title: The role of HPV status in recurrent/metastatic squamous cell carcinoma of the head and neck.
abstract: Although the prognostic role of human papillomavirus (HPV) in locoregionally advanced squamous cell carcinoma of the head and neck (SCCHN) is well established, its prognostic and/or predictive role in recurrent/metastatic settings remains to be defined. Despite epidemic growth of HPV-positive oropharyngeal carcinoma, a low recurrence rate in HPV-positive patients results in a small number of patients entering clinical trials for recurrent and/or metastatic SCCHN. The consequent lack of statistical power and also significant data contamination by misclassification of HPV-positive patients leads to premature study conclusions. Even emerging data from the analysis of 2 randomized trials, SPECTRUM and EXTREME, do not provide enough evidence for any HPV-based therapeutic strategy. Many upcoming studies for locally advanced disease, including the ones with de-escalated strategies, will have an increasing number of patients with HPV. Optimal HPV testing strategies for reliable patient selection and HPV-driven therapeutic approaches will be essential. Here, we comprehensively review the existing data regarding HPV status and prognostic or predictive outcomes in recurrent/metastatic settings and discuss current promising studies and future directions that may help in the design of upcoming trials.
authors: Tisch Cancer Institute, Mount Sinai Health System, New York, NY.
authors: Krzysztof
authors: K
authors: Misiukiewicz
authors: Tisch Cancer Institute, Mount Sinai Health System, New York, NY.
authors: Nadia
authors: N
authors: Camille
authors: Icahn School of Medicine, Mount Sinai Health System, New York, NY.
authors: Vishal
authors: V
authors: Gupta
authors: Icahn School of Medicine, Mount Sinai Health System, New York, NY.
authors: Richard
authors: R
authors: Bakst
authors: Icahn School of Medicine, Mount Sinai Health System, New York, NY.
authors: Marita
authors: M
authors: Teng
authors: Icahn School of Medicine, Mount Sinai Health System, New York, NY.
authors: Brett
authors: B
authors: Miles
authors: Icahn School of Medicine, Mount Sinai Health System, New York, NY.
authors: Eric
authors: E
authors: Genden
authors: Baylor College of Medicine, Houston, TX.
authors: Andrew
authors: A
authors: Sikora
authors: Tisch Cancer Institute, Mount Sinai Health System, New York, NY.
authors: Marshall
authors: M
authors: Posner
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000628:therapy / Q000821:virology*; D003131:Combined Modality Therapy; D006258:Head and Neck Neoplasms / Q000628:therapy / Q000821:virology*; D006801:Humans; D007167:Immunotherapy; D009364:Neoplasm Recurrence, Local / Q000628:therapy / Q000821:virology*; D027383:Papillomaviridae / Q000302:isolation & purification*; D011379:Prognosis; D000077195:Squamous Cell Carcinoma of Head and Neck