oropharyngeal squamous cell carcinomas

‘Risk’ Varies in HPV-Positive Oropharyngeal Cancer: Study

Source: Medscape Medical News > OncologyAuthor: Kate JohnsonDate: February 21, 2013 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 overtreatment of many patients (and the consequent late effects on swallowing function) and undertreatment 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 [...]

Charlotte Parker2013-02-25T13:15:37-07:00February, 2013|Oral Cancer News|

Combo HPV Diagnostic Test for Head and Neck Cancer Outperforms Other Tests

SOURCE: American Association for Cancer Research PHILADELPHIA -- October 3, 2011 -- Researchers have determined that a combination of P16 immunohistochemistry and DNA qPCR to test for viral E6 can accurately determine the oropharyngeal squamous cell carcinomas which derive from human papillomavirus (HPV) type 16, according to a study published in Clinical Cancer Research. "This has immediate clinical applications as we consider recruitment to clinical trials designed to de-escalate the intensity of therapy based on HPV status" said lead researcher Andrew Schache, MD, University of Liverpool, Liverpool, United Kingdom. Dr. Schache said that the attention surrounding HPV, particularly in the last several years, has given rise to a number of diagnostic tests, but the evaluation of these tests has lagged behind. For the current study, researchers evaluated 8 possible combinations of known diagnostic tests on 108 cases of HPV16 derived oropharyngeal squamous cell carcinoma. They used viral gene expression as the standard marker. "Viral gene expression has 100% specificity and sensitivity, but it requires very high quality tissue that is often not available," said Dr. Schache. After evaluating the tests, they found that a combination of DNA qPCR and P16 immunohistochemistry had 97% sensitivity and 94% specificity. Both of these assays are commercially available in proprietary and generic forms, so the combination test could be administered. "Getting the diagnosis right is extremely important because cases like this may receive less aggressive therapy based on a positive test," added Dr. Schache. "You do not want to withhold treatment from a more [...]

Oral Cancer Foundation News Team - A2011-10-15T07:37:14-07:00October, 2011|Oral Cancer News|

HPV Causing “Slow Epidemic” of Oral Cancers

Source: Medscape Today By: Janis C. Kelly October 21, 2010 — Human papillomavirus (HPV) is a risk factor for oropharyngeal squamous cell carcinoma (OSCC), and might account for the steady increase in OSCC incidence, even in subjects who do not smoke or consume alcohol, according to Swedish researchers. A review of recent studies, conducted by Trobjorn Ramqvist, MD, and Tina Dalianis, MD, PhD, and published online October 13 in Emerging Infectious Diseases, suggests that changes in sexual practices are behind the surge in OSCC cases linked to sexually transmitted HPV. The key factors appear to be multiple sex partners, starting sexual activity at a younger age, and increased oral sex. The data are startling. For example, from 1970 to 2002, tonsillar cancer (which is the most common OSCC) increased in Stockholm, Sweden, by 2.8-fold, and by 2006/07, 93% of all tonsillar cancers in that city were HPV-positive. Dr. Dalianis, who is professor of tumor virology and the head of the Department of Oncology–Pathology at Karolinska Institutet in Stockholm, told Medscape Medical News that "we realized that there was an increase in HPV-induced tonsillar cancer, but we did not realize it was so eminent until we separated the 2 groups (HPV-negative and -positive tonsillar cancer cases) the way we did." The most common OSCC is tonsillar cancer, followed by base of tongue cancer. Overall 5-year survival for OSCC is about 25%, and HPV-positive OSCC generally has better clinical outcomes than HPV-negative disease. Dr. Dalianis said that HPV (most commonly type 16) [...]

Oral Cancer Foundation News Team - A2010-10-22T11:17:11-07:00October, 2010|Oral Cancer News|

Oropharyngeal carcinoma related to human papillomavirus

Source: BMJ 2010;340:c1439 Author: Staff Incidence is increasing rapidly, with implications for prognosis and policy Head and neck cancer is the sixth most common cancer, with about 640,000 new cases each year worldwide. Despite an overall marginal decline in the incidence of most head and neck cancers in recent years,1 the incidence of oropharyngeal squamous cell carcinoma has increased greatly, especially in the developed world. In the United States, the incidence of oropharyngeal squamous cell carcinoma increased by 22% from 1.53 per 100,000 to 1.87 per 100,000 between 1999 and 2006, after showing no change between 1975 and 1999. 1 The United Kingdom has seen a 51% increase in oral and oropharyngeal squamous cell carcinoma in men from seven per 100,000 to 11 per 100,000 between 1989 and 2006. 2 The increase in incidence of oropharyngeal squamous cell carcinoma seems to be accounted for by a rise in human papillomavirus (HPV) related oropharyngeal carcinoma. A recent retrospective study showed a progressive proportional increase in the detection of HPV in biopsies taken to diagnose oropharyngeal squamous cell carcinoma in the Swedish county of Stockholm over the past three decades (23.3% in 1970s, 29% in 1980s, 57% in 1990s, 68% between 2000 and 2002, 77% between 2003 and 2005, and 93% between 2006 and 2007).3 Similarly, HPV related oropharyngeal carcinoma has been reported in 60-80% of recent oropharyngeal biopsy samples in studies conducted in the US, compared with 40% in the previous decade.4 More research is needed to establish the incidence of HPV related oropharyngeal carcinoma in African, Asian, and South American countries. HPV related oropharyngeal carcinoma seems to be a new and distinct [...]

Charlotte Parker2010-03-26T16:16:09-07:00March, 2010|Oral Cancer News|

Genetic signatures of HPV-related and unrelated oropharyngeal carcinoma and their prognostic implications

Source: Clinical Cancer Research, 10.1158/1078-0432 Authors: Jens P. K et al. Purpose: Patients with human papillomavirus (HPV)-containing oropharyngeal squamous cell carcinomas (OSCC) have a better prognosis than patients with HPV-negative OSCC. This may be attributed to different genetic pathways promoting cancer. Experimental Design: We used comparative genomic hybridization to identify critical genetic changes in 60 selected OSCC, 28 of which were associated with HPV-16 as determined by HPV-specific PCR and fluorescence in situ hybridization analysis and positive p16INK4A immunostaining. The results were correlated with HPV status and clinical data from patients. Results: Two thirds of OSCC harbored gain at 3q26.3-qter irrespective of HPV status. In HPV-negative tumors this alteration was associated with advanced tumor stage (P = 0.013). In comparison with HPV-related OSCC, the HPV-negative tumors harbored: (a) a higher number of chromosomal alterations and amplifications (P = 0.03 and 0.039, respectively); (b) significantly more losses at 3p, 5q, 9p, 15q, and 18q, and gains/amplifications at 11q13 (P = 0.002, 0.03; <0.001, 0.02, 0.004, and 0.001, respectively); and (c) less often 16q losses and Xp gains (P = 0.02 and 0.03). Survival analysis revealed a significantly better disease-free survival for HPV-related OSCC (P = 0.02), whereas chromosome amplification was an unfavorable prognostic indicator for disease-free and overall survival (P = 0.01 and 0.05, respectively). Interestingly, 16q loss, predominantly identified in HPV-related OSCC, was a strong indicator of favorable outcome (overall survival, P = 0.008; disease-free survival, P = 0.01) and none of these patients had a tumor recurrence. Conclusions: Genetic [...]

Oral Cancer Foundation News Team - A2009-02-22T06:09:58-07:00February, 2009|Oral Cancer News|