HPV Associated Head and Neck Cancer

Spence, Tara; Bruce, Jeff; Yip, Kenneth W.; Liu, Fei‐Fei

doi:10.3390/cancers8080075

Cited by 112 publications

(118 citation statements)

References 72 publications

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“…Overall, HPV-positive tumours in the oropharynx have an improved survival rate when compared with HPV-negative tumours, regardless of the treatment modality employed: 75% 3-year survival rate compared with 50% in HPV-negative tumours [1, 6,8]. These patients also demonstrate a lower rate of recurrence (approximately 50% lower than HPV-negative tumours), and a lower rate of metastatic disease [1,6].…”

Section: Prognosismentioning

confidence: 99%

“…These tumors tend to occur in younger (40-55 years, compared with >60 years), male, Caucasian patients, as well as be associated with higher levels of education achieved, higher income and higher socio-economic status [5,8,13,14]. The patients tend to have lower levels of tobacco and alcohol consumption [1,8]. The tumors are more likely to be of non-keratinizing or basaloid morphology histologically, and while they present at an earlier T-stage, there is an association with advanced nodal disease at diagnosis [5,14].…”

Section: Clinical and Pathologic Featuresmentioning

confidence: 99%

“…Traditionally, tobacco smoking and alcohol consumption are risk factors for this disease, having synergistic carcinogenic effects, and tumours related to these risk factors have demonstrated a stabilization or decline in incidence [1, 2,5,6]. Human papillomavirus (HPV) infection is also now an established risk factor for a subset of HNSCC, particularly HNSCC occurring in the oropharynx (base of tongue and palatine tonsils), following its discovery in these tumours in 1983 by Syrjanen et al [1,[7][8][9]. Since this time, there has been a clear and significant increase in the incidence of oropharyngeal tumours related to HPV of 225% between 1984 and 2004 in America, as well as a decrease of approximately 50% of HPV-negative tumours [10].…”

Section: Epidemiologymentioning

confidence: 99%

Section: Clinical and Pathologic Featuresmentioning

confidence: 99%

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Evaluating cellular microRNA expression in human papillomavirus associated head and neck squamous cell carcinoma

Emmett¹

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Squamous cell carcinoma of mucosal head and neck sites (HNSCC) is the sixth most common cause of cancer world-wide, and is associated with a significant morbidity and mortality despite advances in therapeutic options over the past decades. HNSCC includes tumours of the oral cavity, oropharynx, larynx and hypopharynx. While there has been a decline in tumours occurring as a result of exposure to the traditional risk factors of tobacco smoking and alcohol consumption, a significant increase has been observed in the number of tumours attributed to the Human Papillomavirus (HPV). This has primarily been associated with causation of tumours in the oropharynx, however, a smaller number of tumours at other subsites are also likely to be related to the virus. Although HPV-related tumours tend to have an improved prognosis and a better response to chemo-and radiotherapy, the pathobiology underlying these differences is not yet fully understood.MiRNAs are short, non-coding single strands of RNA which regulate gene expression at the posttranscriptional level. They have been identified to be dysregulated and function as tumour suppressor or oncogenes in a number of human cancers, including head and neck cancers. MiRNAs have also been associated with prognostication including associations with recurrence of disease and diseasefree survival. As they are readily available across a range of body tissues including solid tissue, saliva, and plasma, these biomarkers have potential utility in relation to screening for disease diagnosis, recurrence or progression. Although there is an established difference between HPV-positive and negative tumours in the oropharynx clinically, the majority of studies investigating miRNA expression in HNSCC have not taken this factor into account. In the small number of studies which have examined the effect of HPV on miRNA expression in HNSCC, there is a lack of consistency in the results described.This thesis aimed to assess the difference in miRNA expression between HPV-positive and negative tumours, through use of miRNA microarray followed by validation with real-time PCR using TaqMan assays combined with a sensitive detection method (Fluidigm HD) in a larger cohort of patients. It also investigated differences in miRNA expression in association with lifestyle factors, demographics and clinical outcomes. A set of seven miRNAs was identified to be differentially expressed between HPV-positive and negative tumours in the oropharynx. No difference in miRNA expression was observed between the two tumour cohorts at other subsites in the head and neck.Differences in miRNA expression were also observed with lifestyle factors such as smoking status and alcohol consumption. Recurrence of the primary tumour and overall disease-free survival were further associated with altered miRNA expression. The findings outlined in this thesis add to the present literature regarding differences in miRNA expression between HPV-positive and negative iii tumours in the oropharynx, and provide a basis for further...

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Section: Prognosismentioning

confidence: 99%

Section: Clinical and Pathologic Featuresmentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

Section: Clinical and Pathologic Featuresmentioning

confidence: 99%

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Evaluating cellular microRNA expression in human papillomavirus associated head and neck squamous cell carcinoma

Emmett¹

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“…In recurrences, the former treatment and the current patient performance status have to be considered in regards to further therapeutic options. Since HPV-status has emerged as an important prognostic marker in HNSCC it now has to be taken into account for treatment decision in oropharyngeal cancer, as de-intensification of treatment might be an option (19). Limitations of surgery are the preservation of organ function and avoidance of severe cosmetic deformity.…”

Section: Treatmentmentioning

confidence: 99%

The impact of Survivin, WRAP53β, and Hypoxia on treatment response in Head and Neck Cancer

Tiefenböck-Hansson¹

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v ABSTRACTSquamous cell carcinoma (SCC) is the most common histological type of cancer in the head and neck region and arises in the epithelial mucosa of the upper aerodigestive tract.Approximately one and a half million people are living with the diagnosis. Despite efforts in prevention and advances in treatment, the 5-year survival rate still lies around 60%, and recurrences and second primary tumors remain a problem. Moreover, treatment responses vary from patient to patient, highlighting the need for individually tailored treatments. To make this possible, biomarkers predicting treatment outcome are needed to better guide treatment decisions.The aim of this thesis was to evaluate the expression of certain proteins and the frequency of certain SNPs (Single nucleotide polymorphisms) in tumor biopsies and cell cultures of head and neck squamous cell carcinomas (HNSCC), and to explore their potential as biomarkers for treatment outcome. Furthermore, we aimed to study the impact of hypoxia on treatment response, epithelial-to-mesenchymal transition (EMT), and induction of cancer stem cells (CSC).In papers I and II, we investigated two proteins, survivin and WRAP53β, using immunohistochemistry (IHC) in tumor biopsies from 40 patients categorized as Nonresponders or Responders to radiotherapy. High expression of survivin and nuclear expression of WRAP53β were significantly more prevalent in the Responder group. The combination of these two factors correlated strongest to overall survival, but not to a significantly higher extent compared to survivin alone. Moreover, when examined separately, a high percentage of p53-stained cells and the presence of the SNP FGFR4 Gln388Arg correlated to improved overall survival, whereas the SNP XPD Lys751Gln was associated with worse overall survival. The latter three showed no significant correlations to radiotherapy response. In paper III, the two ABSTRACT vi most promising proteins identified in papers I and II were analyzed in a study cohort of 149 tumor biopsies of glottic laryngeal SCC, categorized as T2N0-T3N0. In this patient group, no significant associations between survivin expression and survival could be found. However, expression of cytoplasmic WRAP53β was significantly linked to worse disease-free-survival (DSF) compared to nuclear WRAP53β or negative staining for WRAP53β. Positive expression of p16INK4a was found in 7% of the tumors. The prevalence of p16 INK4a was higher in younger patients (<60) and associated with absence of recurrence and longer DSF.In paper IV, five HNSCC cell lines were cultured in normoxic (20% O 2 ) and hypoxic (1% O 2 )conditions and changes in treatment response, EMT profile, and expression of CSC markers were examined. As expected, hypoxia induced EMT and to a certain extent expression of CSC markers. Silencing of the hypoxia-inducible-factor-1α (HIF-1α) only partly reversed these effects, suggesting that other mechanisms are involved. Whereas most cell lines became more resistant to treatment in hypoxia, one cell line (LK0412) ...

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Barriers in Access to Care for Patients With Head and Neck Cancer in Resource-Limited Settings

Beaudoin

Anchouche

Gaffar

et al. 2020

JAMA Otolaryngol Head Neck Surg

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The identification of the barriers to care for patients with head and neck cancer in low-income and lower-middle-income countries is a crucial first step toward the identification of targets for developing and implementing cost-effective programs to increase awareness, prevention, and treatment of head and neck cancer in this setting.OBJECTIVE To identify the barriers to care for patients presenting with head and neck cancer in low-income and lower-middle-income countries.EVIDENCE REVIEW Nine databases were searched from their inception to December 21, 2017: Africa-Wide Information, the Cochrane Library, Embase, Global Health, LILACS, MEDLINE, BIOSIS Previews, and Web of Science. Search terms referred to head and neck cancer, barriers to care, and low-and lower-middle-income countries, and no temporal and linguistic restrictions were imposed. Articles were reviewed by 2 independent investigators, and differences in inclusion were resolved by discussion. Bibliographies of all included articles were screened, and all relevant articles were reviewed using the same procedure. Quantitative articles were assessed using the Methodological Index for Non-Randomized Studies tool, and articles with qualitative data used the Critical Appraisal Skills Programme qualitative checklist. This systematic review was registered in PROSPERO (registration No. CRD42018092448) and followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols.FINDINGS Of the 44 articles selected for review, 18 (41%) met the selection criteria. All articles reported quantitative results, and 3 (17%) added some qualitative material to the study design. Most (11 [61%]) of the studies originated from India. A total of 41 different barriers to care were identified, with low level of education (cited in 8 articles [44%]), low socioeconomic status (in 4 articles [22%]), and lack of knowledge about head and neck cancer (in 3 articles [17%]) being statistically associated with a delayed presentation. Misunderstanding of signs and symptoms, use of alternative medicine, and inability to access health care were other barriers discussed in the qualitative articles.CONCLUSIONS AND RELEVANCE This systematic review highlighted the lack of both qualitative and quantitative information for patients with head and neck cancer in low-income and lower-middle-income countries. The findings suggest that integrating the barriers to care with information from patient lives may identify the clinical and social relevance of these barriers and guide future research.

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HPV Associated Head and Neck Cancer

Cited by 112 publications

References 72 publications

Evaluating cellular microRNA expression in human papillomavirus associated head and neck squamous cell carcinoma

Evaluating cellular microRNA expression in human papillomavirus associated head and neck squamous cell carcinoma

The impact of Survivin, WRAP53β, and Hypoxia on treatment response in Head and Neck Cancer

Barriers in Access to Care for Patients With Head and Neck Cancer in Resource-Limited Settings

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