Review of the Clinical and Biologic Aspects of Human Papillomavirus-Positive Squamous Cell Carcinomas of the Head and Neck

Abstract

Human papillomavirus (HPV), a known etiology of a subset of head and neck squamous cell carcinomas (HNCs), causes numerous alterations in normal cellular functions. This article reviews the biology, detection and treatment of HPV-positive HNC. The role of HPV oncoproteins in tumor development, the natural history of HPV infection, and risk factors for and prevention of transmission of oral HPV are considered. Commonly used methods for detecting HPV infection including limitations of these methods are discussed to aid the practicing clinician in utilizing these tests in their clinical practice. Clinical characteristics of HPV-positive HNC including potential explanations for the improved outcomes seen in patients with HPV-positive HNC are assessed. Ongoing clinical trials specific for patients with HPV-positive HNC are described and areas in need of additional research are summarized. Until the results of ongoing trials are known, treatment of HPV-positive HNC should not differ in clinical practice from treatment of similar non-HPV related cancers.

High-grade acute organ toxicity and p16INK4A expression as positive prognostic factors in primary radio(chemo)therapy for patients with head and neck squamous cell carcinoma

“…Although a highly sensitive nested PCR approach was used [14,15], HPV DNA was detected in 44 samples only, while positive p16 INK4A staining was detected in 102 samples. Such a discrepancy between HPV DNA and p16 INK4A positivity is not uncommon [16] and may be related to inefficient virus DNA detection or to p16 INK4A expression unrelated to HPV infection. The use of partially long-stored material in this study may have compromised PCR amplification of HPV-specific DNA [15,17].…”

Epidemiology of HPV-Associated Oropharyngeal Squamous Cell Carcinoma

“…HPV has a relatively unique life cycle (reviewed in detail by Rautava and Syrjänen 2012;Blitzer et al 2014). Unlike many viruses that infect, multiply in, and are released by the same cell, HPV requires the infected cells to divide and differentiate.…”

“…Probably as a result of less chromosomal instability and fewer mutations in their tumors, patients with HPV-positive OPSCC have better disease-free and overall survival than those with HPV-negative tumors (Pytynia et al 2014). A detailed review of the role of radiation therapy in the better prognosis of HPV-positive OPSCC is reviewed by Blitzer et al (2014).…”

Development and feasibility of an electronic-Swallowing Intervention Package (e-SiP) to support swallowing function in patients with head and neck cancer (Preprint)

“…In Scotland the rates of HNC are almost 40% higher than in England [2].There is a link between HNC and the presence of the human papillomavirus (HPV), and HPV-positive cases now account for around 30-65% of HNCs [3]. The demographic of HNC is therefore changing, as patients who are positive for the human papillomavirus tend to be younger at diagnosis, generally have a higher socioeconomic status and better education, and a better prognosis (despite often presenting at a more advanced stage of cancer) than patients with HPV-negative HNCs [3][4][5]. Younger age at diagnosis and improved treatment effectiveness mean that more people are now living with the consequences of HNC and its treatment.…”