Human papillomavirus (HPV)-related oropharyngeal cancer cofactors: Viral co-infections, second cancers, and survival trends—A single Veterans Administration (VA) institution.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17531-e17531
Author(s):  
George Anthony Dawson ◽  
Yue Hua Zhang ◽  
Angela Laurio ◽  
Patricia Smith ◽  
Michael Dellatto ◽  
...  
Keyword(s):  
Head And Neck ◽  
Survival Data ◽  
Oropharyngeal Cancer ◽  
Statistical Significance ◽  
Small Sample ◽  
Head And Neck Cancers ◽  
Field Cancerization ◽  
Head Neck Cancer ◽  
Second Cancers ◽  
Hpv Status

e17531 Background: Oropharyngeal cancers related to HPV are increasing in number. Common factors associated with HPV related head and neck cancers include ethnicity, young age, and low usage of alcohol and tobacco. All are typical of HPV+ related Oropharyngeal cancer in non-VA populations. Methods: This IRB approved chart review of 73 documented patients with Oropharyngeal cancers from co-HPV infections from 01/01/2011 - 12/31/2016. In this version of report we discuss second cancers, trends and other co-factors. Results: Overall trend was notable for a reversal (more HPV+ / less HPV- ) cases. All cancers were squamous cell variety. 2011 /2012 /2013/ 2014/2015/2016 HPV +: 4 / 4 / 0 / 6 / 11 / 7. HPV -: 6 / 8 / 4 / 8 / 6 / 5. Clinical stage: Evident adenopathy - (N2 to N3) was noted in 51/73(70%) cases: HPV+ 30/36 (83%) / HPV- 21/37(57%). As noted, there are ~40 co-factor events in each group with no clear association with HPV + or – status numbers of cases were too small for meaningful analysis. Second Cancers HPV+: PROSTATE 7 / BLADDER 2 / TESTICULAR 1 / RENAL 1 / LUNG 1 / SKIN 4. HPV- : FOM 2 / LARYNX 2 / TONSILLAR 1 / PAROTID 1 / BLADDER 1 / SKIN 5 / PROSTATE 1 / LUNG 1. Survival data results: There was evidence in our data that survival was prolonged in patients who are HPV negative, but this sample was too small to show statistical significance. Further, it appears white race improves the odds of survival p-value 0.073, however, not statistically significant, due to the small sample. Conclusions: As in the non-VA community, our data noted an increase in HPV+ oropharyngeal cancers treated at the Bronx VA during review period. Further, our HPV+ group had predominant advanced adenopathy, and whites had longer survival regardless of HPV status. Second cancers in HPV- group followed field cancerization effects in regards number new or old head / neck cancer events. Interestingly, with almost equal tobacco / alcohol use in both groups, no 2nd head and neck cancers in the HPV+ group were discovered. Potential immuno-protection for HPV+ 2nd h and N cancers.[Table: see text]

scholarly journals Survival-Associated Metabolic Genes in Human Papillomavirus-Positive Head and Neck Cancers

Cancers ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 253 ◽  
Author(s):  
Martin A. Prusinkiewicz ◽  
Steven F. Gameiro ◽  
Farhad Ghasemi ◽  
Mackenzie J. Dodge ◽  
Peter Y. F. Zeng ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Head And Neck ◽  
Patient Survival ◽  
Tricarboxylic Acid Cycle ◽  
Predictive Biomarkers ◽  
Head And Neck Cancers ◽  
The Cancer Genome Atlas ◽  
Metabolic Genes ◽  
Hpv Status ◽  
The Impact

Human papillomavirus (HPV) causes an increasing number of head and neck squamous cell carcinomas (HNSCCs). Altered metabolism contributes to patient prognosis, but the impact of HPV status on HNSCC metabolism remains relatively uncharacterized. We hypothesize that metabolism-related gene expression differences unique to HPV-positive HNSCC influences patient survival. The Cancer Genome Atlas RNA-seq data from primary HNSCC patient samples were categorized as 73 HPV-positive, 442 HPV-negative, and 43 normal-adjacent control tissues. We analyzed 229 metabolic genes and identified numerous differentially expressed genes between HPV-positive and negative HNSCC patients. HPV-positive carcinomas exhibited lower expression levels of genes involved in glycolysis and higher levels of genes involved in the tricarboxylic acid cycle, oxidative phosphorylation, and β-oxidation than the HPV-negative carcinomas. Importantly, reduced expression of the metabolism-related genes SDHC, COX7A1, COX16, COX17, ELOVL6, GOT2, and SLC16A2 were correlated with improved patient survival only in the HPV-positive group. This work suggests that specific transcriptional alterations in metabolic genes may serve as predictive biomarkers of patient outcome and identifies potential targets for novel therapeutic intervention in HPV-positive head and neck cancers.

The role of HPV vaccination as a cancer prevention agent.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13566-e13566
Author(s):  
N Mullai ◽  
Soleiman Osman ◽  
Joseph Rattenni
Keyword(s):  
High Risk ◽  
Head And Neck ◽  
Sexually Transmitted Diseases ◽  
Hpv Vaccination ◽  
Hpv Infection ◽  
Head And Neck Cancers ◽  
Papilloma Virus ◽  
Sexually Transmitted ◽  
Hpv Status ◽  
High Risk Hpv

e13566 Background: Human papilloma virus (HPV) is the most common sexually transmitted agent and has extensive association with many malignancies such as cervical, vaginal, vulvar, penile, and head and neck cancers. Vaccination helps prevent sexually transmitted diseases due to HPV. In addition, it provides protection against cancers caused by persistent, high-risk HPV infection in both male and female. Methods: Data collected from the medical records of patients diagnosed with anogenital, and head and neck cancers during 2017-2019 were studied retrospectively and the association of HPV infection was analyzed. Results: There were thirty-three cases of anogenital, and head and neck cancers diagnosed during the study period. The following were the occurrences: penile cancer 1, anal cancer 4, cervical/uterine/vaginal cancers 10, and head and neck cancer including tonsil, base of tongue, vocal cord, and glottis 18. HPV status was available in twenty-six (79%) patients. Fourteen patients were positive for high-risk 16/18 HPV strain, twelve were HPV negative, and HPV status was unknown for seven patients. Most of the patients were smokers and none of them had received HPV vaccination. The patients were treated appropriately with chemotherapy, radiation, and surgery. Conclusions: Human papilloma virus (HPV) infection type 16/18 is the most common sexually transmitted infection associated with significant anogenital and head and neck cancers.Vaccinations protect against persistent, high-risk HPV infection that may lead to malignancies. However, the HPV vaccination initiation and completion rates are only 41.7% and 21.6% respectively in males, and 60% and 39.7% respectively in females. The lack of opportunity does not appear to be a major reason for this low coverage. Some of the barriers for low adoption of HPV vaccination were concern about vaccine safety (70%), lack of knowledge about HPV related diseases (56%), very young to vaccinate (56%), fear of riskier sexual behavior (56%), and reluctance as not being included in the required immunization schedule (71%). In addition, several people refused HPV vaccination due to misinformation in social media. The primary purpose of HPV vaccination is to help prevent sexually transmitted diseases. Further, such vaccination can also prevent several cancers caused by persistent infection. Therefore, HPV vaccination has the potential to eliminate such risk if enforced at a young age in school. The above study and data stress this role and the importance of public awareness of the HPV vaccine as a cancer prevention agent.

scholarly journals Is AJCC/UICC Staging Still Appropriate for Head and Neck Cancers in Developing Countries?

OTO Open ◽  
2020 ◽  
Vol 4 (3) ◽  
pp. 2473974X2093831
Author(s):  
Johannes J. Fagan ◽  
Julie Wetter ◽  
Jeffrey Otiti ◽  
Joyce Aswani ◽  
Anna Konney ◽  
...  
Keyword(s):  
Developing Countries ◽  
Head And Neck ◽  
Treatment Outcomes ◽  
Cancer Patients ◽  
Oropharyngeal Cancer ◽  
Head And Neck Cancers ◽  
Anatomical Location ◽  
African Countries ◽  
International Union ◽  
Do So

By 2030, 70% of cancers will occur in developing countries. Head and neck cancers are primarily a developing world disease. While anatomical location and the extent of cancers are central to defining prognosis and staging, the American Joint Committee on Cancer (AJCC)/International Union Against Cancer (UICC) have incorporated nonanatomic factors that correlate with prognosis into staging (eg, p16 status of oropharyngeal cancers). However, 16 of 17 head and neck surgeons from 13 African countries cannot routinely test for p16 status and hence can no longer apply AJCC/UICC staging to oropharyngeal cancer. While the AJCC/UICC should continue to refine staging that best reflects treatment outcomes and prognosis by incorporating new nonanatomical factors, they should also retain and refine anatomically based staging to serve the needs of clinicians and their patients in resource-constrained settings. Not to do so would diminish their global relevance and in so doing also disadvantage most of the world’s cancer patients.

HSR19-078: Human Papillomavirus Status and Survival Among Patients With Oropharyngeal Cancer: Analyses of a United States Health System

2019 ◽  
Vol 17 (3.5) ◽  
pp. HSR19-078
Author(s):  
Himani Aggarwal ◽  
Li Li ◽  
Gebra Cuyun Carter ◽  
Kathy Fraeman ◽  
Ariel Berger
Keyword(s):  
Squamous Cell Carcinoma ◽  
Health System ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Oropharyngeal Cancer ◽  
Statistical Tests ◽  
Significant Risk ◽  
Distant Metastases ◽  
Small Sample ◽  
Hpv Status

Background: The incidence of oropharyngeal cancer (OPC) due to tobacco and alcohol, respectively, has been declining, while that linked to human papilloma virus (HPV) has been rising. Epidemiologic, biologic, and prognostic characteristics of OPC differ by HPV-status. This study compared overall survival (OS) among HPV-positive and -negative patients with OPC in a real-world setting. Methods: This retrospective observational study used electronic medical records data from the Geisinger Health System to select patients diagnosed with OPC between January 1, 2010 and September 30, 2015. Patients were designated as HPV-positive if the HPV or P16 test closest to the diagnosis date was positive. All other patients were deemed HPV-negative. Descriptive statistics and relevant statistical tests were used to compare baseline characteristics by HPV status; survival by HPV status was examined using Kaplan–Meier methods and multivariable Cox models. Results: In this study, 152 patients met all selection criteria; 110 (72.4%) were HPV-positive. HPV-positive patients were more likely to be men (89.1% vs 73.8%; P=.019) and to have lymph node involvement (88.2% vs 59.5%; P=.0008); they were less likely to have cerebrovascular disease (6.9% vs. 23.5%; P=.01), or distant metastases (1.8% vs 9.5%; P=.029) vs HPV-negative patients. Among HPV-positive patients, 75.5%, 12.7%, and 10.9% had squamous cell carcinoma NOS, basaloid squamous cell carcinoma, and squamous cell carcinoma large cell non-keratinizing, respectively; corresponding values for HPV-negative patients were 85.7%, 0.0%, and 2.4%, respectively (P=.0013). HPV-positive patients were nominally younger than HPV-negative patients (median: 58 vs 61 years; P=.085). Log-rank test showed OS of HPV-positive patients (median OS from treatment initiation: not reached) is higher than of HPV-negative patients (median OS: 3.7 years; P=.002). In multivariable analyses, HPV-negative status was associated with increased mortality risk (P=.0035); other significant risk factors included alcohol use, diabetes, and distant metastases. Conclusions: HPV-positive status was associated with a decreased risk of mortality among OPC patients in this study. Despite the small sample size and potential violation of assumption of proportional hazard rate, this study underscores the prognostic implication of HPV status in OPC, which may have important ramifications in optimizing treatment decisions among this patient population.

Application of radiomics for the prediction of HPV status for patients with head and neck cancers

2020 ◽  
Vol 47 (2) ◽  
pp. 563-575 ◽  
Author(s):  
Hassan Bagher‐Ebadian ◽  
Mei Lu ◽  
Farzan Siddiqui ◽  
Ahmed I. Ghanem ◽  
Ning Wen ◽  
...  
Keyword(s):  
Head And Neck ◽  
Head And Neck Cancers ◽  
Hpv Status

scholarly journals Human Papillomavirus Drives Tumor Development Throughout the Head and Neck: Improved Prognosis Is Associated With an Immune Response Largely Restricted to the Oropharynx

2016 ◽  
Vol 34 (34) ◽  
pp. 4132-4141 ◽  
Author(s):  
Ankur Chakravarthy ◽  
Stephen Henderson ◽  
Stephen M. Thirdborough ◽  
Christian H. Ottensmeier ◽  
Xiaoping Su ◽  
...  
Keyword(s):  
Gene Expression ◽  
Dna Methylation ◽  
Human Papillomavirus ◽  
Head And Neck ◽  
Squamous Cell ◽  
Survival Data ◽  
Squamous Cell Carcinomas ◽  
Causal Role ◽  
Anatomic Site ◽  
Hpv Status

Purpose In squamous cell carcinomas of the head and neck (HNSCC), the increasing incidence of oropharyngeal squamous cell carcinomas (OPSCCs) is attributable to human papillomavirus (HPV) infection. Despite commonly presenting at late stage, HPV-driven OPSCCs are associated with improved prognosis compared with HPV-negative disease. HPV DNA is also detectable in nonoropharyngeal (non-OPSCC), but its pathogenic role and clinical significance are unclear. The objectives of this study were to determine whether HPV plays a causal role in non-OPSCC and to investigate whether HPV confers a survival benefit in these tumors. Methods Meta-analysis was used to build a cross-tissue gene-expression signature for HPV-driven cancer. Classifiers trained by machine-learning approaches were used to predict the HPV status of 520 HNSCCs profiled by The Cancer Genome Atlas project. DNA methylation data were similarly used to classify 464 HNSCCs and these analyses were integrated with genomic, histopathology, and survival data to permit a comprehensive comparison of HPV transcript-positive OPSCC and non-OPSCC. Results HPV-driven tumors accounted for 4.1% of non-OPSCCs. Regardless of anatomic site, HPV+ HNSCCs shared highly similar gene expression and DNA methylation profiles; nonkeratinizing, basaloid histopathological features; and lack of TP53 or CDKN2A alterations. Improved overall survival, however, was largely restricted to HPV-driven OPSCCs, which were associated with increased levels of tumor-infiltrating lymphocytes compared with HPV-driven non-OPSCCs. Conclusion Our analysis identified a causal role for HPV in transcript-positive non-OPSCCs throughout the head and neck. Notably, however, HPV-driven non-OPSCCs display a distinct immune microenvironment and clinical behavior compared with HPV-driven OPSCCs.

The Epidemic of HPV-Associated Oropharyngeal Cancer Is Here: Is It Time to Change Our Treatment Paradigms?

2011 ◽  
Vol 9 (6) ◽  
pp. 665-673 ◽  
Author(s):  
Erich M. Sturgis ◽  
K. Kian Ang
Keyword(s):  
Clinical Trial ◽  
Human Papillomavirus ◽  
Head And Neck ◽  
Oropharyngeal Cancer ◽  
Head And Neck Cancers ◽  
Population Changes ◽  
Clinical Behavior ◽  
Incidence Trends

Although relatively uncommon, oropharyngeal cancers are increasing in incidence despite declining prevalence of smoking and in direct opposition to a decreasing incidence of all other head and neck cancers. An epidemic of human papillomavirus (HPV)–associated oropharyngeal cancers seems to account for these incidence trends. Important demographic, behavioral, and prognostic characteristics define this unique population. Changes in prevention, diagnosis, evaluation, staging, and treatment are needed. This article summarizes the epidemiology and clinical behavior of HPV-associated oropharyngeal cancer and discusses evolving/potential paradigms of treatment. However, data are currently insufficient to change treatment paradigms for HPV-associated oropharyngeal cancer outside of a closely monitored clinical trial.

scholarly journals HPV Status as Prognostic Biomarker in Head and Neck Cancer—Which Method Fits the Best for Outcome Prediction?

Cancers ◽  
2021 ◽  
Vol 13 (18) ◽  
pp. 4730
Author(s):  
Jan Philipp Kühn ◽  
Wendelin Schmid ◽  
Sandrina Körner ◽  
Florian Bochen ◽  
Silke Wemmert ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Oropharyngeal Cancer ◽  
Direct Detection ◽  
Multivariable Analysis ◽  
Tissue Samples ◽  
Hpv Dna ◽  
Hpv Status ◽  
Dna Pcr

The incidence of human papillomavirus (HPV)-related head and neck cancer (HNSCC) is rising globally, presenting challenges for optimized clinical management. To date, it remains unclear which biomarker best reflects HPV-driven carcinogenesis, a process that is associated with better therapeutic response and outcome compared to tobacco/alcohol-induced cancers. Six potential HPV surrogate biomarkers were analyzed using FFPE tissue samples from 153 HNSCC patients (n = 78 oropharyngeal cancer (OPSCC), n = 35 laryngeal cancer, n = 23 hypopharyngeal cancer, n = 17 oral cavity cancer): p16, CyclinD1, pRb, dual immunohistochemical staining of p16 and Ki67, HPV-DNA-PCR, and HPV-DNA-in situ hybridization (ISH). Biomarkers were analyzed for correlation with one another, tumor subsite, and patient survival. P16-IHC alone showed the best performance for discriminating between good (high expression) vs poor outcome (low expression; p = 0.0030) in OPSCC patients. Additionally, HPV-DNA-ISH (p = 0.0039), HPV-DNA-PCR (p = 0.0113), and p16-Ki67 dual stain (p = 0.0047) were significantly associated with prognosis in uni- and multivariable analysis for oropharyngeal cancer. In the non-OPSCC group, however, none of the aforementioned surrogate markers was prognostic. Taken together, P16-IHC as a single biomarker displays the best diagnostic accuracy for prognosis stratification in OPSCC patients with a direct detection of HPV-DNA by PCR or ISH as well as p16-Ki67 dual stain as potential alternatives.

Sign in / Sign up

Export Citation Format

Share Document