Format

Send to

Choose Destination
J Clin Oncol. 2015 Oct 10;33(29):3243-50. doi: 10.1200/JCO.2015.61.2358. Epub 2015 Sep 8.

Human Papillomavirus-Associated Oropharyngeal Cancer: Defining Risk Groups and Clinical Trials.

Author information

1
Aarti Bhatia, Fox Chase Cancer Center, Philadelphia, PA; and Barbara Burtness, Yale Cancer Center, Yale University School of Medicine, New Haven, CT.
2
Aarti Bhatia, Fox Chase Cancer Center, Philadelphia, PA; and Barbara Burtness, Yale Cancer Center, Yale University School of Medicine, New Haven, CT. barbara.burtness@yale.edu.

Erratum in

Abstract

Human papillomavirus-associated oropharynx cancer (HPVA-OPC) is rapidly increasing in incidence and has unique epidemiologic, molecular, and biologic characteristics. Despite being recognized as having superior prognosis, current evidence does not support less intense therapy compared with HPV-negative OPC. Current combined modality therapies confer a significant risk of morbidity, and patients with HPVA-OPC have a younger median age. These patients, therefore, live longer with the adverse effects of treatment, and this spurs the development of treatment deintensification trials that attempt to decrease treatment-related morbidity without compromising efficacy. Many radiation and chemotherapy de-escalation trials are underway. Minimally invasive surgical techniques are also being evaluated. It is important to identify the ideal patient group for treatment deintensification and to define prognostic risk groups to avoid undertreating the poorer-risk subset in HPVA-OPC, and validated biomarkers are needed to identify patients with the best prognosis. Significant smoking exposure mitigates the favorable prognosis of HPVA-OPC. Currently, less intense treatment is an option only in the setting of clinical trials, and patients with HPVA-OPC should be offered clinical trial options whenever they are available. Finally, recognition of novel therapeutic targets and signaling pathways is critical to the development of new treatment strategies that are desperately needed for patients with poor risk and those with recurrent and metastatic disease.

PMID:
26351343
PMCID:
PMC5814107
DOI:
10.1200/JCO.2015.61.2358
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Atypon Icon for PubMed Central
Loading ...
Support Center