HPV Subtype may predict outcomes in head and neck cancers, Finds study

In contrast to the data derived from The Cancer Genome Atlas, patients with HPV-16 tumors trended towards decreased progression free survival (PFS) and overall survival (OS) compared with tumors driven by other HPV genotypes, reports a study published in the International Journal of Otolaryngology.

Hedyeh Ziai and colleagues from the Department of Otolaryngology-Head and Neck Surgery, Western University, ON, Canada aimed to examine the association of HPV subtypes and survival in a large cohort of patient samples from our institution.

The study by Bratman had strengths such as relatively large sample size and definitive HPV detection and subtyping through RNA sequencing; however, it also had weakness including lack of an independent validation cohort, imperfect TCGA survival data, and the fact that 30% of patients did not receive treatment that complied with the NCCN guidelines.

Fresh frozen primary site biopsy samples were collected either in clinic or at the time of surgery. Patient demographic, staging, and survival data were also collected. Tumors were tested for HPV subtypes by quantitative polymerase chain reaction (qPCR).

Univariable and multivariable analyses were performed using Cox proportional hazards regression.

The following findings were highlighted-

a. 280 patient biopsy samples were collected.

b. Mean ± standard deviation (SD) age was 61.9 ± 11.1 years and most patients (78%) were male.

c. The majority of cancers were of the oral cavity (60%) or oropharynx (25%) and 30% had HPV-positive disease.

d. Median follow-up was 3.76 years and 96/280 patients (34%) developed recurrences.

e. Patients with p16-positive versus negative disease had significantly improved 5-year overall survival.

f. Similarly improved 5-year OS and PFS were observed for patients with HPV-positive versus negative disease.

g. Patients with HPV-16 compared to other HPV diseases had worse 5-year OS and PFS.

Therefore, the authors concluded that "patients with HPV-types other than 16 trended towards improved progression-free survival compared with HPV-16 related disease."

Furthermore, large, multi-institutional efforts are needed to conclusively determine the correlation of HPV type and survival in HNSCC.