Source: www.cancernetwork.com Author: Russ Conroy Human papillomavirus and p16 discordance may correlate with a worse prognosis for oropharyngeal cancer, according to data from an individual patient data analysis. Patients with discordant p16-negative, human papillomavirus (HPV)–positive or p16-positive, HPV-negative oropharyngeal cancer had a significantly worse prognosis compared with patients who had p16-positive and HPV-positive disease and a better prognosis compared with those who have p16-negative and HPV-negative disease. The data suggest the need for routine p16 immunohistochemistry and mandated HPV testing in clinical trials for oropharyngeal cancer, according to findings from the HNCIG-EPIC-OPC individual patient data analysis. The 5-year overall survival (OS) rate was 81.1% (95% CI, 79.5%-82.7%) for patients with p16-positive, HPV-positive disease; 40.4% (95% CI, 38.6%-42.4%) for those with p16-negative, HPV-negative disease; 53.2% (95% CI, 46.6%-60.8%) for those with p16-negative, HPV-positive disease; and 54.7% (95% CI, 49.2%-60.9%) for those with p16-positive, HPV-negative disease. Additionally, 5-year disease-free survival (DFS) was 84.3% (95% CI, 82.9%-85.7%), 60.8% (95% CI, 58.8%-62.9%), 71.1% (95% CI, 64.7%-78.2%), and 67.9% (95% CI, 62.5%-73.7%) for each respective patient group. Investigators of this multi-center, international individual patient data analysis included retrospective and prospective cohorts with a minimum size of at least 100 patients with primary squamous cell carcinoma of the oropharynx. Patients underwent cross-sectional imaging; histological confirmation by biopsy; and treatment with surgery, radiotherapy, chemotherapy, or combination therapy for oropharyngeal cancer. The primary end points of the analysis included OS, DFS, and the proportion of patients in the overall cohort who showed different p16 and HPV result combinations. [...]