Staging and treatment outcomes in oropharyngeal squamous cell carcinoma: a single-centre UK cohort

Zubair, Farhan; McMahon, Jeremy; Afzali, Payam; Cuschieri, Kate; Yan, Yao; Schipani, Stefano; Brands, Marieke T.; Ansell, Mark

doi:10.1016/j.bjoms.2020.07.007

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…39. 58 HPV Genotyping 44.0% Zubair et al ( 2020 ) Finland 2000–2016 157 110/47 59.5 NA p16 IHC 9.8% Sievert et al ( 2020 ) Spain 2017–2019 54 43/11 62 NA p16 IHC and HPV DNA 18.5% Viros Porcuna et al ( 2020 ) Cameroon 2014–2015 101 31/70 42 32, 68, 82 p16 IHC and HPV RNA ISH 5.0% Rettig et al ( 2019 ) Sweden 2000–2018 195 123/72 67 NA HPV DNA and p16 IHC …”

Section: Introductionmentioning

confidence: 99%

Current Status of Human Papillomavirus-Related Head and Neck Cancer: From Viral Genome to Patient Care

Dong

Shu

et al. 2021

Virol. Sin.

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Human papillomavirus (HPV) infection identified as a definitive human carcinogen is increasingly being recognized for its role in carcinogenesis of human cancers. Up to 38%–80% of head and neck squamous cell carcinoma (HNSCC) in oropharyngeal location (OPSCC) and nearly all cervical cancers contain the HPV genome which is implicated in causing cancer through its oncoproteins E6 and E7. Given by the biologically distinct HPV-related OPSCC and a more favorable prognosis compared to HPV-negative tumors, clinical trials on de-escalation treatment strategies for these patients have been studied. It is therefore raised the questions for the patient stratification if treatment de-escalation is feasible. Moreover, understanding the crosstalk of HPV-mediated malignancy and immunity with clinical insights from the proportional response rate to immune checkpoint blockade treatments in patients with HNSCC is of importance to substantially improve the treatment efficacy. This review discusses the biology of HPV-related HNSCC as well as successful clinically findings with promising candidates in the pipeline for future directions. With the advent of various sequencing technologies, further biomolecules associated with HPV-related HNSCC progression are currently being identified to be used as potential biomarkers or targets for clinical decisions throughout the continuum of cancer care.

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Section: Introductionmentioning

confidence: 99%

Current Status of Human Papillomavirus-Related Head and Neck Cancer: From Viral Genome to Patient Care

Dong

Shu

et al. 2021

Virol. Sin.

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Role of TORS as De-Escalation Strategy in HPV-Related Oropharyngeal Cancer, What We Need to Know

Molteni,

Bassani,

Arsie

et al. 2024

Healthcare

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Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) presents unique challenges and opportunities for treatment, particularly regarding de-escalation strategies to reduce treatment morbidity without compromising oncological outcomes. This paper examines the role of Transoral Robotic Surgery (TORS) as a de-escalation strategy in managing HPV-related OPSCC. We conducted a comprehensive literature review from January 2010 to June 2023, focusing on studies exploring TORS outcomes in patients with HPV-positive OPSCC. These findings highlight TORS’s potential to reduce the need for adjuvant therapy, thereby minimizing treatment-related side effects while maintaining high rates of oncological control. TORS offers advantages such as precise tumor resection and the ability to obtain accurate pathological staging, which can guide the tailoring of adjuvant treatments. Some clinical trials provide evidence supporting the use of TORS in specific patient populations. The MC1273 trial demonstrated promising outcomes with lower doses of adjuvant radiotherapy (RT) following TORS, showing high locoregional tumor control rates and favorable survival outcomes with minimal side effects. ECOG 3311 evaluated upfront TORS followed by histopathologically directed adjuvant therapy, revealing good oncological and functional outcomes, particularly in intermediate-risk patients. The SIRS trial emphasized the benefits of upfront surgery with neck dissection followed by de-escalated RT in patients with favorable survival and excellent functional outcomes. At the same time, the PATHOS trial examined the impact of risk-adapted adjuvant treatment on functional outcomes and survival. The ongoing ADEPT trial investigates reduced-dose adjuvant RT, and the DART-HPV study aims to compare standard adjuvant chemoradiotherapy (CRT) with a reduced dose of adjuvant RT in HPV-positive OPSCC patients. These trials collectively underscore the potential of TORS in facilitating treatment de-escalation while maintaining favorable oncological and functional outcomes in selected patients with HPV-related OPSCC. The aim of this scoping review is to discuss the challenges of risk stratification, the importance of HPV status determination, and the implications of smoking on treatment outcomes. It also explores the evolving criteria for adjuvant therapy following TORS, focusing on reducing radiation dosage and volume without compromising treatment efficacy. In conclusion, TORS emerges as a viable upfront treatment option for carefully selected patients with HPV-positive OPSCC, offering a pathway toward treatment de-escalation. However, selecting the optimal candidate for TORS-based de-escalation strategies is crucial to fully leverage the benefits of treatment de-intensification.

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Staging and treatment outcomes in oropharyngeal squamous cell carcinoma: a single-centre UK cohort

Cited by 2 publications

References 15 publications

Current Status of Human Papillomavirus-Related Head and Neck Cancer: From Viral Genome to Patient Care

Current Status of Human Papillomavirus-Related Head and Neck Cancer: From Viral Genome to Patient Care

Role of TORS as De-Escalation Strategy in HPV-Related Oropharyngeal Cancer, What We Need to Know

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