March 8, 2009

HPV-positive Head and Neck Cancers Have Improved Prognosis


HPV-positive Head and Neck Cancers Have Improved Prognosis

Patients with head and neck cancer who test positive for the human papillomavirus (HPV) have a better prognosis compared with those who do not have HPV. These results were recently published in the Journal of the National Cancer Institute.

Head and neck cancers originate in the oral cavity (lip, mouth, tongue), salivary glands, paranasal sinuses, nasal cavity, pharynx (upper back part of the throat), larynx (voice box), and lymph nodes in the upper part of the neck. Worldwide, head and neck cancer is diagnosed in approximately 640,000 people annually and is responsible for approximately 350,000 deaths each year. Squamous cell carcinoma of the head and neck (HNSCC) is the most common type of head and neck cancer. It originates in squamous cells, which are commonly part of the outermost layers of tissues.

Human papillomaviruses (HPV) consist of more than 100 different viruses. Some types of HPV cause warts on the hands or feet; others cause genital warts; and some have been linked with cancer, most notably cervical cancer. Recent studies have suggested that HPV may also be strongly associated with the development of head and neck cancer.

Researchers from several institutions in the United States recently evaluated data from 96 patients with advanced HNSCC who had participated in a previous clinical trial evaluating chemotherapy and radiation therapy for their disease. Patients’ cancers were tested for HPV.

  • HPV types 16, 33, or 35 were present in 40% of cancer.
  • Patients with HPV-positive cancer had improved anticancer responses to chemotherapy and chemotherapy plus radiation therapy.
  • At two years overall survival was 95% for patients with HPV-positive cancer compared with only 62% for patients with HPV-negative cancer.
  • Patients with HPV-positive cancer had a lower risk of cancer progression or death from any cause compared with patients with HPV-negative cancers.

The researchers concluded: “For patients with HNSCC…HPV status is strongly associated with therapeutic response and survival.” Patients with HNSCC may wish to speak with their healthcare provider regarding HPV testing and different therapeutic options based on HPV status.

Reference: Fakhry C, Westra W, Li S, et al. Improved survival of patients with human papillomavirus–positive head and neck squamous cell carcinoma in a prospective clinical trial. Journal of the National Cancer Institute [early online publication]. February 13, 2008. DOI: doi:10.1093/jnci/djn011.

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