Abstract 2207: High-risk human papillomavirus detection in head and neck cancers using saliva

This chapter discusses head and neck cancers, and covers the epidemiology and molecular biology of head and neck cancer. Head and neck cancer is a heterogeneous disease and most commonly caused by tobacco and alcohol use, as well as high-risk human papillomavirus (HPV) infection. HPV-negative and -positive HNSCC are demographically, biologically and clinically distinct entities with more favourable outcomes associated with HPV-positive tumours of the oropharynx. Comprehensive genomic analyses show that more functional loss of tumour suppressors are present in HPV-negative tumours compared to HPV-positive tumours. Furthermore, HNSCC can be molecularly characterized into five subtypes. The challenges facing future investigations are efficient translation of these biological findings into clinically meaningful advancements in patient treatment.

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Role of mucosal high-risk human papillomavirus types in head and neck cancers in Romania

PLoS ONE ◽

10.1371/journal.pone.0199663 ◽

2018 ◽

Vol 13 (6) ◽

pp. e0199663 ◽

Cited By ~ 6

Author(s):

Ramona Gabriela Ursu ◽

Mihai Danciu ◽

Irene Alexandra Spiridon ◽

Ruediger Ridder ◽

Susanne Rehm ◽

...

Keyword(s):

Human Papillomavirus ◽

High Risk ◽

Head And Neck ◽

Head And Neck Cancers

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Psychosocial outcomes of human papillomavirus (HPV)‐ and non‐HPV‐related head and neck cancers: A longitudinal study

Psycho-Oncology ◽

10.1002/pon.5803 ◽

2021 ◽

Author(s):

Melissa Henry ◽

Emily Arnovitz ◽

Saul Frenkiel ◽

Michael Hier ◽

Anthony Zeitouni ◽

...

Keyword(s):

Human Papillomavirus ◽

Longitudinal Study ◽

Head And Neck ◽

Psychosocial Outcomes ◽

Head And Neck Cancers

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Comorbidity and prognosis in head and neck cancers: Differences by subsite, stage, and human papillomavirus status

Head & Neck ◽

10.1002/hed.23360 ◽

2013 ◽

Vol 36 (6) ◽

pp. 802-810 ◽

Cited By ~ 49

Author(s):

Steven Habbous ◽

Luke T. G. Harland ◽

Anthony La Delfa ◽

Ehab Fadhel ◽

Wei Xu ◽

...

Keyword(s):

Human Papillomavirus ◽

Head And Neck ◽

Head And Neck Cancers

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Systematic review and evidence synthesis of non-cervical human papillomavirus-related disease health system costs and quality of life estimates

Sexually Transmitted Infections ◽

10.1136/sextrans-2018-053606 ◽

2018 ◽

Vol 95 (1) ◽

pp. 28-35 ◽

Cited By ~ 2

Author(s):

Koh Jun Ong ◽

Marta Checchi ◽

Lorna Burns ◽

Charlotte Pavitt ◽

Maarten J Postma ◽

...

Keyword(s):

Systematic Review ◽

Human Papillomavirus ◽

Head And Neck ◽

Anal Cancer ◽

Penile Cancer ◽

Vulvar Cancer ◽

Head And Neck Cancers ◽

Economic Evaluations ◽

Anogenital Warts ◽

Utility Elicitation

BackgroundMany economic evaluations of human papillomavirus vaccination should ideally consider multiple disease outcomes, including anogenital warts, respiratory papillomatosis and non-cervical cancers (eg, anal, oropharyngeal, penile, vulvar and vaginal cancers). However, published economic evaluations largely relied on estimates from single studies or informal rapid literature reviews.MethodsWe conducted a systematic review of articles up to June 2016 to identify costs and utility estimates admissible for an economic evaluation from a single-payer healthcare provider’s perspective. Meta-analyses were performed for studies that used same utility elicitation tools for similar diseases. Costs were adjusted to 2016/2017 US$.ResultsSixty-one papers (35 costs; 24 utilities; 2 costs and utilities) were selected from 10 742 initial records. Cost per case ranges were US$124–US$883 (anogenital warts), US$6912–US$52 579 (head and neck cancers), US$12 936–US$51 571 (anal cancer), US$17 524–34 258 (vaginal cancer), US$14 686–US$28 502 (vulvar cancer) and US$9975–US$27 629 (penile cancer). The total cost for 14 adult patients with recurrent respiratory papillomatosis was US$137 601 (one paper).Utility per warts episode ranged from 0.651 to 1 (12 papers, various utility elicitation methods), with pooled mean EQ-5D and EQ-VAS of 0.86 (95% CI 0.85 to 0.87) and 0.74 (95% CI 0.74 to 0.75), respectively. Fifteen papers reported utilities in head and neck cancers with range 0.29 (95% CI 0.0 to 0.76) to 0.94 (95% CI 0.3 to 1.0). Mean utility reported ranged from 0.5 (95% CI 0.4 to 0.61) to 0.65 (95% CI 0.45 to 0.75) (anal cancer), 0.59 (95% CI 0.54 to 0.64) (vaginal cancer), 0.65 (95% CI 0.60 to 0.70) (vulvar cancer) and 0.79 (95% CI 0.74 to 0.84) (penile cancer).ConclusionsDifferences in values reported from each paper reflect variations in cancer site, disease stages, study population, treatment modality/setting and utility elicitation methods used. As patient management changes over time, corresponding effects on both costs and utility need to be considered to ensure health economic assumptions are up-to-date and closely reflect the case mix of patients.

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Neoadjuvant and Adjuvant Pembrolizumab in Resectable Locally Advanced, Human Papillomavirus-Unrelated Head and Neck Cancer: A Multicenter, Phase 2 Trial

10.1101/2020.03.18.20037846 ◽

2020 ◽

Author(s):

Ravindra Uppaluri ◽

Katie M. Campbell ◽

Ann Marie Egloff ◽

Paul Zolkind ◽

Zachary L. Skidmore ◽

...

Keyword(s):

Human Papillomavirus ◽

High Risk ◽

Head And Neck ◽

Relapse Rate ◽

Locally Advanced ◽

Giant Cells ◽

Phase 2 ◽

Phase 2 Trial ◽

One Year ◽

The One

SUMMARYBackgroundPembrolizumab improved survival of patients with recurrent or metastatic head and neck squamous-cell carcinoma (HNSCC). The aims of this phase 2 trial were to determine if pembrolizumab administered to patients with resectable locally advanced, human papillomavirus (HPV)-unrelated HNSCC would be safe, result in pathologic tumor response (pTR), and lower the relapse rate.MethodsNeoadjuvant pembrolizumab (200 mg) was administered 2-3 weeks before surgery. Resection of the primary tumor and involved/at-risk nodes was performed. Post-operative (chemo) radiation was planned. Patients with high-risk pathology (positive margins and/or extranodal extension) were to receive adjuvant pembrolizumab. pTR was quantified as the proportion of the resection bed with tumor necrosis, keratinous debris, and giant cells/histiocytes: pTR-0 (<10%), pTR-1 (10-49%), and pTR-2 (≥50%). Co-primary endpoints were pTR-2 among all patients, and one-year relapse rate in patients with high-risk pathology (historical: 35%). Correlations of baseline PD-L1 expression and T-cell infiltration with pTR were assessed, and tumor clonal dynamics were evaluated. Analyses were done per protocol. This trial is registered with ClinicalTrials.gov(NCT02296684), and is ongoing but closed to accrual.FindingsBetween June 30, 2015, and March 30, 2018, 36 patients enrolled. After neoadjuvant pembrolizumab, serious (grades 3-4) adverse events and unexpected surgical delays/complications did not occur. pTR-2 occurred in eight patients (22%), and pTR-1 in eight other patients (22%). pTR ≥10% correlated with baseline tumor PD-L1 expression, immune infiltrate, and IFN-γ pathway activity. Matched sample analysis showed compensatory upregulation of multiple immune inhibitory checkpoints in patients with pTR-0, and confirmed that clonal loss occurred in some patients. The one-year relapse rate among the eighteen patients with high-risk pathology was 16.7% (95%CI: 3.6-41.4%).ConclusionsAmong patients with locally advanced, HPV-unrelated HNSCC, neoadjuvant pembrolizumab was safe, and resulted in pTR-1 or pTR-2 in 44% of patients. The one-year relapse rate in patients with high-risk-pathology was lower than historical.FundingMerck, NCI, NIDCR, NHGRI and The V Foundation.

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