title: Biological Features of Human Papillomavirus-related Head and Neck Cancers Contributing to Improved Response.
abstract: Head and neck squamous cell carcinomas (HNSCC) are the sixth most common malignancy globally, and an increasing proportion of oropharyngeal HNSCCs are associated with the human papillomavirus (HPV). Patients with HPV-associated tumours have markedly improved overall and disease-specific survival compared with their HPV-negative counterparts when treated with chemoradiation. Although the difference in outcomes between these two groups is clearly established, the mechanism underlying these differences remains an area of investigation. Data from preclinical, clinical and genomics studies have started to suggest that an increase in radio-sensitivity of HPV-positive HNSCC may be responsible for improved outcomes, the putative mechanisms of which we will review here. The Cancer Genome Atlas and others have recently documented a multitude of molecular differences between HPV-positive and HPV-negative tumours. Preclinical investigations by multiple groups have explored possible mechanisms of increased sensitivity to therapy, including examining differences in DNA repair, hypoxia and the immune response. In addition to differences in the response to therapy, some groups have started to investigate phenotypic differences between the two diseases, such as tumour invasiveness. Finally, we will conclude with a brief review of ongoing clinical trials that are attempting to de-escalate treatment to minimise long-term toxicity while maintaining cure rates. New insights from preclinical and genomic studies may eventually lead to personalised treatment paradigms for HPV-positive patients.
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: C
authors.initials: C
authors.lastname: Cleary
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Leeman
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: D S
authors.initials: DS
authors.lastname: Higginson
authors.affiliation: Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: N
authors.initials: N
authors.lastname: Katabi
authors.affiliation: Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: E
authors.initials: E
authors.lastname: Sherman
authors.affiliation: Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: L
authors.initials: L
authors.lastname: Morris
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: S
authors.initials: S
authors.lastname: McBride
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. Electronic address: leen2@mskcc.org.
authors.forename: N
authors.initials: N
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. Electronic address: riazn@mskcc.org.
authors.forename: N
authors.initials: N
authors.lastname: Riaz
mesh_terms: D019468:Disease Management; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000628:therapy* / Q000821:virology*; D006801:Humans; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications / Q000635:transmission* / Q000821:virology
keywords: Biology; DNA repair; HPV; head and neck cancer; radiosensitivity