M R Posner1, J H Lorch2, O Goloubeva3, M Tan3, L M Schumaker3, N J Sarlis4, R I Haddad2, K J Cullen3. 1. The Tisch Cancer Institute, Mount Sinai Medical Center, New York. Electronic address: marshall.posner@mssm.edu. 2. Dana-Farber Cancer Institute, Harvard Medical School, Boston. 3. Marlene and Stewart Greenebaum Cancer Center, University of Maryland, Baltimore. 4. Sanofi-aventis U.S., Bridgewater, USA.
Abstract
BACKGROUND: The association between human papillomavirus (HPV) and overall survival (OS) in oropharynx cancer (OPC) was retrospectively examined in TAX 324, a phase III trial of sequential therapy for locally advanced head and neck cancer. METHODS: Accrual for TAX 324 was completed in 2003 and data updated through 2008. Pretherapy tumor biopsies were studied by PCR for human papillomavirus type 16 and linked to OS, progression-free survival (PFS) and demographics. RESULTS: Of 264 patients with OPC, 111 (42%) had evaluable biopsies; 56 (50%) were HPV+ and 55 (50%) were HPV-. HPV+ patients were significantly younger (54 versus 58 years, P = 0.02), had T1/T2 primary cancers (49% versus 20%, P = 0.001), and had a performance status of zero (77% versus 49%, P = 0.003). OS and PFS were better for HPV+ patients (OS, hazard ratio = 0.20, P < 0.0001). Local-regional failure was less in HPV+ patients (13% versus 42%, P = 0.0006); at 5 years, 82% of HPV+ patients were alive compared with 35% of HPV- patients (P < 0.0001). CONCLUSIONS: HPV+ OPC has a different biology compared with HPV- OPC; 5-year OS, PFS, and local-regional control are unprecedented. These results support the possibility of selectively reducing therapy and long-term morbidity in HPV+ OPC while preserving survival and approaching HPV- disease with more aggressive treatment.
BACKGROUND: The association between human papillomavirus (HPV) and overall survival (OS) in oropharynx cancer (OPC) was retrospectively examined in TAX 324, a phase III trial of sequential therapy for locally advanced head and neck cancer. METHODS: Accrual for TAX 324 was completed in 2003 and data updated through 2008. Pretherapy tumor biopsies were studied by PCR for human papillomavirus type 16 and linked to OS, progression-free survival (PFS) and demographics. RESULTS: Of 264 patients with OPC, 111 (42%) had evaluable biopsies; 56 (50%) were HPV+ and 55 (50%) were HPV-. HPV+ patients were significantly younger (54 versus 58 years, P = 0.02), had T1/T2 primary cancers (49% versus 20%, P = 0.001), and had a performance status of zero (77% versus 49%, P = 0.003). OS and PFS were better for HPV+ patients (OS, hazard ratio = 0.20, P < 0.0001). Local-regional failure was less in HPV+ patients (13% versus 42%, P = 0.0006); at 5 years, 82% of HPV+ patients were alive compared with 35% of HPV- patients (P < 0.0001). CONCLUSIONS:HPV+ OPC has a different biology compared with HPV- OPC; 5-year OS, PFS, and local-regional control are unprecedented. These results support the possibility of selectively reducing therapy and long-term morbidity in HPV+ OPC while preserving survival and approaching HPV- disease with more aggressive treatment.
Authors: K Kian Ang; Jonathan Harris; Richard Wheeler; Randal Weber; David I Rosenthal; Phuc Felix Nguyen-Tân; William H Westra; Christine H Chung; Richard C Jordan; Charles Lu; Harold Kim; Rita Axelrod; C Craig Silverman; Kevin P Redmond; Maura L Gillison Journal: N Engl J Med Date: 2010-06-07 Impact factor: 91.245
Authors: Arlene A Forastiere; Helmuth Goepfert; Moshe Maor; Thomas F Pajak; Randal Weber; William Morrison; Bonnie Glisson; Andy Trotti; John A Ridge; Clifford Chao; Glen Peters; Ding-Jen Lee; Andrea Leaf; John Ensley; Jay Cooper Journal: N Engl J Med Date: 2003-11-27 Impact factor: 91.245
Authors: Danny Rischin; Richard J Young; Richard Fisher; Stephen B Fox; Quynh-Thu Le; Lester J Peters; Ben Solomon; Jimin Choi; Brian O'Sullivan; Lizbeth M Kenny; Grant A McArthur Journal: J Clin Oncol Date: 2010-08-09 Impact factor: 44.544
Authors: Anthony J Cmelak; Sigui Li; Meredith A Goldwasser; Barbara Murphy; Michael Cannon; Harlan Pinto; David I Rosenthal; Maura Gillison; Arlene A Forastiere Journal: J Clin Oncol Date: 2007-09-01 Impact factor: 44.544
Authors: J L Lefebvre; F Rolland; M Tesselaar; E Bardet; C R Leemans; L Geoffrois; P Hupperets; L Barzan; D de Raucourt; D Chevalier; L Licitra; F Lunghi; R Stupp; D Lacombe; J Bogaerts; J C Horiot; J Bernier; J B Vermorken Journal: J Natl Cancer Inst Date: 2009-01-27 Impact factor: 13.506
Authors: Carole Fakhry; William H Westra; Sigui Li; Anthony Cmelak; John A Ridge; Harlan Pinto; Arlene Forastiere; Maura L Gillison Journal: J Natl Cancer Inst Date: 2008-02-12 Impact factor: 13.506
Authors: Mitchell Machtay; Jennifer Moughan; Andrew Trotti; Adam S Garden; Randal S Weber; Jay S Cooper; Arlene Forastiere; K Kian Ang Journal: J Clin Oncol Date: 2008-06-16 Impact factor: 44.544
Authors: David J Adelstein; Yi Li; George L Adams; Henry Wagner; Julie A Kish; John F Ensley; David E Schuller; Arlene A Forastiere Journal: J Clin Oncol Date: 2003-01-01 Impact factor: 44.544
Authors: Christine H Chung; Qiang Zhang; Christina S Kong; Jonathan Harris; Elana J Fertig; Paul M Harari; Dian Wang; Kevin P Redmond; George Shenouda; Andy Trotti; David Raben; Maura L Gillison; Richard C Jordan; Quynh-Thu Le Journal: J Clin Oncol Date: 2014-09-29 Impact factor: 44.544
Authors: Adam A Garsa; Albert J Chang; Todd Dewees; Christopher R Spencer; Douglas R Adkins; Farrokh Dehdashti; Hiram A Gay; Wade L Thorstad Journal: J Radiat Oncol Date: 2013-03
Authors: Glenn J Hanna; Alec Kacew; Nicole G Chau; Priyanka Shivdasani; Jochen H Lorch; Ravindra Uppaluri; Robert I Haddad; Laura E MacConaill Journal: JCI Insight Date: 2018-09-06
Authors: P Sinha; W T Thorstad; B Nussenbaum; B H Haughey; D R Adkins; D Kallogjeri; J S Lewis Journal: Oral Oncol Date: 2013-11-06 Impact factor: 5.337
Authors: Jeffrey M Vainshtein; Matthew E Spector; Mohannad Ibrahim; Carol R Bradford; Gregory T Wolf; Matthew H Stenmark; Francis P Worden; Jonathan B McHugh; Mark E Prince; Thomas Carey; Douglas B Chepeha; Avraham Eisbruch Journal: Head Neck Date: 2015-07-15 Impact factor: 3.147
Authors: Dan P Zandberg; Sandy Liu; Olga Goloubeva; Robert Ord; Scott E Strome; Mohan Suntharalingam; Rodney Taylor; Robert E Morales; Jeffrey S Wolf; Ann Zimrin; Joshua E Lubek; Lisa M Schumaker; Kevin J Cullen Journal: Head Neck Date: 2015-06-30 Impact factor: 3.147