Impact of specific high‐risk human papillomavirus genotypes on survival in oropharyngeal cancer

Garset‐Zamani, Martin; Carlander, A.; Jakobsen, Kathrine Kronberg; Friborg, Jeppe; Kiss, Katalin; Marvig, Rasmus L.; Olsen, Caroline Holkmann; Nielsen, Finn C.; Andersen, Elo; Grønhøj, Christian

doi:10.1002/ijc.33893

Cited by 19 publications

(12 citation statements)

References 32 publications

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“…In future, it may add value in relation to liquid biopsies with cell-free HPV DNA in the follow-up surveillance after treatment [ 10 ]. A recent study has investigated the role of high-risk HPV genotypes on survival in patients with oropharyngeal cancer, and found no differences when comparing HPV16 with non-HPV16 genotypes [ 11 ]. The subgroup analysis indicated that the group of patients with genotypes HPV33 and HPV35 has a significantly better 5-year overall survival than other non-HPV16 genotypes.…”

Section: Discussionmentioning

confidence: 99%

Validation of the VisionArray® Chip Assay for HPV DNA Testing in Histology Specimens of Oropharyngeal Squamous Cell Carcinoma

Channir,

Bendtsen,

Melchior

et al. 2024

Head and Neck Pathol

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Background The detection of human papillomavirus (HPV) has several implications in the diagnostic work-up and management of oropharyngeal squamous cell carcinoma (OPSCC). The choice of HPV detection assay and testing algorithms differ across institutions and vary in cost, detection targets, technical feasibility, and turnaround time. In this study, we aimed to validate the VisionArray® HPV Chip for formalin-fixed and paraffin-embedded (FFPE) samples of OPSCC using the previously applied standard pan-HPV DNA PCR assay as a reference. Methods The validation cohort consisted of FFPE tissue samples from patients previously diagnosed with HPV DNA-positive OPSCC (n = 80), HPV DNA-negative OPSCC (n = 21), and a benign group of tumor samples consisting of Warthin’s tumors (n = 20) and branchial cleft cysts of the lateral neck (n = 14). All samples were tested with p16 immunohistochemistry, pan-HPV DNA PCR, and the VisionArray® HPV Chip. Results The overall sensitivity and specificity of the VisionArray® HPV Chip assay were 100% [95% CI 95.5%; 100.0%] and 96.3% [95% CI 87.3%; 99.6%] and the positive predictive value and negative predictive value were 97.6% [95% CI 91.5%; 99.7%] and 100% [95% CI 93.2%; 100%], respectively. Conclusions The VisionArray® HPV Chip assay can be recommended for high-risk HPV testing in FFPE tissue samples from OPSCC, providing both a fast and simultaneous genotyping for 41 clinically relevant HPV types.

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Section: Discussionmentioning

confidence: 99%

Validation of the VisionArray® Chip Assay for HPV DNA Testing in Histology Specimens of Oropharyngeal Squamous Cell Carcinoma

Channir,

Bendtsen,

Melchior

et al. 2024

Head and Neck Pathol

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“…HPV infection can be classified into P16+/HPV+, p16+/HPV−, or p16−/HPV+. Some studies have reported that the OS of p16+/HPV− and p16−/HPV+ are poor ( 37 ). However, the included studies in this meta-analysis failed to distinguish between these three specific categories, and thus, we could determine whether our results were affected by HPV status in the two groups.…”

Section: Discussionmentioning

confidence: 99%

Reduced-dose radiation in human papillomavirus-associated oropharyngeal carcinoma can improve outcome: a systematic review and meta-analysis

Yang¹,

Liu²,

Sui³

et al. 2022

Ann Transl Med

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Background: Despite its effectiveness, the standard course of chemoradiation for the treatment of human papillomavirus (HPV)-related oropharyngeal carcinoma (OPC) results in considerable treatmentrelated adverse effects. Studies proved that HPV-positive OPC is very sensitive to radiotherapy. Using deescalation therapy as a new strategy is critical to maintaining positive outcomes while alleviating side effects.However, some studies hold that reduced dose causes insufficient effect on tumor killing. We conducted this systematic review and meta-analysis of survival and adverse reactions in patients with HPV-related OPC by retrospective analysis and evaluated the therapeutic effect of reducing the radiation dose.Methods: Data were double-selected and extracted by searching seven electronic databases, Original studies in all language treated HPV-associated OPC with reduced-dose and standard-dose therapies were included.Overall survival (OS), progression-free survival (PFS), and incidence rates of adverse events were obtained by pooling analyses. Statistical analyses were performed using RStudio Version 1.1.383 (RStudio, Boston, MA, USA) via the Meta-Analysis R Package (metafor). Heterogeneity was evaluated using the I 2 statistic and the Cochran Q test. We used Stata (version 15.0) for forest graph.Results: Thirteen studies were included in this meta-analysis, involving a dose range of 66-70 Gy for the standard treatment regimen and <66 Gy for the reduced-dose group. There was no significant difference in the age of the patients in the standard and the reduced treatment groups (60.9±5.9 vs. 58.6±2.4 years). Nine studies were included as standard cohort and thirteen studies were enrolled as reduced-dose cohort. The 2and 3-year overall survival rates in the reduced-dose group (95.66% and 91.51%, respectively) were superior to those in the standard-dose group (88.36% and 87.46%, respectively). There was no significant difference in PFS between the two groups. A systematic review of articles on dose reduction and the standard dose was also conducted. The most common complication in reduced-dose radiation was oral mucositis (36.4%), followed by decreased white blood cell (WBC) count (30.5%) and dry mouth (29.1%).Conclusions: Reducing the radiation dose in patients with HPV-related OPC substantially alleviates the treatment toxicities and optimizes the quality of life of patients while at the same time maintaining favorable oncologic outcomes.

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“…Although the natural history of the transition to oropharyngeal cancer is not fully clarified, it is now commonly accepted that a subclinical oral HPV infection persisting for 10–30 years is an obligate precursor of the majority of OPSCCs [ 12 , 13 , 16 ] Indeed, HPV detection in OPSCCs increased dramatically over time and several high-risk types have been identified, including 16 and 18, 31, 33, 35, 52, 58 (all genetically related to HPV 16); and 39, 45, 59 (genetically related to HPV 18), with HPV 16 accounting for 70–80% of cases [ 17 , 18 ].…”

Section: Epidemiological Background Of Oropharyngeal Hpv Infectionmentioning

confidence: 99%

A clinician’s dilemma: what should be communicated to women with oncogenic genital HPV and their partners regarding the risk of oral viral transmission?

et al. 2022

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Head and neck cancer, the sixth most common cancer worldwide, account for about 1 out of 20 malignant tumors. In recent years a reduction in the incidence of cervical cancer, but a concomitant major increase in the incidence of HPV-mediated oropharyngeal cancer caused by orogenital HPV transmission has been observed. Consequently, in wealthy countries oropharyngeal squamous-cell carcinomas (OPSCC) is now the most frequent HPV-related cancer, having overtaken cervical cancer. Without effective medical interventions, this incidence trend could continue for decades. As no specific precursor lesion has been consistently identified in the oral cavity and oropharynx, HPV vaccination is the logical intervention to successfully counteract also the rising incidence of OPSCCs. However, HPV vaccine uptake remains suboptimal, particularly in males, the population at higher risk of OPSCC. Alternative primary prevention measures, such as modifications in sexual behaviors, could be implemented based on knowledge of individual genital HPV status. Until recently, this information was not available at a population level, but the current gradual shift from cytology (Pap test) to primary HPV testing for cervical cancer screening is revealing the presence of oncogenic viral genotypes in millions of women. In the past, health authorities and professional organizations have not consistently recommended modifications in sexual behaviors to be adopted when a persistent high-risk HPV cervicovaginal infection was identified. However, given the above changing epidemiologic scenario and the recent availability of an immense amount of novel information on genital HPV infection, it is unclear whether patient counseling should change. The right of future partners to be informed of the risk could also be considered. However, any modification of the provided counseling should be based also on the actual likelihood of a beneficial effect on the incidence of HPV-associated oropharyngeal cancers. The risk is on one side to induce unjustified anxiety and provide ineffective instructions, on the other side to miss the opportunity to limit the spread of oral HPV infections. Thus, major health authorities and international gynecologic scientific societies should issue or update specific recommendations, also with the aim of preventing inconsistent health care professionals’ behaviors.

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Impact of specific high‐risk human papillomavirus genotypes on survival in oropharyngeal cancer

Cited by 19 publications

References 32 publications

Validation of the VisionArray® Chip Assay for HPV DNA Testing in Histology Specimens of Oropharyngeal Squamous Cell Carcinoma

Validation of the VisionArray® Chip Assay for HPV DNA Testing in Histology Specimens of Oropharyngeal Squamous Cell Carcinoma

Reduced-dose radiation in human papillomavirus-associated oropharyngeal carcinoma can improve outcome: a systematic review and meta-analysis

A clinician’s dilemma: what should be communicated to women with oncogenic genital HPV and their partners regarding the risk of oral viral transmission?

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