Historical Perspective: How the Discovery of HPV Virus Led to the Utilization of a Robot

Abstract

The treatment of oropharyngeal cancer has undergone many paradigms shifts in recent decades. First considered a surgical disease, improvements in radiotherapy led to its popularization in the 1990s. Subsequently, the discovery of the human papillomavirus (HPV) in the pathogenesis of oropharyngeal cancer, as well as the increase in HPV-associated oropharynx cancer incidence, have prompted a reevaluation of its management. Its sensitivity to standard treatment with a favorable prognosis compared to non HPV-associated oropharyngeal cancer led to a focus on minimizing treatment toxicity. Advances in radiation and surgical techniques, including the use of transoral robotic surgery, gave the rationale to ongoing de-escalation clinical trials in HPV-associated oropharynx cancer.

Therapeutic Vaccines for HPV-Associated Oropharyngeal and Cervical Cancer: The Next De-Intensification Strategy?

“…Some trials (NCT05232851) are also investigating the possibility of adding therapeutic vaccines to checkpoint inhibitors in the neoadjuvant setting. The rationale here is to reduce the size of the tumor before surgery and thus reduce the amount of normal tissue that needs to be removed, thus de-intensifying the treatment [ 6 ].…”

“…On the other hand, the incidence of HPV-negative OPSCC has decreased by 50%, in accordance with the gradual reduction in tobacco and alcohol use since the 1980s [ 4 ]. HPV-related OPSCC shows a distinct epidemiology, clinical presentation and pathophysiology [ 5 , 6 ]. Patients are younger, healthier, and with a higher socioeconomic status [ 2 , 7 ].…”