HPV in oropharyngeal tumors signifies increased survival
The presence of human papilloma virus (HPV) in oropharyngeal tumors is the most important predictor of patient survival, according to a study at the OSUCCC – James.
This is the first study large enough to show that HPV in tumors accounts for better response to therapy, rather than other favorable factors that may be present, such as young age and small tumors. The second-leading predictor of survival is lifetime smoking history, followed by cancer stage.
The findings suggest that the HPV status and patients’ smoking history may be used, in addition to cancer stage, to determine the aggressiveness of therapy.
“Previous studies indicated a relationship existed between the presence or absence of HPV in oropharyngeal tumors and patient survival, but they couldn’t determine if other favorable factors present in these patients were responsible for their better outcome,” says study leader Maura Gillison, MD, PhD, medical oncologist and head and neck cancer specialist. “These findings close the door on these questions and will allow the field to move forward with clinical trials to determine how we should use molecular and behavioral factors to personalize therapy.”
Gillison says there is insufficient data at this time to indicate how a patient’s therapy should be tailored based on these factors.
The research analyzed the tumors and outcomes of 323 patients with stage III or IV oropharyngeal cancer who were part of a Radiation Therapy Oncology Group clinical trial. Of these, 206 had HPV+ tumors and 117 had HPV- tumors. Three years after treatment, 82 percent of those with HPV+ tumors were alive, compared with 57 percent of those with HPV- tumors.
Published in the New England Journal of Medicine.