It appears that patients with HPV-related oropharyngeal cancer have better overall survival than those with HPV-negative disease. Results from this Phase III clinical trial were published in The New England Journal of Medicine.
Oropharyngeal cancer is a type of head and neck cancer. The oropharynx is the part of the throat that includes the soft palate, the base of the tongue, and the tonsils. Exposures that are known to increase the risk of oropharyngeal cancer include tobacco and alcohol use, as well as infection with high-risk types of human papillomavirus (HPV).
Human papillomaviruses (HPV) consist of more than 100 different viruses. Some types of HPV cause warts on the hands or feet; others cause genital warts; and some have been linked with cancer, most notably cervical cancer.
Previous studies have suggested that oropharyngeal cancer that is linked with HPV infection has a better prognosis than oropharyngeal cancer that is linked with other causes such as smoking. This recent study further investigated whether HPV status is associated with prognosis in oropharyngeal cancer.
To evaluate whether HPV status can be predictive of overall survival in oropharyngeal cancer, researchers studied outcomes among 323 patients with Stage III-IV oropharyngeal cancer. The study included 206 patients with HPV-positive disease and 117 with HPV-negative disease. Participants were treated with a combination of radiation therapy and chemotherapy. At a median follow-up of almost five years, the following was observed:
- Patients with HPV-positive disease had better three-year rates of overall survival compared with those with HPV-negative disease (82% versus 57%, respectively).
- Progression-free survival was also better in the HPV-positive group than in the HPV-negative group (74% versus 43%, respectively).
- When other prognostic factors were taking into account—including age, race, disease stage, and tobacco use—patients with HPV-positive disease had a 58% reduction in risk of death compared with the HPV-negative group. (It also was noted that tobacco use “significantly” increased the risk of death.)
The researchers concluded that HPV status appears to be linked with survival in oropharyngeal cancer; specifically, HPV-positive disease may be predictive of better overall survival. These findings may be used to determine risk groups for clinical trials and to select appropriate patients for trials of more intensive therapies.
Reference: Ang KK, Harris J, Wheeler R. et al**.** Human papillomavirus and survival of patients with oropharyngeal cancer. The New England Journal of Medicine. 363:24-35. July 1, 2010.
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