HPV status predicts for improved survival following chemotherapy in metastatic squamous cell carcinoma of the oropharynx. (November 2018)

• Record Type: Journal Article
• Authors: Pike, Luke R.G.; Hwang, William L.; Royce, Trevor J.; Sanford, Nina N.; Mahal, Brandon A.
• Is Part Of: Oral oncology. Volume 86(2018)
• Page Start: 69
• Page End: 74
• Publication Date: 2018-11
• Subjects: Head and neck cancer -- Human papillomavirus -- Predictive biomarker -- Metastatic squamous cell cancer -- Systemic therapy; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2018.09.007
• Languages: English
• ISSNs: 1368-8375

Abstract

Highlights: CSM is superior for patients with HPV+ metastatic OPC than for those with HPV-OPC. HPV status is predictive of outcome following systemic therapy in metastatic OPC. Abstract: Objective: We sought to further define prognostic and predictive value of human papillomavirus (HPV) status in metastatic squamous cell carcinoma of the oropharynx (OPC). Materials and methods: A Surveillance, Epidemiology, and End Results custom database identified 5940 adult patients, >18-years-old, with primary SCCHN and known HPV status, diagnosed from 2013 to 2014. Wilcoxon rank-sum and Mantel-Haenszel χ 2 tests compared distributions of continuous and categorical covariates. Fine-Gray competing risks regressions estimated hazard ratios by HPV status, and predictive analyses were performed including the interaction term HPV status × Receipt of Chemotherapy. Results: 182 of 5940 patients (4.0%) had metastatic OPC at diagnosis (106/3925 [2.7%] HPV+ and 76/1894 [4.0%] HPV−). HPV+ disease was prognostic for improved 20-month cancer-specific mortality (CSM) (47.1% vs 72.5%, HR 0.43, 95% CI 0.26–0.74, p = 0.002) on univariable analysis. HPV status was predictive of response to chemotherapy—adjusted HRs for receipt of chemotherapy were 0.11 (95% CI 0.03–0.37) and 0.34 (95% CI 0.18–0.64) for HPV+ versus HPV− disease, respectively (PHPV status∗Chemotherapy = 0.036). Conclusion: HPV status has known prognostic value in locally advanced OPC, but data on metastatic OPC are sparse. In this work, we demonstrate that HPV status is strongly prognostic for CSM in metastatic OPC and show for the first time that HPV status predicts for response to chemotherapy.