title: The current and future impact of human papillomavirus on treatment of squamous cell carcinoma of the head and neck.
abstract: 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 (OPC) 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 (LA) and recurrent/metastatic (RM) 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+ OPC and better survival, particularly for LA disease. Current data on RM disease are limited, but they also suggest prognostic significance for HPV.
  
  
  CONCLUSIONS
  Better outcomes in HPV+ LA disease may allow for less aggressive treatment in the future, and several trials are evaluating deintensified regimens in patients with HPV+, LA OPC; it should be emphasized that deintensification strategies are appropriate only 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 RM 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.
  
  
  BACKGROUND
  NCT00226239, NCT00301028, NCT00387127, NCT00410826, NCT00503997, NCT00514943, NCT00544414, NCT00768664, NCT00939627, NCT01084083, NCT01302834, NCT01687413, NCT01706939.
authors: Department of Medicine, Section of Medical Oncology, Attikon University Hospital, Athens, Greece. Electronic address: psyrri237@yahoo.com.
authors: A
authors: A
authors: Psyrri
authors: Department of Surgery (Otolaryngology), Yale University School of Medicine, New Haven, USA.
authors: T
authors: T
authors: Rampias
authors: Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium.
authors: J B
authors: JB
authors: Vermorken
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D000068818:Cetuximab; D002986:Clinical Trials as Topic; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D006801:Humans; D009959:Oropharyngeal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D000077544:Panitumumab; D027383:Papillomaviridae / Q000472:pathogenicity; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D000077195:Squamous Cell Carcinoma of Head and Neck
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000077544:Panitumumab; D000068818:Cetuximab
keywords: cetuximab; human papillomavirus; oropharyngeal cancer; panitumumab; squamous cell carcinoma of the head and neck