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Ann Oncol. 2014 Jul;25(7):1410-6. doi: 10.1093/annonc/mdu167. Epub 2014 May 5.

Prognostic significance of human papillomavirus in recurrent or metastatic head and neck cancer: an analysis of Eastern Cooperative Oncology Group trials.

Author information

1
Division of Hematology/Oncology Cancer Therapy and Research Center, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio athanassios.argiris@gmail.com.
2
Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston.
3
Ragon Institute of Harvard, MIT and MGH and Harvard Medical School, Boston.
4
Department of Otolaryngology.
5
Department of Pathology, University of Pittsburgh, Pittsburgh.
6
Department of Medical Oncology, Johns Hopkins University, Baltimore.
7
Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, USA.

Abstract

BACKGROUND:

The purpose of this article was to study the association of human papillomavirus (HPV) with clinical outcomes in patients with recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN).

PATIENTS AND METHODS:

Archival baseline tumor specimens were obtained from patients treated on two clinical trials in recurrent or metastatic SCCHN: E1395, a phase III trial of cisplatin and paclitaxel versus cisplatin and 5-fluorouracil, and E3301, a phase II trial of irinotecan and docetaxel. HPV DNA was detected by in situ hybridization (ISH) with a wide-spectrum probe. p16 status was evaluated by immunohistochemistry. Clinical outcomes of interest were objective response, progression-free survival (PFS) and overall survival (OS).

RESULTS:

We analyzed 64 patients for HPV ISH and 65 for p16. Eleven tumors (17%) were HPV+, 12 (18%) were p16+, whereas 52 (80%) were both HPV- and p16-. The objective response rate was 55% for HPV-positive versus 19% for HPV-negative (P = 0.022), and 50% for p16-positive versus 19% for p16-negative (P = 0.057). The median survival was 12.9 versus 6.7 months for HPV-positive versus HPV-negative patients (P = 0.014), and 11.9 versus 6.7 months for p16-positive versus p16-negative patients (P = 0.027). After adjusting for other covariates, hazard ratio for OS was 2.69 (P = 0.048) and 2.17 (P = 0.10), favoring HPV-positive and p16-positive patients, respectively. The other unfavorable risk factor for OS was loss of ≥5% weight in previous 6 months (P = 0.0021 and 0.023 for HPV and p16 models, respectively).

CONCLUSION:

HPV is a favorable prognostic factor in recurrent or metastatic SCCHN that should be considered in the design of clinical trials in this setting.

CLINICAL TRIAL IDENTIFIER:

NCT01487733 Clinicaltrials.gov.

KEYWORDS:

head and neck cancer; human papillomavirus

PMID:
24799460
PMCID:
PMC4071756
DOI:
10.1093/annonc/mdu167
[Indexed for MEDLINE]
Free PMC Article

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