The Current and Future Impact of Human Papillomavirus on Treatment of Squamous Cell Carcinoma of the Head and Neck
A partir d'une revue de la littérature, cette étude analyse l'association entre une infection par le papillomavirus humain et la survie de patients atteints d'un carcinome épidermoïde de la tête et du cou
Background : Squamous cell carcinoma of the head and neck (SCCHN) was traditionally associated with smoking and alcohol use; however, human papillomavirus (HPV) infection has recently been implicated as a novel risk factor for oropharyngeal tumors. Furthermore, HPV-associated oropharyngeal carcinoma appears to be a distinct entity with different epidemiology, biology, and clinical outcomes. Methods : Here, we comprehensively review the existing data regarding HPV status and prognostic or predictive outcomes in both the locoregionally advanced and recurrent/metastatic disease setting and discuss ongoing trials that may eventually impact the treatment of patients with HPV-positive (HPV+) SCCHN. Results : A body of retrospective and prospective data established an association between HPV+ oropharyngeal carcinoma and better survival, particularly for locoregionally advanced disease. Current data on recurrent/metastatic disease are limited, but they also suggest prognostic significance for HPV. Conclusions : Better outcomes in HPV+ locoregionally advanced disease may allow for less aggressive treatment in the future, and several trials are evaluating deintensified regimens in patients with HPV+, locoregionally advanced oropharyngeal carcinoma; it should be emphasized that deintensification strategies are only appropriate in a clinical research setting and only for selected subgroups of HPV+ patients. In addition, HPV-targeted strategies, such as vaccines, are currently undergoing clinical evaluation. On the other hand, the prognostic impact of HPV in recurrent/metastatic disease requires further validation before any modifications in treatment can be made. Likewise, the predictive significance of HPV status in both disease settings remains to be defined.