Abstract
Human papillomaviruses (HPV) cause a subset of head and neck cancers (HNSCC). HPV16 predominantly signs responsible for approximately 10% of all HNSCC and over 50% of tonsillar (T)SCCs. Prevalence rates depend on several factors, such as the geographical region where patients live, possibly due to different social and sexual habits. Smoking plays an important role, with non-smoking patients being mostly HPV-positive and smokers being mostly HPV-negative. This is of unparalleled clinical relevance, as the outcome of (non-smoking) HPV-positive patients is significantly better, albeit with standard and not with de-escalated therapies. The results of the first prospective de-escalation studies have dampened hopes that similar superior survival can be achieved with de-escalated therapy. In this context, it is important to note that the inclusion of p16INK4A (a surrogate marker for HPV-positivity) in the 8th TMN-classification has only prognostic, not therapeutic, intent. To avoid misclassification, highest precision in determining HPV-status is of utmost importance. Whenever possible, PCR-based methods, still referred to as the "gold standard”, should be used. New diagnostic antibodies represent some hope, e.g., to detect primaries and recurrences early. Prophylactic HPV vaccination should lead to a decline in HPV-driven HNSCC as well. This review discusses the above aspects in detail.
Highlights
A considerable amount of benign and malignant diseases are caused by infections with human papillomaviruses (HPV) [1]
After the HPV-associated carcinogenesis of cervical and other anogenital malignancies was established, has a link been detected between benign and malignant mucosal neoplasms in the head and neck region: HPV6 and 11 sign responsible for the occurrence of recurrent respiratory papillomatosis [2] whereas predominantly HPV16 causes a subset of squamous cell carcinomas of the head and neck (HNSCC) [4,5,6]
In a multi-center study, with all the analysis being performed in a single laboratory, we showed the rate of HPV DNA positive cases in the larynx, hypopharynx, oral cavity, and oropharynx other than tonsil to be 9.1, 5.2, 5.1, and 15%, respectively, and the rate of HPV-positive tonsillar SCCs (TSCC) to be 43.7% [13], with HPV16 being the genotype detected in approx. 95% of all cases, followed by HPV18, and 33
Summary
A considerable amount of benign and malignant diseases are caused by infections with human papillomaviruses (HPV) [1]. Knowledge of the HPV status in HNSCC has led to unparalleled clinical relevance, e.g., HPV status is an important prognostic factor, and is considered to possibly influence treatment decisions, in terms of therapy de-intensification [17]. This hope has recently been dampened by the negative results from two large clinical trials aiming to successfully treat patients with HPV-driven. Throughout, the authors aimed to provide scientific evidence to corroborate their partly critical or even contradictory view on of the mainstream knowledge regarding HPV-driven diseases of the head and neck
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
