proportional hazards models were generated for OS, DFS, LRC using predictors found to be significant (p<0.05) on univariate models. Results: A total of 205 patients were included: 150 had HPV DNA PCR testing, 120 (80%) were positive, and 114 had a known HPV type. Ninetynine of 114 (87%) were positive for HPV16 and fifteen (13%) were positive for HPV-non16. p16 immunohistochemistry was available in 35 patients and positive in 97% of HPV16 and 100% of HPV-non16 patients. There were no significant differences in age, ECOG performance status, oropharynx subsite, AJCC 7th/8th Edition stage, smoking or alcohol use between HPV-16 and HPV-non16 patients. 3-year OS, DFS, and LRC for HPV16 and HPV-non16 was 84% v. 69% (pZ0.02), 80% v. 63% (pZ0.04), and 82% v. 62% (pZ0.01), respectively. Multivariable models including ECOG, smoking status, AJCC 8th Edition stage, and treatment found HPV16 associated with OS (aHR 0.31, 95% CI 0.10-0.95, pZ0.04) and LRC (aHR 0.33, 95% CI 0.11-0.99, pZ0.05). Conclusion: This study provides insight into the outcomes of HPV positive oropharyngeal squamous cell carcinoma stratified by HPV16 and HPV-non16 subtypes. These data suggest that patients with HPV-non16-associated OPSCC may have worse outcomes including decreased survival and locoregional control compared to patients who carry the HPV16 subtype.
elevated creatinine, hyponatremia;1-each: dehydration, emesis, neutropenic fever, infection). Gr 3/4 cytopenias occurred in 57% of pts.Of 36 pts who had RC the median time to surgery was 5.3 wks from last dose. Baseline stage was cT2 51%, cT3 44%, cT4a 5%. The PaIR was 61%. Sixteen pts were downstaged to pT0 (44.4%), 3 to pTis (8.3%), and 3 to pT1 (8.3%). PaIR did not correlate with baseline PD-L1 score. At 17.4 (1.6-33.3) months median follow up, the relapse free-, overall-, and disease specific-survival, was 70%, 81%, and 90%, respectively.CONCLUSIONS: Neoadjuvant chemo-immunotherapy with pembro in locally advanced UC has manageable toxicity, a comparable time to surgery as NAC, and has improved pathologic outcomes compared to historic controls. Furthermore, the long-term effects of immunotherapy with a sustained high disease specific survival may provide control rates that warrant further study.Clinical trial identification Clinicaltrials.gov: NCT02365766
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