular and genetic aspects of the cancer to try and predict what treatments may be most effective for that particular patient. I think that HPV is one of the parameters that may help us in the future, along with other parameters, to select treatment for certain patients with larynx cancer or oropharynx cancer. It will help us select whether they should get chemotherapy or not, whether they should have surgery or not and whether radiation is going to be effective or not. From the point of view of personalized medicine, I think this kind of information will become increasingly important to help us select treatment for patients. Essentially, the most important part of this study is looking to the future of the personalized medicine concept.

– Louis Harrison, MD

HemOnc Today Editorial Board member