HPV-positive cancer

New Study Shows Variable Risk in HPV-Positive Oropharyngeal Cancer

by Kate Johnson for Medscape Deintensification of chemotherapy might not be the best option for all patients with oropharyngeal cancer whose disease is associated with human papillomavirus (HPV). However, such an approach might be reasonable for patients with a low risk for distant recurrence; namely, those with less advanced disease and limited exposure to smoking, according to a large retrospective institutional study conducted by Brian O'Sullivan, MD, from the Princess Margaret Hospital in Toronto, Ontario, Canada, and colleagues. The study was published in the February 10 issue of the Journal of Clinical Oncology. The findings "provocatively suggest there is a limit to the favorable biology of HPV-associated OPSCC [oropharyngeal squamous cell carcinoma]," write Harry Quon, MD, and Arlene Forastiere, MD, from the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University in Baltimore, Maryland, in an accompanying editorial. "It could be that today's treatment paradigms result in the over treatment of many patients (and the consequent late effects on swallowing function) and under treatment of a smaller subset," they add. There is growing concern among OPSCC experts about patients' risks for radiation-related morbidity, particularly severe late swallowing complications, Dr. Forastiere told Medscape Medical News. "The potential for this damage is increased when chemotherapy is added to the radiation," she explained. "One simple strategy is to drop the chemotherapy from the treatment of those with a low risk for recurrence of tumor in the oropharynx or the regional lymph nodes in the neck." However, she pointed out that Dr. O'Sullivan and colleagues "have refined this 'risk definition' [...]

Charlotte Parker2014-05-30T22:37:54-07:00May, 2014|Oral Cancer News|

Prognostic Significance of HPV Status in Oropharyngeal Cancer

OncologySTAT Editorial Team Dr. Maura Gillison is Professor of Medicine, Epidemiology, and Otolaryngology at Ohio State University in Columbus. OncologySTAT: The results of the Radiation Therapy Oncology Group (RTOG) 0129 trial showed that the human papillomavirus (HPV) is an independent prognostic factor in oropharyngeal cancer. Could you tell us about the rationale for this study? Dr. Gillison: Over the last 10 years, our research has shown that cancers of the oropharynx are actually 2 completely different diseases that can look quite similar. One subset is caused HPV infection, and the other is more closely associated with long-term use of alcohol and tobacco. Initial studies suggested that the presence of HPV in a patient’s tumor had prognostic significance, but study limitations made that conclusion dubious. We set out to determine whether or not HPV was indeed an independent prognostic factor in head and neck cancer. To show whether there was a direct relationship between HPV infection and head and neck cancer, we needed to prospectively study a uniformly treated and uniformly staged patient population. Thus, we used the study population from the trial conducted by the RTOG. We divided the patients into 2 groups—those whose tumors were caused by HPV and those whose tumors were not—and we compared survival outcomes for the 2 groups. The results showed that HPV status was the single most important predictor of patient outcome, even more so than disease stage and other well-known prognostic factors such as performance status and presence of anemia. In fact, after [...]

Charlotte Parker2012-04-18T10:16:03-07:00April, 2012|Oral Cancer News|

Head and Neck Cancers Linked to HPV are on the Rise

Source: The Wall Street Journal A form of head and neck cancer associated with the sexually transmitted human papillomavirus is on the rise, especially in men, the WSJ reports. Fast-rising rates of oropharyngeal cancer — tumors in the tonsil and back-of-the-tongue area — have been linked to changes in sexual behavior that include the increased practice of oral sex and a greater number of sexual partners. But HPV-positive cancer has also been reported in individuals who report few or no sexual partners. It may also be possible for the virus to be transmitted to an infant via an infected mother’s birth canal. An HPV vaccine is routinely recommended for girls because the virus can cause cervical cancer. The rise in HPV-positive head and neck cancers is leading to a new focus both on treatment of the disease, and whether recommending routine vaccination for boys could prevent oral infections and cancers. (A CDC advisory panel said in 2009 that it was fine for boys to get the vaccine, but recommended against routine administration.) Eric Genden, chief of head and neck oncology at Mt. Sinai Medical Center, tells the Health Blog that when treated appropriately, patients with HPV-positive cancers have an 85% to 90% disease-free survival rate over five years. By contrast, patients with HPV-negative head and neck cancers, which are often associated with smoking and drinking, typically have more advanced disease when the cancer is detected and face a five-year survival rate of only 25% to 40%, Genden says. HPV-induced head [...]

Oral Cancer Foundation News Team - A2011-05-31T11:00:57-07:00May, 2011|Oral Cancer News|

Low prevalence of HPV infection may be tied to poor prognosis for blacks with head and neck cancer

Source: www.eurekalert.org Author: public release Groundbreaking study seeks to explain major disparity in survival between blacks and whites Researchers at the University of Maryland Marlene and Stewart Greenebaum Cancer have found that head and neck cancer patients who test positive for the human papillomavirus (HPV) have much better survival rates than patients who don't have the virus, according to a new study in the journal Cancer Prevention Research. The researchers also discovered that blacks in the study had a very low rate of HPV infection, and consequently worse survival, which may explain why African-American patients traditionally have had a poor prognosis for head and neck cancer. "For the first time, we have evidence that the major difference in survival between black and white patients with head and neck cancer appears to be the rate of HPV infection. We found an astounding difference in prognosis between patients who are HPV-positive and those who are HPV-negative," says the study's senior author, Kevin J. Cullen, M.D., director of the University of Maryland Marlene and Stewart Greenebaum Cancer Center and professor of medicine at the University of Maryland School of Medicine. Scott Lippman, M.D., chairman of the Department of Clinical Cancer Prevention at the University of Texas M.D. Anderson Cancer Center, called the study, "practice-changing." "Squamous cell carcinoma of the head and neck is one of the fastest growing cancers, and this study gives us a new way to assess prognosis for our patients," says Dr. Lippman, who is editor-in-chief of Cancer Prevention Research, [...]

Oral Cancer Foundation News Team - A2009-07-29T19:36:35-07:00July, 2009|Oral Cancer News|