[High-risk human papilloma virus associated oropharynx squamous cell carcinomas: clinical, biological implications and therapeutical perspectives].
The infection of the head and neck epithelium by high-risk human papillomaviruses (HPV) is a risk factor for cancer onset and development. The incidence of HPV-related head and neck squamous cell carcinoma is currently increasing. These lesions display distinct clinical features. HPV positive patients are often younger and have a smaller history of tobacco smoking and alcohol drinking, but have a history of virus-transmitting sex practices. HPV-related tumours are mainly found in the oropharynx, are more associated to a local lymph node invasion and display a poorly differentiated morphology. Despite these more aggressive features, HPV-positive head and neck squamous cell carcinomas correlate with an improved local control, disease-free and global survival. It is thought that HPV-driven specific biologic abnormalities underlie higher tumour sensitivity to chemotherapeutic drugs and ionizing radiations. The expression of the HPV E6 and E7 oncoproteins induce cell transformation by interfering with cell signalling pathways involved in apoptosis, cell cycle, angiogenesis and induce the overexpression of the CDKN2A gene. Therefore, alternative treatments based on therapies targeting these pathways in combination with radiation dose de-escalation could be proposed to HPV-positive patients, if they are properly and reliably identified.
Département de radiothérapie, centre de lutte contre le cancer Paul-Strauss, BP 42, 3, rue de la Porte-de-l'Hôpital, 67065 Strasbourg cedex, France.
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S
Guihard
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AC
Jung
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G
Noël
D002294:Carcinoma, Squamous Cell / Q000235:genetics / Q000628:therapy / Q000821:virology*; D002471:Cell Transformation, Neoplastic; D004279:DNA, Viral / Q000302:isolation & purification; D019942:Genes, p16; D006801:Humans; D009959:Oropharyngeal Neoplasms / Q000235:genetics / Q000628:therapy / Q000821:virology*; D027383:Papillomaviridae / Q000235:genetics / Q000472:pathogenicity*; D030361:Papillomavirus Infections / Q000473:pathology; D053918:Papillomavirus Vaccines; D018579:Patient Selection; D016133:Polymerase Chain Reaction; D011836:Radiation Tolerance; D014412:Tumor Virus Infections
D004279:DNA, Viral; D053918:Papillomavirus Vaccines