title: Oropharyngeal squamous cell carcinoma treatment: current standards and future directions.
abstract: OBJECTIVE
  To discuss the changing landscape and significant developments in the diagnosis and management of oropharyngeal squamous cell carcinoma.
  
  
  RESULTS
  High-risk human papilloma viruses (HPVs) have been recognized as important causative factors for oropharyngeal cancer. The diagnosis is established with type-specific and broad-spectrum in-situ hybridization probes and/or p16 immunohistochemistry assays on fresh frozen paraffin-embedded tissue blocks. HPV-associated tumors have superior response and outcomes compared with HPV-unrelated tumors. Retrospective studies have been able to stratify oropharyngeal squamous cell carcinoma based on HPV status, tumor stage, nodal stage, and smoking history into risk groups with differing risks of death or distant disease. Selected patients, nonsmokers with less advanced nodal stage, may be overtreated with current treatment paradigms, and deintensification of curative therapy is a current research focus for these patients. Smokers, patients with advanced nodal or tumor stage, and those with HPV-unrelated cancers have a less favorable prognosis and the search for novel targets is particularly important for these patients.
  
  
  CONCLUSIONS
  The present review will highlight the current standards and the future direction of novel therapies in both HPV-associated and HPV-unrelated cancers.
authors.affiliation: aJohns Hopkins University, School of Medicine, Baltimore, Maryland bFox Chase Cancer Center, Philadelphia, Pennsylvania, USA.
authors.forename: Shanthi
authors.initials: S
authors.lastname: Marur
authors.forename: Barbara
authors.initials: B
authors.lastname: Burtness
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000628:therapy* / Q000821:virology; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000628:therapy* / Q000821:virology; D006801:Humans; D009959:Oropharyngeal Neoplasms / Q000175:diagnosis / Q000628:therapy* / Q000821:virology; D030361:Papillomavirus Infections / Q000150:complications*; D012307:Risk Factors; D000077195:Squamous Cell Carcinoma of Head and Neck
chemical_list: D000970:Antineoplastic Agents