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DiBlasi M, McNamara R, Jayne C, Berzansky I, Pottle C, Colden D. Two brothers with human papillomavirus-positive oropharyngeal squamous cell carcinoma of the tonsil: A case report. SAGE Open Med Case Rep 2024; 12:2050313X241271762. [PMID: 39140028 PMCID: PMC11320681 DOI: 10.1177/2050313x241271762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 06/26/2024] [Indexed: 08/15/2024] Open
Abstract
Oropharyngeal squamous cell carcinoma is a distinct subtype of head and neck cancer that has become increasingly linked to human papillomavirus over the last four decades. Described is the case of two brothers diagnosed with human papillomavirus-positive oropharyngeal squamous cell carcinoma 6 years apart. The first brother, R.M., presented with an 8-month history of tonsillar swelling, found to be stage III human papillomavirus-positive oropharyngeal squamous cell carcinoma. Despite delayed treatment with chemoradiation, he developed metastatic disease and succumbed to his illness. The second brother, K.M., presented only 3 weeks after the development of neck swelling given his family history, which was also diagnosed as stage III human papillomavirus-positive oropharyngeal squamous cell carcinoma. Following prompt chemoradiation and neck dissection, K.M. has remained in remission for 9 years. Literature has yet to characterize this degree of familial clustering among human papillomavirus-positive oropharyngeal squamous cell carcinomas. Hence, this introduces the possibility of a genetic predisposition to human papillomavirus's oncogenesis in the oropharynx. This case emphasizes the importance for clinicians to stay vigilant of the family history of human papillomavirus, as well as poses significant implications for future research investigating the interaction of genetic aberrations on human papillomavirus's oncogenic process.
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Affiliation(s)
- Marco DiBlasi
- Colden and Seymour Ear, Nose, Throat, and Allergy, Newburyport, MA, USA
- Creighton University School of Medicine, Omaha, NE, USA
| | - Reilly McNamara
- Colden and Seymour Ear, Nose, Throat, and Allergy, Newburyport, MA, USA
| | - Christopher Jayne
- Colden and Seymour Ear, Nose, Throat, and Allergy, Newburyport, MA, USA
- Creighton University School of Medicine, Omaha, NE, USA
| | - Isa Berzansky
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Carson Pottle
- Colden and Seymour Ear, Nose, Throat, and Allergy, Newburyport, MA, USA
| | - Daryl Colden
- Colden and Seymour Ear, Nose, Throat, and Allergy, Newburyport, MA, USA
- Harvard Medical School, Boston, MA, USA
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2
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Yan S, Zhang X, Lin Q, Du M, Li Y, He S, Chen J, Li X, Bei J, Chen S, Song M. Deciphering the interplay of HPV infection, MHC-II expression, and CXCL13 + CD4 + T cell activation in oropharyngeal cancer: implications for immunotherapy. Cancer Immunol Immunother 2024; 73:206. [PMID: 39105803 PMCID: PMC11303625 DOI: 10.1007/s00262-024-03789-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 07/22/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND Human papillomavirus (HPV) infection has become an important etiological driver of oropharyngeal squamous cell carcinoma (OPSCC), leading to unique tumor characteristics. However, the interplay between HPV-associated tumor cells and tumor microenvironment (TME) remains an enigma. METHODS We performed a single-cell RNA-sequencing (scRNA-seq) on HPV-positive (HPV+) and HPV-negative (HPV‒) OPSCC tumors, each for three samples, and one normal tonsil tissue. Ex vivo validation assays including immunofluorescence staining, cell line co-culture, and flow cytometry analysis were used to test specific subtypes of HPV+ tumor cells and their communications with T cells. RESULTS Through a comprehensive single-cell transcriptome analysis, we uncover the distinct transcriptional signatures between HPV+ and HPV‒ OPSCC. Specifically, HPV+ OPSCC tumor cells manifest an enhanced interferon response and elevated expression of the major histocompatibility complex II (MHC-II), potentially bolstering tumor recognition and immune response. Furthermore, we identify a CXCL13+CD4+ T cell subset that exhibits dual features of both follicular and pro-inflammatory helper T cells. Noteworthily, HPV+ OPSCC tumor cells embrace extensive intercellular communications with CXCL13+CD4+ T cells. Interaction with HPV+ OPSCC tumor cells amplifies CXCL13 and IFNγ release in CD4+T cells, fostering a pro-inflammatory TME. Additionally, HPV+ tumor cells expressing high MHC-II and CXCL13+CD4+ T cell prevalence are indicative of favorable overall survival rates in OPSCC patients. CONCLUSIONS Together, our study underscores a synergistic inflammatory immune response orchestrated by highly immunogenic tumor cells and CXCL13+CD4+ T cells in HPV+ OPSCC, offering useful insights into strategy development for patient stratification and effective immunotherapy in OPSCC.
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Affiliation(s)
- Shida Yan
- Department of Head and Neck Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
| | - Xing Zhang
- Department of Head and Neck Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
| | - Qiaohong Lin
- Department of Head and Neck Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
| | - Mingyuan Du
- Department of Head and Neck Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
| | - Yiqi Li
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
| | - Shuai He
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
| | - Jingtao Chen
- Department of Head and Neck Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
| | - Xiyuan Li
- Department of Head and Neck Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
| | - Jinxin Bei
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
| | - Shuwei Chen
- Department of Head and Neck Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China.
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.
| | - Ming Song
- Department of Head and Neck Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China.
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.
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Yan S, Liu L, Zhang X, Wei L, Jiang W, Gao X, Yang A, Liu X, Chen W, Chen Y, Li H, Lin Q, Li M, Chen J, Zhang Q, Chen S, Song M. Neoadjuvant chemoimmunotherapy shows major pathological response and low recurrence in head and neck squamous cell carcinoma. Clin Transl Oncol 2024; 26:1192-1202. [PMID: 37989823 DOI: 10.1007/s12094-023-03342-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/26/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND The study aimed to investigate the efficacy and survival outcomes of neoadjuvant chemotherapy combined with programmed cell death protein 1 (PD-1) blockade (neoadjuvant chemoimmunotherapy) for patients with resectable head and neck squamous cell carcinoma (HNSCC). METHODS A retrospective analysis was conducted. Patients with initially diagnosed, resectable HNSCCs who received the neoadjuvant chemoimmunotherapy and radical surgery were included. Correlation analysis between patients' clinical characteristics and pathological responses, and survival analysis were performed. RESULTS A total of 79 patients were included. The majority of patients (55, 69.6%) were diagnosed at locally advanced stages and most of them (58, 73.4%) had tumor located at the oral cavity. Nearly half of patients (35, 44.3%) received two cycles of neoadjuvant chemoimmunotherapy and the rest had three or more cycles. The R0 resection rate was 98.7%. In the pathological evaluation, 53.1% of patients reached pathological complete responses or major pathological responses. After a median follow-up of 17.0 months, the 1-year disease-free survival (DFS) and overall survival (OS) rates were 87.2% and 97.4%, respectively. The pathological response showed a significantly positive association with survival benefits (p < 0.001). Patients with human papillomavirus (HPV)-positive oropharyngeal cancer had the best pathological response and survival outcomes. Besides, history of radiation at head and neck region and poor pathological response were found to be independent risk factors of DFS for patients receiving such treatments. CONCLUSION Neoadjuvant chemoimmunotherapy of HNSCC showed high rate of pathological response and low recurrence rate, holding promise for becoming the new standard of care for resectable HNSCC.
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Affiliation(s)
- Shida Yan
- Department of Head and Neck, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Lili Liu
- Department of Pathology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Xing Zhang
- Department of Head and Neck, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Lijun Wei
- Department of Pathology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Wenmei Jiang
- Department of Head and Neck, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Xianlu Gao
- Department of Head and Neck, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Ankui Yang
- Department of Head and Neck, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Xuekui Liu
- Department of Head and Neck, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Wenkuan Chen
- Department of Head and Neck, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Yanfeng Chen
- Department of Head and Neck, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Hui Li
- Department of Head and Neck, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Qiaohong Lin
- Department of Head and Neck, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Menghua Li
- Department of Head and Neck, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Jingtao Chen
- Department of Head and Neck, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Quan Zhang
- Department of Head and Neck, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China.
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, China.
| | - Shuwei Chen
- Department of Head and Neck, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China.
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, China.
| | - Ming Song
- Department of Head and Neck, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China.
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, China.
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Felipe Carvajal V, Felipe Cardemil M, Vásquez BP, Oliva CE, Barría TA, Bruna MA, Moyano LA, Bustos FA, Muñoz PA, Araya CF, Oyarzún JE, Villa EA, Floriano FA, Del Rio AJ, Indo SR, Castellón EA, Contreras HR. Epidemiological and clinical description of patients with oropharyngeal cancer treated in a public oncology referral hospital in Chile. Ecancermedicalscience 2024; 18:1685. [PMID: 38566759 PMCID: PMC10984838 DOI: 10.3332/ecancer.2024.1685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction The incidence of squamous carcinoma of the oropharynx (OPSCC) has presented an increase worldwide, a fact that occurs along with a phenomenon of epidemiological transition, whose pathogenesis is linked to human papilloma virus (HPV) in a significant part of the cases. Published evidence at the Latin American level is scarce. The present study aims to evaluate the epidemiological and clinical characteristics of patients with oropharyngeal cancer treated in a public oncology reference centre in Chile. Methodology A cross-sectional study was carried out. Patients with histological confirmation of OPSCC aged 18 years or older, referred to the National Cancer Institute of Chile between 2012 and 2023 were included. The association with HPV was determined by immunohistochemistry for p16. Results 178 patients were analysed, most of them in locoregionally advanced stages involving the palatine tonsil. Seventy-seven percent were male, with a median age of 60 years. Sixty-seven percent of patients were positive for p16, with a progressive increase to 85% in the last 2 years of the study. The p16(+) patients were younger and had fewer classical risk factors. Primary treatment was radiotherapy in 94% of patients. Conclusion The epidemiological profile of patients with OPSCC treated in a Chilean public oncology referral centre reflects the epidemiological transition observed in developed countries. This change justifies the need to adapt health policies and conduct research that considers the characteristics of this new epidemiological profile.
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Affiliation(s)
- V Felipe Carvajal
- Department of Radiotherapy, National Cancer Institute, Santiago 8380000, Chile
- Department of Radiotherapy, Hospital Base Valdivia, Los Ríos 5090145, Chile
- Department of Basic Clinical Oncology, School of Medicine, Universidad de Chile, Santiago 8380453, Chile
| | - M Felipe Cardemil
- Department of Basic Clinical Oncology, School of Medicine, Universidad de Chile, Santiago 8380453, Chile
- Department of Otolaryngology, School of Medicine, Universidad de Chile, Santiago 8380453, Chile
| | - Beatriz P Vásquez
- Department of Radiotherapy, National Cancer Institute, Santiago 8380000, Chile
| | - Carolina E Oliva
- Department of Otolaryngology, School of Medicine, Universidad de Chile, Santiago 8380453, Chile
- Department of Basic Clinical Oncovirology, School of Medicine, Universidad de Chile, Santiago 7591047, Chile
| | - Tamra A Barría
- Department of Otolaryngology, School of Medicine, Universidad de Chile, Santiago 8380453, Chile
- Department of Otolaryngology, Clínica Las Condes, Región Metropolitana 7500922, Chile
- Department of Otolaryngology, Hospital del Salvador, Región Metropolitana 8380453, Chile
| | - Maribel A Bruna
- Department of Radiotherapy, National Cancer Institute, Santiago 8380000, Chile
| | - Leonor A Moyano
- Department of Anatomic Pathology, National Cancer Institute, Santiago 8380000, Chile
| | - Felipe A Bustos
- Department of Head and Neck Surgery, National Cancer Institute, Santiago 8380000, Chile
- Centro de Investigación y Especialidades Médicas (CDIEM), Santiago 7500859, Chile
| | - Paola A Muñoz
- Department of Radiotherapy, Hospital Regional de Talca, Talca 3460001, Chile
| | - Cristóbal F Araya
- Department of Head and Neck Surgery, National Cancer Institute, Santiago 8380000, Chile
- Department of Head and Neck Surgery, Clínica Alemana, Región Metropolitana 7650568, Chile
- School of Dentistry, Universidad de Chile, Santiago 8380453, Chile
| | - Jorge E Oyarzún
- Department of Radiotherapy, Hospital Base Valdivia, Los Ríos 5090145, Chile
| | - Eduardo A Villa
- School of Medicine, Universidad de Chile, Santiago 8380453, Chile
| | - Federico A Floriano
- Management Information Area, Medical Subdirectorate of Institutional Development, National Cancer Institute, Santiago 8380000, Chile
| | - Alexis J Del Rio
- School of Medical Technology, School of Medicine, Universidad de Chile, Santiago 8380453, Chile
| | - Sebastián R Indo
- Department of Medical Technology, School of Medicine, Universidad de Chile, Santiago 8380453, Chile
| | - Enrique A Castellón
- Department of Basic Clinical Oncology, School of Medicine, Universidad de Chile, Santiago 8380453, Chile
| | - Héctor R Contreras
- Department of Basic Clinical Oncology, School of Medicine, Universidad de Chile, Santiago 8380453, Chile
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Sunga GM, Hartgerink J, Sikora AG, Young S. Enhancement of Immunotherapies in Head and Neck Cancers Using Biomaterial-Based Treatment Strategies. Tissue Eng Part C Methods 2023; 29:257-275. [PMID: 37183412 PMCID: PMC10282827 DOI: 10.1089/ten.tec.2023.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 05/12/2023] [Indexed: 05/16/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a challenging disease to treat because of typically late-stage diagnoses and tumor formation in difficult-to-treat areas, sensitive to aggressive or invasive treatments. To date, HNSCC treatments have been limited to surgery, radiotherapy, and chemotherapy, which may have significant morbidity and often lead to long-lasting side effects. The development of immunotherapies has revolutionized cancer treatment by providing a promising alternative to standard-of-care therapies. However, single-agent immunotherapy has been only modestly effective in the treatment of various cancers, including HNSCC, with most patients receiving no overall benefit or increased survival. In addition, single-agent immunotherapy's limitations, namely immune-related side effects and the necessity of multidose treatments, must be addressed to further improve treatment efficacy. Biocompatible biomaterials, in combination with cancer immunotherapies, offer numerous advantages in the concentration, localization, and controlled release of drugs, cancer antigens, and immune cells. Biomaterial structures are diverse, and their design can generally be customized to enhance immunotherapy response. In preclinical settings, the use of biomaterials has shown great promise in improving the efficacy of single-agent immunotherapy. Herein, we provide an overview of current immunotherapy treatments for HNSCC and their limitations, as well as the potential applications of biomaterials in enhancing cancer immunotherapies. Impact Statement Advances in anticancer immunotherapies for the past 30 years have yielded exciting clinical results and provided alternatives to long-standing standard-of-care treatments, which are associated with significant toxicities and long-term morbidity. However, patients with head and neck squamous cell carcinoma (HNSCC) have not benefited from immunotherapies as much as patients with other cancers. Immunotherapy limitations include systemic side effects, therapeutic resistance, poor delivery kinetics, and limited patient responses. Biomaterial-enhanced immunotherapies, as explored in this review, are a potentially powerful means of achieving localized drug delivery, sustained and controlled drug release, and immunomodulation. They may overcome current treatment limitations and improve patient outcomes and care.
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Affiliation(s)
- Gemalene M. Sunga
- Katz Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
| | - Jeffrey Hartgerink
- Department of Chemistry, Rice University, Houston, Texas, USA
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | - Andrew G. Sikora
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Simon Young
- Katz Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
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Conarty JP, Wieland A. The Tumor-Specific Immune Landscape in HPV+ Head and Neck Cancer. Viruses 2023; 15:1296. [PMID: 37376596 DOI: 10.3390/v15061296] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Human papillomaviruses (HPVs) are the causative agent of several anogenital cancers as well as head and neck cancers, with HPV+ head and neck squamous cell carcinoma (HNSCC) becoming a rapidly growing public health issue in the Western world. Due its viral etiology and potentially its subanatomical location, HPV+ HNSCC exhibits an immune microenvironment which is more inflamed and thus distinct from HPV-negative HNSCC. Notably, the antigenic landscape in most HPV+ HNSCC tumors extends beyond the classical HPV oncoproteins E6/7 and is extensively targeted by both the humoral and cellular arms of the adaptive immune system. Here, we provide a comprehensive overview of HPV-specific immune responses in patients with HPV+ HNSCC. We highlight the localization, antigen specificity, and differentiation states of humoral and cellular immune responses, and discuss their similarities and differences. Finally, we review currently pursued immunotherapeutic treatment modalities that attempt to harness HPV-specific immune responses for improving clinical outcomes in patients with HPV+ HNSCC.
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Affiliation(s)
- Jacob P Conarty
- Department of Otolaryngology, The Ohio State University, Columbus, OH 43210, USA
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH 43210, USA
- Biomedical Sciences Graduate Program, The Ohio State University, Columbus, OH 43210, USA
| | - Andreas Wieland
- Department of Otolaryngology, The Ohio State University, Columbus, OH 43210, USA
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH 43210, USA
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH 43210, USA
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7
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Yang C, Garg R, Fredenburg K, Weidert F, Mendez-Gomez H, Amdur R, Lee JH, Ku J, Kresak J, Staras S, Sikora AG, Wang L, McGrail D, Mitchell D, Sayour E, Silver N. Association of Suppressive Myeloid Cell Enrichment with Aggressive Oropharynx Squamous Cell Carcinoma. Cancers (Basel) 2023; 15:2346. [PMID: 37190274 PMCID: PMC10136648 DOI: 10.3390/cancers15082346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/22/2023] [Accepted: 04/10/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND While immune-cell infiltrated tumors, such as human papillomavirus positive (HPV+) ororpharyngeal squamous cell carcinomas (OPSCC) have been associated with an improved clinical prognosis, there is evidence to suggest that OPSCCs are also subjected to increased immunoregulatory influence. The objective of this study was to assess whether patients with clinically aggressive OPSCC have a distinct immunosuppressive immune signature in the primary tumor. METHODS This retrospective case-control study analyzed 37 pre-treatment tissue samples from HPV+ and HPV-negative OPSCC patients treated at a single institution. The cases were patients with known disease recurrence and the controls were patients without disease recurrence. An mRNA-expression immune-pathway profiling was performed, and correlated to clinical outcomes. The TCGA head and neck cancer database was utilized to make comparisons with the institutional cohort. RESULTS In our cohort, HPV-negative and HPV+ patients with known disease recurrence both had significantly increased suppressive monoctyte/macrophage and granulocyte cell-expression-profile enrichment. Similar findings were found in the TCGA cohort when comparing HPV-negative to positive patients. CONCLUSIONS our study demonstrates that patients with recurrent HPV+ OPSCC had suppressive monocyte/macrophage and granulocyte immune-cell enrichment, similar to those seen in the more aggressive HPV-negative OPSCC.
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Affiliation(s)
- Changlin Yang
- Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA
| | - Rekha Garg
- Department of Pediatrics, University of Florida, Gainesville, FL 32603, USA
| | | | - Frances Weidert
- Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA
| | - Hector Mendez-Gomez
- Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA
| | - Robert Amdur
- Department of Radiation Oncology, University of Florida, Gainesville, FL 32608, USA
| | - Ji-Hyun Lee
- Department of Biostatistics, University of Florida, Gainesville, FL 32603, USA
| | - Jamie Ku
- Head and Neck Institute, Cleveland Clinic, Cleveland, OH 44106, USA
| | - Jesse Kresak
- Department of Pathology, University of Florida, Gainesville, FL 32610, USA
| | - Stephanie Staras
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL 32610, USA
| | - Andrew G. Sikora
- Department of Head and Neck Surgery, MD Anderson Cancer Center, University of Texas, Houston, TX 77030, USA
| | - Lily Wang
- Translational Hematology and Oncology, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Daniel McGrail
- Lerner Research Institute, Cleveland Clinic, Center of Immunotherapy and Precision Immuno-Oncology, Cleveland, OH 44106, USA
| | - Duane Mitchell
- Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA
| | - Elias Sayour
- Department of Neurosurgery, University of Florida, Gainesville, FL 32608, USA
| | - Natalie Silver
- Head and Neck Institute, Cleveland Clinic, Cleveland, OH 44106, USA
- Lerner Research Institute, Cleveland Clinic, Center of Immunotherapy and Precision Immuno-Oncology, Cleveland, OH 44106, USA
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Abstract
Head and neck cancer (HNC) survivorship is increasing, and with it, a shift in treatment practices has occurred. Radical surgical resections for the treatment of HNC have decreased, and organ preservation treatments have increased. Although effective in treating HNC, chemoradiation therapy toxicities can be detrimental to a patient's overall health, nutrition status, and quality of life (QOL). Considering that dysphagia is typically a driving element of dysfunction, speech-language pathologists are vital to the prehabilitation phase. Prehabilitation programs include a variety of components, with the primary goal being to improve functional and QOL outcomes posttreatment.
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Affiliation(s)
- Mary Caroline Murray
- University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.
| | - Anne Kane
- University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA
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9
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Almarzooqi S, Hashim MJ, Awwad A, Sharma C, Saraswathiamma D, Albawardi A. Lower Prevalence of Human Papillomavirus in Head and Neck Squamous Cell Carcinoma in Middle Eastern Population: Clinical Implications for Diagnosis and Prevention. Cureus 2023; 15:e34912. [PMID: 36938175 PMCID: PMC10016730 DOI: 10.7759/cureus.34912] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 02/16/2023] Open
Abstract
Introduction Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide. The prevalence of human papillomavirus (HPV) in HNSCC varies across regions. Objective This study aimed to determine the prevalence of high-risk HPV (hrHPV) among patients with HNSCC in the Middle East region. Methods Samples from patients with oropharyngeal or laryngeal lesions who underwent biopsy or resection at a tertiary care hospital from 2010 to 2015 were collected. Those confirmed as squamous cell carcinoma (SCC) on histopathology were identified as cases (n = 61), whereas benign lesions were used as controls (n = 83). Immunohistochemistry (IHC) for p16, p53, Ki-67, and in situ hybridization (ISH) for hrHPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 66 were performed on all cases. Results A total of 154 cases were studied: 61 squamous cell cancers (cases), 83 benign lesions (control), and 10 dysplasia specimens. Among the cases, only five (8.6%) were positive for hrHPV, whereas only one control specimen tested positive. The SCC group had higher mean age, male sex, and history of cigarette smoking and alcohol usage. Among the hrHPV-positive SCC cases, 80% had a tumor in the oropharyngeal region. All hrHPV-positive cases were positive for p16 and p53 immunostains. Conclusion Among HNSCC cases, hrHPV was detected at a lower rate compared to other regions of the world. This study suggests that hrHPV plays a minor role in the pathogenesis of HNSCC in this region, compared to tobacco use and alcohol consumption.
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Affiliation(s)
- Saeeda Almarzooqi
- Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University (UAE) University, Al Ain, ARE
| | - Muhammad Jawad Hashim
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University (UAE) University, Al Ain, ARE
| | - Aktham Awwad
- Department of Laboratory Medicine, Tawam Hospital, Al Ain, ARE
| | - Charu Sharma
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University (UAE) University, Al Ain, ARE
| | - Dhanya Saraswathiamma
- Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University (UAE) University, Al Ain, ARE
| | - Alia Albawardi
- Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University (UAE) University, Al Ain, ARE
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10
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Guo F, Chang M, Scholl M, McKinnon B, Berenson AB. Trends in Oropharyngeal Cancer Incidence Among Adult Men and Women in the United States From 2001 to 2018. Front Oncol 2022; 12:926555. [PMID: 35924171 PMCID: PMC9339703 DOI: 10.3389/fonc.2022.926555] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background The human papillomavirus (HPV) vaccine was approved in 2006 and has been shown to decrease vaccine-related HPV types in the oropharynx. Its impact on the incidence of HPV-related oropharyngeal squamous cell carcinoma (OPSCC) has not been examined. We investigated the impact of HPV vaccination on the incidence of HPV-related OPSCC in the US among male and female adults from different age groups. Methods The US Cancer Statistics 2001-2018 database and the National Cancer Institute (NCI)'s Surveillance Epidemiology and End Results (SEER) program were used in this study. OPSCC incidence was age-adjusted to the US standard population in 2000. Cause-specific 5-year survival probability was calculated using 60 monthly intervals in SEER*Stat software. Results Incidence of HPV-related OPSCC was much higher in males than in females. Age-adjusted annual incidence of OPSCC was significantly lower in 2014-2018 than in 2002-2006 among males 20-44 years old (11.4 vs 12.8 per 1,000,000, rate ratio 0.89, 95% confidence interval 0.84-0.93) and among females 20-44 years old (3.0 vs 3.6 per 1,000,000, rate ratio 0.86, 95% confidence interval 0.78-0.95), but increased in both 45-64 year old and 65+ year old males and females. Joinpoint regression revealed a significant joint in the HPV-OPSCC incidence trend for 20-44-year-old males in 2008 at which time the incidence began to decrease. Except for 20-44 year old females (74.8% in 2002-2006 vs. 75.7% in 2009-2013, p=0.84), cancer-specific 5-year survivals significantly improved for males and females of all age groups. Conclusions HPV-related OPSCC was much more common in males. Incidence of HPV-related OPSCC declined among young adults during the vaccination era compared with pre-vaccination era. Cancer-specific 5-year survival was significantly improved in young males but not in young females.
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Affiliation(s)
- Fangjian Guo
- Center for Interdisciplinary Research in Women’s Health, The University of Texas Medical Branch, Galveston, TX, United States
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, TX, United States
| | - Mihyun Chang
- Center for Interdisciplinary Research in Women’s Health, The University of Texas Medical Branch, Galveston, TX, United States
| | - Matthew Scholl
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, TX, United States
| | - Brian McKinnon
- Department of Otolaryngology-Head and Neck Surgery, The University of Texas Medical Branch, Galveston, TX, United States
| | - Abbey B. Berenson
- Center for Interdisciplinary Research in Women’s Health, The University of Texas Medical Branch, Galveston, TX, United States
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, TX, United States
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11
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Human Papillomavirus Detected in Oropharyngeal Cancers from Chilean Subjects. Viruses 2022; 14:v14061212. [PMID: 35746684 PMCID: PMC9229111 DOI: 10.3390/v14061212] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 01/02/2023] Open
Abstract
High-risk human papillomaviruses (HR-HPV) are the causal agents of an important subset of oropharyngeal cancers that has increased considerably in incidence in recent years. In this study, we evaluated the presence of HPV in 49 oropharyngeal cancers from Chilean subjects. The presence of HPV DNA was analyzed by conventional PCR, the genotypes were identified through sequencing, and the expression of E6/E7 transcripts was evaluated by a reverse transcriptase polymerase chain reaction (RT-PCR). Additionally, to determine p16 expression—a surrogate marker for oncogenic HPV infection—a tissue array was constructed for immunohistochemistry (IHC). HPV was detected in 61.2% of oropharyngeal carcinomas, the most prevalent genotype being HPV16 (80%). E6 and E7 transcripts were detected in 91.6% and 79.1% of the HPV16-positive specimens, respectively, demonstrating functional HPV infections. Furthermore, p16 expression was positive in 58.3% of cases. These findings show a high prevalence of HR-HPV in oropharyngeal tumors from Chile, suggesting the necessity of additional studies to address this growing public health concern.
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12
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Gama-Cuellar AG, Francisco ALN, Scarini JF, Mariano FV, Kowalski LP, Gondak R. Decreased CD1a + and CD83 + cells in tonsillar squamous cell carcinoma regardless of HPV status. J Appl Oral Sci 2022; 30:e20210702. [PMID: 35584505 PMCID: PMC9126112 DOI: 10.1590/1678-7757-2020-0702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/06/2022] [Indexed: 11/22/2022] Open
Abstract
Dendritic cells (DCs) are specialized antigen-presenting cells that play a critical role in the immune response against human papillomavirus (HPV) infection, and represent a therapeutic target in cancer.
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Affiliation(s)
| | | | - João Figueira Scarini
- Universidade Estadual de Campinas - UNICAMP, Departamento de Anatomia-Patológica, Faculdade de Ciências Médicas, Campinas, SP, Brasil
| | - Fernanda Viviane Mariano
- Universidade Estadual de Campinas - UNICAMP, Departamento de Anatomia-Patológica, Faculdade de Ciências Médicas, Campinas, SP, Brasil
| | | | - Rogério Gondak
- Universidade Federal de Santa Catarina - UFSC, Departamento de Patologia, Florianópolis, SC, Brasil
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13
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Williamson CW, Nelson T, Thompson CA, Vitzthum LK, Zakeri K, Riviere P, Bryant AK, Sharabi AB, Zou J, Mell LK. Bias Reduction through Analysis of Competing Events (BRACE) Correction to Address Cancer Treatment Selection Bias in Observational Data. Clin Cancer Res 2022; 28:1832-1840. [PMID: 35140122 DOI: 10.1158/1078-0432.ccr-21-2468] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/24/2021] [Accepted: 02/07/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cancer treatments can paradoxically appear to reduce the risk of non-cancer mortality in observational studies, due to residual confounding. Here we introduce a method, Bias Reduction through Analysis of Competing Events (BRACE), to reduce bias in the presence of residual confounding. METHODS BRACE is a novel method for adjusting for bias from residual confounding in proportional hazards models. Using standard simulation methods, we compared BRACE vs. Cox proportional hazards regression in the presence of an unmeasured confounder. We examined estimator distributions, bias, mean squared error (MSE), and coverage probability. We then estimated treatment effects of high vs. low intensity treatments in 36,630 prostate cancer, 4,069 lung cancer, and 7,117 head/neck cancer patients, using the Veterans Affairs database. We analyzed treatment effects on cancer-specific mortality (CSM), non-cancer mortality (NCM), and overall survival (OS), using conventional multivariable Cox and propensity score (adjusted using inverse probability weighting) models, vs. BRACE-adjusted estimates. RESULTS In simulations with residual confounding, BRACE uniformly reduced both bias and MSE. In the absence of bias, BRACE introduced bias toward the null, albeit with lower MSE. BRACE markedly improved coverage probability, but with a tendency toward overcorrection for effective but non-toxic treatments. For each clinical cohort, more intensive treatments were associated with significantly reduced hazards for CSM, NCM, and OS. BRACE attenuated OS estimates, yielding results more consistent with findings from randomized trials and meta-analyses. CONCLUSIONS BRACE reduces bias and MSE when residual confounding is present and represents a novel approach to improve treatment effect estimation in non-randomized studies.
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Affiliation(s)
| | - Tyler Nelson
- Radiation Medicine and Applied Sciences, UC San Diego
| | | | - Lucas K Vitzthum
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego
| | - Kaveh Zakeri
- Radiation Oncology, Memorial Sloan Kettering Cancer Center
| | - Paul Riviere
- Radiation Medicine and Applied Sciences, UC San Diego Health System
| | | | - Andrew B Sharabi
- Radiation Medicine and Applied Sciences, University of California, San Diego
| | - Jingjing Zou
- Department of Family Medicine and Public Health and Department of Mathematics, UC San Diego
| | - Loren K Mell
- Radiation Medicine and Applied Sciences, University of California, San Diego
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14
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Taylor MA, Switchenko J, Stokes W, Patel MR, McDonald M, Steuer C, Aiken A, Beitler JJ, Shin DM, Saba NF. Incidence trends of squamous cell carcinoma of the head and neck (SCCHN) in the aging population--A SEER-based analysis from 2000 to 2016. Cancer Med 2021; 10:6070-6077. [PMID: 34288563 PMCID: PMC8419769 DOI: 10.1002/cam4.4134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/30/2022] Open
Abstract
Background Tobacco and alcohol use are risk factors for Squamous Cell Carcinoma of the Head and Neck (SCCHN); however, there is growing recognition of HPV as a risk factor for SCCHN. HPV‐related SCCHN is thought to affect mostly middle‐aged individuals but as the US population ages, it is important to evaluate the change in incidence of HPV‐ and non‐HPV‐related SCCHN in individuals who are ≥65 years old. Methods This was a retrospective study using data from a population‐based cancer registry (SEER) to identify individuals ≥65 years old diagnosed with SCCHN between 2000 and 2016 also stratified by sex, race, and birth cohort. The subgroups of HPV‐associated and non‐HPV associated sites were analyzed independently. The incidence per year was calculated and joinpoint detection was used to identity significant changes in incidence trends and annual percent change (APC). Results For HPV‐associated sites from 2000 to 2016, there was an average annual rate of 10.8 per 100,000 individuals with an APC of 2.92% (p = <0.05). For HPV‐ and non‐HPV‐related SCCHN males had a higher annual rate compared to females, 54.5 versus 18.0 in non‐HPV‐related and 19.1 versus 4.4 in HPV‐related sites. For non‐HPV‐related sites there was a decrease in APC across all stratified groups. For HPV‐related sites there was an increase in APC across all stratified groups, especially males (APC 8.82% 2006–2016 p < 0.05) and White individuals (APC 8.19% 2006–2016 p < 0.05). When stratified by birth cohort, HPV‐related SCCHN sites had a higher APC in ages 65–69 (8.38% p < 0.05) and 70–74 (8.54% p < 0.05). Conclusion Among the population ≥65 years old from 2000 to 2016, the incidence rate for HPV‐related SCCHN sites has increased across all stratified groups, especially in White individuals, males, and age groups 65–74. The incidence rate for non‐HPV‐related sites has decreased across all stratified groups during this time.
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Affiliation(s)
| | - Jeffery Switchenko
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - William Stokes
- Emory University, Winship Cancer Institute, Atlanta, GA, USA
| | - Mihir R Patel
- Emory University, Winship Cancer Institute, Atlanta, GA, USA
| | - Mark McDonald
- Emory University, Winship Cancer Institute, Atlanta, GA, USA
| | - Conor Steuer
- Emory University, Winship Cancer Institute, Atlanta, GA, USA
| | - Ashley Aiken
- Emory University, Winship Cancer Institute, Atlanta, GA, USA
| | | | - Dong M Shin
- Emory University, Winship Cancer Institute, Atlanta, GA, USA
| | - Nabil F Saba
- Emory University, Winship Cancer Institute, Atlanta, GA, USA
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15
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Fu EWZ, Chilagondanahalli N, Bundele MM, Gan JY, Li H, Lim MY. Trends in HPV-related oropharyngeal cancers in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2021; 50:508-509. [PMID: 34195763 DOI: 10.47102/annals-acadmedsg.2020499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Ernest Wei Zhong Fu
- Department of Otorhinolaryngology, Head and Neck Surgery, Tan Tock Seng Hospital, Singapore
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16
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Lorenzatti Hiles G, Chang KP, Bellile EL, Wang CI, Yen WC, Goudsmit CM, Briggs HL, Thomas TB, Peters L, Afsari MA, Pinatti LM, Morris AC, Jawad N, Carey TE, Walline HM. Understanding the impact of high-risk human papillomavirus on oropharyngeal squamous cell carcinomas in Taiwan: A retrospective cohort study. PLoS One 2021; 16:e0250530. [PMID: 33891627 PMCID: PMC8064583 DOI: 10.1371/journal.pone.0250530] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 04/08/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Human papillomavirus (HPV)-driven oropharyngeal squamous cell carcinoma (OPSCC) is increasing globally. In Taiwan, HPV-positive OPSCC is obscured by tobacco, alcohol, and betel quid use. We investigated the role of high-risk HPV (hrHPV) in a large retrospective Taiwan OPSCC cohort. METHODS AND RESULTS The cohort of 541 OPSCCs treated at Chang Gung Memorial Hospital from 1998-2016 consisted of 507 men (94%) and 34 women (6%). Most used tobacco (81%), alcohol (51%), and betel quid (65%). Formalin-fixed, paraffin-embedded tissue was used for p16 staining (a surrogate marker for HPV) and testing for HPV DNA presence and type by Multiplex HPV PCR-MassArray. HPV DNA and/or p16 staining (HPV-positive) was found in 28.4% (150/528) tumors. p16 and HPV DNA were strongly correlated (F < 0.0001). HPV16 was present in 82.8%, and HPV58 in 7.5% of HPV-positive tumors. HPV was associated with higher age (55.5 vs. 52.7 years, p = 0.004), lower T-stage (p = 0.008) better overall survival (OS) (hazard ratio [HR] 0.58 [95% CI 0.42-0.81], p = 0.001), and disease-free survival (DFS) (HR 0.54 [95% CI 0.40-0.73], p < 0.0001). Alcohol was strongly associated with recurrence and death (OS: HR 2.06 [95% CI 1.54-2.74], p < 0.0001; DFS: HR 1.72 [95% CI 1.33-2.24], p < 0.0001). OS and DFS in HPV-positive cases decreased for alcohol users (p < 0.0001). Obscured by the strong alcohol effect, predictive associations were not found for tobacco or betel quid. CONCLUSIONS As with HPV-positive OPSCC globally, HPV is an increasingly important etiological factor in Taiwanese OPSCC. HPV-positive OPSCC has considerable survival benefit, but this is reduced by alcohol, tobacco, and betel quid use. hrHPV is a cancer risk factor in males and females. Vaccinating both sexes with a multivalent vaccine including HPV58, combined with alcohol and tobacco cessation policies will be effective cancer-prevention public health strategies in Taiwan.
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Affiliation(s)
- Guadalupe Lorenzatti Hiles
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Kai-Ping Chang
- Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital (Linkou Medical Center), Taoyuan, Taiwan, Republic of China
- College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China
| | - Emily L. Bellile
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Chun-I Wang
- Radiation Biology Research Center, Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China
| | - Wei-Chen Yen
- Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital (Linkou Medical Center), Taoyuan, Taiwan, Republic of China
| | - Christine M. Goudsmit
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Hannah L. Briggs
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Trey B. Thomas
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Lila Peters
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Macy A. Afsari
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Lisa M. Pinatti
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
- Cancer Biology Program, Rackham Graduate School, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Anna C. Morris
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Nadine Jawad
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Thomas E. Carey
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
| | - Heather M. Walline
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, United States of America
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17
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Prehabilitation in head and neck cancer patients: a literature review. J Otolaryngol Head Neck Surg 2021; 50:2. [PMID: 33407922 PMCID: PMC7789666 DOI: 10.1186/s40463-020-00486-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 12/21/2020] [Indexed: 12/26/2022] Open
Abstract
Background Dysphagia is one consequence of head and neck cancer that has a significant impact on quality of life for head and neck cancer survivors. While survival rates continue to improve, focus has shifted to maximizing long-term function, with prevention or prehabilitation programs becoming more common. Prehabilitation programs typically include an exercise regime that specifies the exercise type, the number of repetitions to complete per set, the number of sets of each exercise to complete per day, as well as the length of the treatment block. Ideally, exercise programs are designed with principles of neuromuscular plasticity in mind. Methods Twenty-nine original research articles published between 2006 and 2020 were included in this state-of-the-art review and examined for program timing and details. Results Two definitions for prehabilitation were noted: one third of the studies defined prehabilitation as preventative exercises prior to the start of acute cancer treatment; the remaining two thirds defined prehabilitation as treatment concurrent prehabilitation. Exercises prescribed ranged from general stretching and range of motion exercises, to trismus and swallowing specific exercises. The most common swallowing specific exercise was the Mendelsohn’s maneuver, followed by the effortful swallow, Shaker, and Masako maneuver. The most common dose was 10 repetitions of an exercise, three times per day for the duration of radiation therapy. The most common measures were questionnaires, followed by g-tube dependence, mouth opening, and MBS reports. Conclusion This review of the literature has shed light on the variability of prehabilitation timing, exercise type, dose, duration of treatment, and outcomes associated with prehabilitation, making the selection of an optimal prehabilitation program difficult at this time.
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An Immunocompetent Mouse Model of HPV16(+) Head and Neck Squamous Cell Carcinoma. Cell Rep 2020; 29:1660-1674.e7. [PMID: 31693903 PMCID: PMC6870917 DOI: 10.1016/j.celrep.2019.10.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 09/03/2019] [Accepted: 10/01/2019] [Indexed: 12/15/2022] Open
Abstract
The incidence of human papilloma virus (HPV)-associated head and neck squamous cell carcinoma (HNSCC) is increasing and implicated in more than 60% of all oropharyngeal carcinomas (OPSCCs). Although whole-genome, transcriptome, and proteome analyses have identified altered signaling pathways in HPV-induced HNSCCs, additional tools are needed to investigate the unique pathobiology of OPSCC. Herein, bioinformatics analyses of human HPV(+) HNSCCs revealed that all tumors express full-length E6 and identified molecular subtypes based on relative E6 and E7 expression levels. To recapitulate the levels, stoichiometric ratios, and anatomic location of E6/E7 expression, we generated a genetically engineered mouse model whereby balanced expression of E6/E7 is directed to the oropharyngeal epithelium. The addition of a mutant PIK3CAE545K allele leads to the rapid development of pre-malignant lesions marked by immune cell accumulation, and a subset of these lesions progress to OPSCC. This mouse provides a faithful immunocompetent model for testing treatments and investigating mechanisms of immuno- suppression. Carper et al. present the ‘‘iKHP’’ mouse, in which HPV16 oncogenes are inducibly activated in vivo in a tissue-specific and temporal manner. Oropharyngeal- specific expression of E6/E7 with PIK3CAE545K in these mice promotes the development of premalignant lesions marked by immune cell infiltration, but only a subset spontaneously convert to OPSCC.
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Increasing prevalence of HPV in oropharyngeal carcinoma suggests adaptation of p16 screening in Southeast Asia. J Clin Virol 2020; 132:104637. [PMID: 32932151 DOI: 10.1016/j.jcv.2020.104637] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/02/2020] [Accepted: 09/06/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) is etiologically linked to increasing oropharyngeal squamous cell carcinoma (OPSCC) rates in the Western world. However, the role of HPV in Southeast Asia, a high incidence region, hasn't been assessed. METHODS 96 formalin-fixed, paraffin-embedded (FFPE) tissue blocks and corresponding patient data were obtained from Srinagarind Hospital, Thailand from 2012-2017. DNA from areas of 70 %+ cellularity were genotyped using polymerase chain reaction (PCR) and stained for p16, a surrogate marker for HPV. Inverse probability weights based on data from the hospital-based cancer registry were used in statistical analyses. Adjusted linear regression was used to assess changes in OPSCC HPV prevalence and conduct projections. Kaplan-Meier and Cox proportional hazard models were used to determine HPV-specific survival differences. RESULTS 14 patients exhibited monoinfection with HPV16, two with HPV18 and one was HPV16/18 coinfected. PCR results were in agreement with p16 staining. On average, HPV + patients were more likely to have tonsil cancer (p-value:0.002). HPV prevalence increased by 2% annually (pvalue: 0.01), from 16 % in 2012 to 26 % in 2017. At the current rate, OPSCC HPV positivity will exceed 50 % by 2030. HPV positivity was shown to be protective in Kaplan-Meier (log-rank p = 0.02) and sex, age and stage adjusted Cox models (HR:0.34 [95 %CI:0.22, 0.52]). CONCLUSION Given the increased prevalence and similarities in presentation of HPV + OPSCC to those observed in Western countries, the data suggest the adaptation of p16 staining and subsequent restaging of OPSCC tumors as suggested by the American Joint Committee on Cancer in Southeast Asia.
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Girardi FM, Wagner VP, Martins MD, Abentroth AL, Hauth LA. Prevalence of p16 expression in oropharyngeal squamous cell carcinoma in southern Brazil. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:681-691. [PMID: 32981865 DOI: 10.1016/j.oooo.2020.08.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/16/2020] [Accepted: 08/16/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Our aim was to evaluate the prevalence of human papillomavirus (HPV)-positive tumors in a cohort of patients with oropharyngeal squamous cell carcinoma (OPSCC) at a single center in southern Brazil and determine the short-term prognostic factors in this sample. STUDY DESIGN Ninety-one consecutive patients with newly diagnosed primary OPSCC between January 2017 and December 2019 were retrospectively included. Demographic, clinical, pathologic, and survival data were collected. HPV status was determined by using p16 immunohistochemistry. RESULTS The overall prevalence of HPV-positive (HPV+) OPSCC was 20.9%. Patients with HPV+ tumors presented a nodal metastasis as the first clinical sign (P = .02); reported less alcohol (P < .001) and tobacco use (P < .001); exhibited lower tumor stages (P < .001) and higher microscopic grades (P = .01); and had higher chances of having resectable tumors (P = .008). p16-negative status (P = .01); unresectable/inoperable tumors (P < .001); presence of nodal metastasis (P = .005); and higher American Joint Committee on Cancer (AJCC) stage (P = .002) were significantly associated with worse disease-specific survival. CONCLUSIONS The prevalence of HPV+ OPSCC in southern Brazil is relatively low, and p16-positive status was associated with Better prognosis. Higher AJCC stage, nodal metastasis, and unresectability/inoperability were associated with the highest hazard ratios for death resulting from OPSCC.
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Affiliation(s)
| | - Vivian P Wagner
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Manoela Domingues Martins
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil; Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Oral Medicine, Porto Alegre Clinics Hospital (HCPA/UFRGS), Porto Alegre, RS, Brazil
| | | | - Luiz Alberto Hauth
- Integrated Oncology Center of Ana Nery Hospital, Santa Cruz do Sul, RS, Brazil
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Larish A, Yin L, Glaser G, Moore E, Bakkum-Gamez J, Routman D, Ma D, Price D, Janus J, Price K, Chintakuntlawar A, Neben-Wittich M, Foote R, Van Abel K. Human Papillomavirus-Associated Anogenital Pathology in Females With HPV-Positive Oropharyngeal Squamous Cell Carcinoma. Otolaryngol Head Neck Surg 2020; 164:369-374. [PMID: 32663054 DOI: 10.1177/0194599820941499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
We sought to determine the incidence and location of human papillomavirus (HPV)-associated anogenital disease in women with HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) via a retrospective cohort study with prospective contact to update history at Mayo Clinic in Rochester, Minnesota. Females undergoing treatment for nonmetastatic HPV-positive OPSCC from 2011 to 2019 were identified. Clinical history and outcomes were abstracted from medical records. Patients without documented anogenital history were contacted, consented, and administered a survey, and external records were requested and reviewed. Seventeen of 46 patients (37.0%) had a history of anogenital HPV-associated disease, and 16 of 17 (94.1%) required procedures to diagnose or treat HPV lesions. The cervix was the most common site (16/17, 94.1%). Procedures included colposcopy (n = 6), cervical excision (n = 3), cryotherapy (n = 4), and hysterectomy (n = 3). One case of fatal cervical carcinoma was noted, diagnosed 1 year following OPSCC. Three of 17 (17.6%) had HPV-related vulvovaginal disease, and 1 of 17 had anal disease. Patients with a history of HPV-positive OPSCC may be at elevated risk for HPV-associated anogenital disease.
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Affiliation(s)
- Alyssa Larish
- Department of Obstetrics and Gynecologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Linda Yin
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Gretchen Glaser
- Department of Obstetrics and Gynecologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Eric Moore
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Jamie Bakkum-Gamez
- Department of Obstetrics and Gynecologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - David Routman
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Daniel Ma
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Daniel Price
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Jeffrey Janus
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Katharine Price
- Department of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Robert Foote
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Kathryn Van Abel
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Argirion I, Zarins KR, Defever K, Suwanrungruang K, Chang JT, Pongnikorn D, Chitapanarux I, Sriplung H, Vatanasapt P, Rozek LS. Temporal Changes in Head and Neck Cancer Incidence in Thailand Suggest Changing Oropharyngeal Epidemiology in the Region. J Glob Oncol 2020; 5:1-11. [PMID: 30860955 PMCID: PMC6449079 DOI: 10.1200/jgo.18.00219] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Head and neck cancer is the sixth most common cancer in the world, and the largest burden occurs in developing countries. Although the primary risk factors have been well characterized, little is known about temporal trends in head and neck cancer across Thailand. METHODS Head and neck squamous cell carcinoma (HNSCC) occurrences diagnosed between 1990 and 2014 were selected by International Classification of Diseases (10th revision; ICD10) code from the Songkhla, Lampang, Chiang Mai, and Khon Kaen cancer registries and the US SEER program for oral cavity (ICD10 codes 00, 03-06), tongue (ICD10 codes 01-02), pharynx (ICD10 codes 09-10, 12-14), and larynx (ICD10 code 32). The data were analyzed using R and Joinpoint regression software to determine age-standardized incidence rates and trends of annual percent change (APC). Incidence rates were standardized using the Segi (1960) population. Stratified linear regression models were conducted to assess temporal trends in early-onset HNSCC across 20-year age groups. RESULTS Although overall HNSCC rates are decreasing across all registries, subsite analyses demonstrate consistent decreases in both larynx and oral cavity cancers but suggest increases in tongue cancers among both sexes in the United States (APCmen, 2.36; APCwomen, 0.77) and in pharyngeal cancer in Khon Kaen and US men (APC, 2.1 and 2.23, respectively). Age-stratified APC analyses to assess young-onset (< 60 years old) trends demonstrated increased incidence in tongue cancer in Thailand and the United States as well as in pharyngeal cancers in Khon Kaen men age 40 to 59 years and US men age 50 to 59 years. CONCLUSION Although overall trends in HNSCC are decreasing across both Thailand and the United States, there is reason to believe that the etiologic shift to oropharyngeal cancers in the United States may be occurring in Thailand.
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Affiliation(s)
- Ilona Argirion
- University of Michigan School of Public Health, Ann Arbor, MI
| | - Katie R Zarins
- University of Michigan School of Public Health, Ann Arbor, MI
| | - Kali Defever
- University of Michigan School of Public Health, Ann Arbor, MI
| | | | - Joanne T Chang
- University of Michigan School of Public Health, Ann Arbor, MI
| | | | | | | | - Patravoot Vatanasapt
- Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand.,Khon Kaen University, Thailand
| | - Laura S Rozek
- University of Michigan School of Public Health, Ann Arbor, MI
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Saeed M, Faisal SM, Akhtar F, Ahmad S, Alreshidi MM, Kausar MA, Kazmi S, Saeed A, Adnan M, Ashraf GM. Human Papillomavirus Induced Cervical and Oropharyngeal Cancers: From Mechanisms to Potential Immuno-therapeutic Strategies. Curr Drug Metab 2020; 21:167-177. [DOI: 10.2174/1389200221666200421121228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 09/04/2019] [Accepted: 01/30/2020] [Indexed: 01/09/2023]
Abstract
The human papillomavirus (HPV) associated infections are the hallmark of cervical and neck cancer.
Almost all the cases of cervical cancer (CC) and 70% of oropharyngeal cancer (OC) are, more or less, caused by the
persistent infection of HPV. CC is the fourth most common cancer globally, and is commenced by the persistent
infection with human papillomaviruses (HPVs), predominantly HPV types; 16 and 18. In the light of the above facts,
there is an immediate requirement to develop novel preventive and innovative therapeutic strategies that may help in
lower occurrences of HPV mediated cancers. Currently, only radiation and chemical-based therapies are the treatment
for HPV mediated neck cancer (NC) and CC. Recent advances in the field of immunotherapy are underway,
which are expected to unravel the optimal treatment strategies for the growing HPV mediated cancers. In this review,
we decipher the mechanism of pathogenesis with current immunotherapeutic advances in regressing the NC and CC,
with an emphasis on immune-therapeutic strategies being tested in clinical trials and predominantly focus on defining
the efficacy and limitations. Taken together, these immunological advances have enhanced the effectiveness of immunotherapy
and promises better treatment results in coming future.
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Affiliation(s)
- Mohd. Saeed
- Department of Biology, College of Science, University of Hail, Hail, Saudi Arabia
| | - Syed Mohd Faisal
- Molecular Immunology Laboratory, Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh 202002, India
| | - Firoz Akhtar
- Department of Pharmacology and Toxicology, Higuchi Biosciences Center, University of Kansas, Lawrence, KS 2099, United States
| | - Saheem Ahmad
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail, Saudi Arabia
| | - Mousa M. Alreshidi
- Department of Biology, College of Science, University of Hail, Hail, Saudi Arabia
| | - Mohd. Adnan Kausar
- Department of Biochemistry, College of Medicine University of Hail, Hail, Saudi Arabia
| | - Shadab Kazmi
- Molecular Immunology Laboratory, Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh 202002, India
| | - Amir Saeed
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail, Saudi Arabia
| | - Mohd. Adnan
- Department of Biology, College of Science, University of Hail, Hail, Saudi Arabia
| | - Ghulam Md Ashraf
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
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Abstract
Human papillomavirus (HPV) is the most common sexually transmitted pathogen, and high-risk HPVs contribute to 5% of human cancers, including 25% of head and neck squamous cell carcinomas (HNSCCs). Despite the significant role played by HPVs in HNSCC, there is currently no available in vivo system to model the process from papillomavirus infection to virus-induced HNSCC. In this paper, we describe an infection-based HNSCC model, utilizing a mouse papillomavirus (MmuPV1), which naturally infects laboratory mice. Infections of the tongue epithelium of two immunodeficient strains with MmuPV1 caused high-grade squamous dysplasia with early signs of invasive carcinoma over the course of 4 months. When combined with the oral carcinogen 4-nitroquinoline-1-oxide (4NQO), MmuPV1 caused invasive squamous cell carcinoma (SCC) on the tongue of both immunodeficient and immunocompetent mice. These tumors expressed markers of papillomavirus infection and HPV-associated carcinogenesis. This novel preclinical model provides a valuable new means to study how natural papillomavirus infections contribute to HNSCC.IMPORTANCE The species specificity of papillomavirus has limited the development of an infection-based animal model to study HPV-associated head and neck carcinogenesis. Our study presents a novel in vivo model using the mouse papillomavirus MmuPV1 to study papillomavirus-associated head and neck cancer. In our model, MmuPV1 infects and causes lesions in both immunodeficient and genetically immunocompetent strains of mice. These virally induced lesions carry features associated with both HPV infections and HPV-associated carcinogenesis. Combined with previously identified cancer cofactors, MmuPV1 causes invasive squamous cell carcinomas in mice. This model provides opportunities for basic and translational studies of papillomavirus infection-based head and neck disease.
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25
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Snietura M, Brewczynski A, Kopec A, Rutkowski T. [Infiltrates of M2-Like Tumour-Associated Macrophages Are Adverse Prognostic Factor in Patients with Human Papillomavirus-Negative but Not in Human Papillomavirus-Positive Oropharyngeal Squamous Cell Carcinoma]. Pathobiology 2020; 87:75-86. [PMID: 32036360 DOI: 10.1159/000505522] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 12/17/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Human papillomavirus with a high oncogenic potential (HR-HPV) is responsible for more than a half of squamous cell carcinomas of the oropharynx. The HR-HPV-dependent cases of this tumour have a better prognosis compared to the HR-HPV-negative cases, despite the usually more advanced disease at the time of diagnosis. In addition to genetic and epigenetic factors, the causes of this more favourable course of the disease are also seen in the participation of the tumour microenvironment, including the patient's immune system. Macrophages are one of the most important elements of the immunocompetent cells landscape that make up the tumour microenvironment. Traditionally, they are divided into 2 groups: inflammatory macrophages with the M1 phenotype and tumour-associated macrophages known as M2 phenotype macrophages. OBJECTIVE The aim of this study was to investigate the impact of the macrophage infiltrates intensity of the M1/M2 and M2 phenotype separately on the clinical outcome of patients with squamous cell carcinoma of the oropharynx (OPSCC), taking into account the HR-HPV status of tumours. METHODS The study involved 85 patients with OPSCC in which HR-HPV status in tumour tissue was determined using a double-check algorithm including the detection of viral DNA by RT-PCR method with subsequent confirmation of its biological activity by immunohistochemical demonstrating the P16INK4A protein overexpression. In each of the groups formed on the basis of HR-HPV status, macrophages were discriminated using CD68 and CD163 proteins as markers of pan-macrophage and M2 phenotype. The intensity of infiltrates was quantified by means of computer-assisted analysis in digital images of whole slides (virtual slides) separately in tumour tissue and stroma. RESULTS In HPV-positive patients, significantly more intense infiltration of both M1/M2 and M2 macrophages was found in the tumour stroma compared to HPV-negative patients. The infiltrates from both types of macrophages in the tumour tissue were less intense and did not differ between these groups. Intensive infiltration of CD68+ macrophages in the tumour front was associated with higher rate of nodal failures and a shorter nodal control in both HR-HPV groups. In the group of HR-HPV-negative patients, heavy infiltration of CD163+ macrophages was associated with significantly shorter: loco-regional control (LRC), metastasis-free survival and overall survival (OS). These parameters and prognosis in patients with scanty CD163+ infiltration were similar to favourable outcomes in HR-HPV-positive patients. The relative risk of local-regional recurrence, distant metastases and disease-related death in HR-HPV-negative patients with intense CD163+ infiltrates was, respectively, 4.7, 5.4 and 5.7 compared to patients with scanty infiltrates. CONCLUSIONS Tumours with a positive HR-HPV status demonstrate intense infiltrations of total pool M1/M2 and M2 macrophages. In the group of HPV-negative patients, intensive M1/M2 macrophage infiltrates correlate with higher risk of nodal failures, and intensive M2 infiltrates are an adverse prognostic factor for LRC, metastasis-free survival and OS.
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Affiliation(s)
- Miroslaw Snietura
- Tumour Pathology Department, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland,
| | - Adam Brewczynski
- Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Agnieszka Kopec
- Tumour Pathology Department, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
| | - Tomasz Rutkowski
- Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
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Vitzthum LK, Park H, Zakeri K, Bryant AK, Feng C, Shen H, Cohen EE, Murphy JD, Mell LK. Selection of Head and Neck Cancer Patients for Intensive Therapy. Int J Radiat Oncol Biol Phys 2020; 106:157-166. [DOI: 10.1016/j.ijrobp.2019.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 08/12/2019] [Accepted: 09/13/2019] [Indexed: 10/25/2022]
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Volesky KD, El-Zein M, Franco EL, Brenner DR, Friedenreich CM, Ruan Y. Cancers attributable to infections in Canada. Prev Med 2019; 122:109-117. [PMID: 31078164 DOI: 10.1016/j.ypmed.2019.03.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Infections are estimated to cause approximately 15% of the world's cancers with large geographic variations. Yet, Canadian estimates for specific cancer-causing infections are not available. To estimate the number of infection-associated cancers diagnosed among Canadian adults in 2015, we calculated population attributable risks (PARs) and the number of attributable cases for seven carcinogenic infections and their 20 associated cancers. A systematic literature search was performed for each infection to obtain data on infection prevalence in the population and the relative risk or odds ratio associated with the cancer it causes. When mechanistic evidence suggested that detection of a given infection within cancer tissue was sufficient to attribute the cancer to the infection, prevalence among cancer cases was used to approximate the PAR. Data from 61 studies formed the basis of our analyses. The estimated number of infection-attributable cancer cases for 2015 was: 3828 for human papillomavirus (HPV), 2052 for Helicobacter pylori, 578 for Epstein-Barr virus, 509 for hepatitis B and C viruses (HBV, HCV), 100 for human herpesvirus type 8, and 30 cases for human T-cell lymphotropic virus type 1. These seven infections were responsible for 3.7% of cancers diagnosed among Canadian adults in 2015; 3.5% among men and 4.0% among women. The infections with the highest number of attributable cases are largely preventable or treatable through vaccination (HBV and HPV), antibiotic therapy (H. pylori), or a combination of interventions (HCV), thereby representing an important target for reducing the infection-caused cancer burden among Canadians.
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Affiliation(s)
- Karena D Volesky
- Gerald Bronfman Department of Oncology, Division of Cancer Epidemiology, McGill University, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
| | - Mariam El-Zein
- Gerald Bronfman Department of Oncology, Division of Cancer Epidemiology, McGill University, Montréal, Québec, Canada
| | - Eduardo L Franco
- Gerald Bronfman Department of Oncology, Division of Cancer Epidemiology, McGill University, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Darren R Brenner
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Yibing Ruan
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
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Volesky KD, El-Zein M, Franco EL, Brenner DR, Friedenreich CM, Ruan Y. Estimates of the future burden of cancer attributable to infections in Canada. Prev Med 2019; 122:118-127. [PMID: 31078165 DOI: 10.1016/j.ypmed.2019.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
More than 7000 incident cancers diagnosed in Canada in 2015 were attributable to infections. The future infection-associated cancer burden can be lowered by reducing the prevalence of major cancer-causing infections; hepatitis B virus (HBV), hepatitis C virus (HCV), Helicobacter pylori (H. pylori) and human papillomavirus (HPV). We modeled the future impact of (1) 10%, 25%, and 50% relative reductions in the prevalence of HBV, HCV and H. pylori and (2) different school-based HPV vaccination coverage levels (lower, current, higher) on Canadian cancer incidence by the year 2042. We modeled counterfactual reductions in HBV, HCV and H. pylori prevalence in 2018, assuming a latency period of 15-years, to estimate the impact on cancer incidence starting in 2033. The number of HPV-attributable cancers among vaccinated cohorts was a function of pre-2018 vaccine coverage levels and the 2018 counterfactuals. A 50% counterfactual reduction in the prevalence of HBV, HCV and H. pylori could prevent an estimated 10,585 cancers from 2018 to 2042; a 25% reduction could prevent 5293 cancers and a 10% reduction could prevent 2117 cancers. Assuming continuity of current estimated country-wide HPV vaccine coverage, 3977 anogenital and 1073 head and neck cancers could be prevented from 2018 to 2042, whereas vaccine coverage of 80% in girls and boys could prevent an additional 311 cancers. Almost 16,000 cancers could be prevented in Canada from 2018 to 2042 with a 50% relative reduction in HBV, HCV and H. pylori prevalence and 80% HPV vaccine coverage of girls and boys.
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Affiliation(s)
- Karena D Volesky
- Gerald Bronfman Department of Oncology, Division of Cancer Epidemiology, McGill University, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
| | - Mariam El-Zein
- Gerald Bronfman Department of Oncology, Division of Cancer Epidemiology, McGill University, Montréal, Québec, Canada
| | - Eduardo L Franco
- Gerald Bronfman Department of Oncology, Division of Cancer Epidemiology, McGill University, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Darren R Brenner
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Yibing Ruan
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
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Human Papillomavirus Detection in Head and Neck Squamous Cell Carcinomas at a Tertiary Hospital in Sub-Saharan Africa. ScientificWorldJournal 2019; 2019:2561530. [PMID: 31061653 PMCID: PMC6466863 DOI: 10.1155/2019/2561530] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/23/2019] [Accepted: 03/12/2019] [Indexed: 01/03/2023] Open
Abstract
Fewer studies have been done over the years to establish the association of human papillomavirus (HPV) with head and neck squamous cell carcinoma (HNSSC) within the subregions of sub-Saharan Africa, and thus this study was designed to investigate the presence of HPV in HNSCC at a tertiary hospital in Ghana, providing additional evidence on the need to explore similar studies in other subregions. A retrospective cross-sectional study was employed to investigate the presence of the DNA of HPV genotypes in HNSCC archived tissue. A total of 100 HNSCC cases were classified as suitable for HPV genotyping. HPV-DNA was detected in 18% of the HNSCC cases, with 17 being HPV-16 and 1 dual infection with HPV-16 and HPV-18. HPV was prevalent in 50% of oropharyngeal cancers, 27% of laryngeal cancers, and 23% of oral cavity cancers. HPV E6/E7 oncogenic DNA was found in 18% of the HNSCC cases, with HPV-16 being the predominant genotype present. The pattern of HPV association was similar to earlier reported studies, recording a higher prevalence in oropharyngeal cancers, followed by laryngeal cancers and oral cavity cancers.
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Götz C, Bischof C, Wolff KD, Kolk A. Detection of HPV infection in head and neck cancers: Promise and pitfalls in the last ten years: A meta-analysis. Mol Clin Oncol 2019; 10:17-28. [PMID: 30655973 PMCID: PMC6313947 DOI: 10.3892/mco.2018.1749] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 08/09/2018] [Indexed: 12/16/2022] Open
Abstract
The current controversial discussion on the disease-specific survival of patients with human papillomavirus (HPV)-positive (+) and -negative (-) squamous cell carcinoma (SCC) of the head neck region was the motivation for the present meta-analysis. Different detection methods for HPV are available, though these often lack sensitivity. As a consequence, there may be false interpretation of HPV positivity. A bias concerning HPV status and therefore also survival rates is serving a non-durable relevance in the discussion of tailored therapies. A literature search was performed via the online database PubMed/NCBI, and data extraction and statistical analysis were conducted. A total of 139 studies published between 2004 and 2014 were evaluated in the present meta-analysis. The HPV detection methods, patient characteristics, tumor localizations and stages, as well as (neo-) adjuvant therapies and survival times were analyzed. The average incidence rates of HPV+ patients with oropharyngeal tumors were higher than those of patients with cancers of other regions of the head and neck. Upon evaluating the results of different detection methods no significant differences were identified. We have compared the HPV incidence rates of each detection method, when studies have used more than one. Regarding overall survival, the pooled adjusted hazard ratio (HR) for oropharyngeal SCC was 0.31 [95% confidence interval (CI)=0.27-0.36]. Unfortunately, only 3 equivalent studies were available on nonoropharyngeal tumors, for which the pooled adjusted HR was 1 (95% CI=0.73-1.36). Overall, the evaluation demonstrated that the survival rates reported in numerous studies were not evaluated multifactorially and important confounders were excluded from the statistics. The HPV detection methods used were often not sufficient in representing HPV positivity. In addition, oropharyngeal and oral SCCs were assessed together in the localization. The widely differing number of HPV+ patients in each of the various studies may be explained by insufficient detection methods and by a lack of localization distinction. The considerations of a tailored therapy according to HPV status should be rejected based on the present information. The previously published studies should be read critically and do not represent a basis for therapeutic decisions.
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Affiliation(s)
- Carolin Götz
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
| | - Clara Bischof
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
| | - Klaus-Dietrich Wolff
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
| | - Andreas Kolk
- Department of Oral and Maxillofacial Surgery, Technical University of Munich, Klinikum Rechts der Isar, D-81675 Munich, Germany
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Modulation of radiation sensitivity and antitumor immunity by viral pathogenic factors: Implications for radio-immunotherapy. Biochim Biophys Acta Rev Cancer 2018; 1871:126-137. [PMID: 30605716 DOI: 10.1016/j.bbcan.2018.12.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/17/2018] [Accepted: 12/03/2018] [Indexed: 02/07/2023]
Abstract
Several DNA viruses including Human Papillomavirus (HPV), Epstein-Barr virus (EBV), and Human cytomegalovirus (HCMV) are mechanistically associated with the development of human cancers (HPV, EBV) and/or modulation of the immune system (HCMV). Moreover, a number of distinct mechanisms have been described regarding the modulation of tumor cell response to ionizing radiation and evasion from the host immune system by viral factors. There is further accumulating interest in the treatment with immune-modulatory therapies such as immune checkpoint inhibitors for malignancies with a viral etiology. Also, patients with HPV-positive tumors have a significantly improved prognosis that is attributable to increased intrinsic radiation sensitivity and may also arise from modulation of a cytotoxic T cell response in the tumor microenvironment (TME). In this review, we will highlight recent advances in the understanding of the biological basis of radiation response mediated by viral pathogenic factors and evasion from and modulation of the immune system by viruses.
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Al-Sahaf S, Hunter KD, Bolt R, Ottewell PD, Murdoch C. The IL-1/IL-1R axis induces greater fibroblast-derived chemokine release in human papillomavirus-negative compared to positive oropharyngeal cancer. Int J Cancer 2018; 144:334-344. [PMID: 30191960 PMCID: PMC6491969 DOI: 10.1002/ijc.31852] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 08/10/2018] [Accepted: 08/27/2018] [Indexed: 12/13/2022]
Abstract
Human papillomavirus (HPV) is now recognised as a major aetiological agent in the pathogenesis of oropharyngeal carcinoma (OPC). HPV-positive tumours are associated with better outcomes compared to HPV-negative tumours, possibly due to differences in their aetiology and/or the tumour microenvironment. Increased numbers of tumour-associated leukocytes have been observed in many cancers including OPC, with variable influence on prognosis depending on the leukocyte subpopulation investigated. Whether HPV status influences leukocyte recruitment to OPC remains unknown. This in-vitro study examined differences in the chemoattractant capacity of HPV-positive and HPV-negative OPC cell lines. Gene and protein expression analysis demonstrated that whilst both monocultures of HPV-positive and HPV-negative cell lines, along with normal tonsillar fibroblasts (NTF), expressed low chemokine levels, NTF cultured with conditioned medium from HPV-negative OPC cells expressed significantly higher levels of all chemokines tested compared to NTF incubated with the medium from HPV-positive OPC cell lines. HPV-negative OPC lines expressed IL-1β mRNA whereas HPV-positive cells did not, and NTF constitutively expressed IL-1R1. Pre-treatment with the IL-R antagonist, anakinra or siRNA to IL-1R1 significantly reduced chemokine secretion from NTF stimulated with conditioned medium from HPV-negative tumour cells or recombinant IL-1β (p < 0.05). These data suggest that secretion of chemokines is driven by the interaction between HPV-negative OPC cells and stromal fibroblasts through an IL-1/IL-1R-mediated mechanism that is less prominent within the HPV-positive tumour microenvironment. These observations may explain differences in leukocyte sub-populations recruited to HPV-positive versus negative OPC and indicate that HPV status is a key determinant in controlling the inflammatory tumour microenvironment.
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Affiliation(s)
- Sarmad Al-Sahaf
- School of Clinical Dentistry, Claremont Crescent, University of Sheffield, United Kingdom
| | - Keith D Hunter
- School of Clinical Dentistry, Claremont Crescent, University of Sheffield, United Kingdom
| | - Robert Bolt
- School of Clinical Dentistry, Claremont Crescent, University of Sheffield, United Kingdom
| | - Penelope D Ottewell
- Department of Oncology & Metabolism, Medical School, Beech Hill Road, University of Sheffield, United Kingdom
| | - Craig Murdoch
- School of Clinical Dentistry, Claremont Crescent, University of Sheffield, United Kingdom
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33
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Dadar M, Chakraborty S, Dhama K, Prasad M, Khandia R, Hassan S, Munjal A, Tiwari R, Karthik K, Kumar D, Iqbal HMN, Chaicumpa W. Advances in Designing and Developing Vaccines, Drugs and Therapeutic Approaches to Counter Human Papilloma Virus. Front Immunol 2018; 9:2478. [PMID: 30483247 PMCID: PMC6240620 DOI: 10.3389/fimmu.2018.02478] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 10/08/2018] [Indexed: 02/05/2023] Open
Abstract
Human papillomavirus (HPV) is a viral infection with skin-to-skin based transmission mode. HPV annually caused over 500,000 cancer cases including cervical, anogenital and oropharyngeal cancer among others. HPV vaccination has become a public-health concern, worldwide, to prevent the cases of HPV infections including precancerous lesions, cervical cancers, and genital warts especially in adolescent female and male population by launching national programs with international alliances. Currently, available prophylactic and therapeutic vaccines are expensive to be used in developing countries for vaccination programs. The recent progress in immunotherapy, biotechnology, recombinant DNA technology and molecular biology along with alternative and complementary medicinal systems have paved novel ways and valuable opportunities to design and develop effective prophylactic and therapeutic vaccines, drugs and treatment approach to counter HPV effectively. Exploration and more researches on such advances could result in the gradual reduction in the incidences of HPV cases across the world. The present review presents a current global scenario and futuristic prospects of the advanced prophylactic and therapeutic approaches against HPV along with recent patents coverage of the progress and advances in drugs, vaccines and therapeutic regimens to effectively combat HPV infections and its cancerous conditions.
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Affiliation(s)
- Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization, Karaj, Iran
| | - Sandip Chakraborty
- Department of Veterinary Microbiology, College of Veterinary Sciences and Animal Husbandry, West Tripura, India
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Minakshi Prasad
- Department of Animal Biotechnology, LLR University of Veterinary and Animal Sciences, Hisar, India
| | - Rekha Khandia
- Department of Genetics, Barkatullah University, Bhopal, India
| | - Sameer Hassan
- Department of Biomedical Informatics, National Institute for Research in Tuberculosis, Indian Council of Medical Research, Chennai, India
| | - Ashok Munjal
- Department of Genetics, Barkatullah University, Bhopal, India
| | - Ruchi Tiwari
- Department of Veterinary Microbiology and Immunology, College of Veterinary Sciences, U P Pt. Deen Dayal Upadhayay Pashu Chikitsa Vigyan Vishwavidyalay Evum Go-Anusandhan Sansthan, Mathura, India
| | - Kumaragurubaran Karthik
- Central University Laboratory, Tamil Nadu Veterinary and Animal Sciences University, Chennai, India
| | - Deepak Kumar
- Division of Veterinary Biotechnology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Hafiz M. N. Iqbal
- Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey, Mexico
| | - Wanpen Chaicumpa
- Department of Parasitology, Center of Research Excellence on Therapeutic Proteins and Antibody Engineering, Faculty of Medicine SIriraj Hospital, Mahidol University, Bangkok, Thailand
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34
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Nyman PE, Buehler D, Lambert PF. Loss of Function of Canonical Notch Signaling Drives Head and Neck Carcinogenesis. Clin Cancer Res 2018; 24:6308-6318. [PMID: 30087145 DOI: 10.1158/1078-0432.ccr-17-3535] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 07/23/2018] [Accepted: 08/01/2018] [Indexed: 01/22/2023]
Abstract
PURPOSE Head and neck squamous cell carcinoma (HNSCC), a common cancer worldwide, is etiologically associated with tobacco use, high alcohol consumption, and high-risk human papillomaviruses (HPV). The Notch signaling pathway, which is involved in cell differentiation decisions with differential downstream targets and effects depending on tissue type and developmental stage, has been implicated in human HNSCC. NOTCH1 is among the most frequently mutated genes in both HPV-positive and HPV-negative HNSCC. These mutations are predicted to inactivate the function of Notch. Other studies have argued the opposite-Notch signaling is increased in HNSCC. EXPERIMENTAL DESIGN To assess the role of Notch signaling in HPV-positive and HPV-negative HNSCC, we utilized genetically engineered mouse (GEM) models for conventional keratinizing HNSCC, in which either HPV16 E6 and E7 oncoproteins or a gain-of-function mutant p53 are expressed, and in which we inactivated canonical Notch signaling via expression of a dominant negative form of MAML1 (DNMAML1), a required transcriptional coactivator of Notch signaling. RESULTS Loss of canonical Notch signaling increased tumorigenesis in both contexts and also caused an increase in nuclear β-catenin, a marker for increased tumorigenic potential. When combined with loss of canonical Notch signaling, HPV oncogenes led to the highest frequency of cancers overall and the largest number of poorly differentiated (high-grade) cancers. CONCLUSIONS These findings inform on the contribution of loss of canonical Notch signaling in head and neck carcinogenesis.
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Affiliation(s)
- Patrick E Nyman
- McArdle Laboratory for Cancer Research, University of Wisconsin School of Medicine and Public Health, Madison Wisconsin
| | - Darya Buehler
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison Wisconsin
| | - Paul F Lambert
- McArdle Laboratory for Cancer Research, University of Wisconsin School of Medicine and Public Health, Madison Wisconsin.
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35
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Kim YS, Jung YS, Kim BK, Kim EK. Oral Health of Korean Patients With Head and Neck Cancer. J Cancer Prev 2018; 23:77-81. [PMID: 30003067 PMCID: PMC6037211 DOI: 10.15430/jcp.2018.23.2.77] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 06/18/2018] [Accepted: 06/20/2018] [Indexed: 01/22/2023] Open
Abstract
Background Association between periodontitis and of head and neck carcinoma was suggested. In the present study, we evaluated the oral health status of patients with head and neck carcinoma and analyzed the relationship between cancer characteristics and oral health. Methods Oral health of 40 patients with head and neck carcinoma was examined. Decayed teeth, missing teeth, plaque index, gingival index, and probing depth were measured. Cancer type and site were recorded based on the patients' medical records. Results The average age of participants was 60.10 ± 8.99 years, and 35 of participants were male. The decay or missing teeth index was 5.43 ± 5.57, and the plaque index, gingival index, and probing depth were 1.37 ± 1.03, 1.57 ± 0.84, and 4.13 ± 1.45, respectively. These indexes showed no significant difference according to the type or site of cancer (P > 0.05). Conclusions This study showed that there was no correlation between oral health parameters and characteristics of head and neck carcinoma.
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Affiliation(s)
- Young-Seok Kim
- Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, Sangju, Korea
| | - Yun-Sook Jung
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Bo-Kyoung Kim
- Department of Dental Science, Yonsei University Graduate School, Seoul, Korea
| | - Eun-Kyong Kim
- Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, Sangju, Korea
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36
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LeHew CW, Weatherspoon DJ, Peterson CE, Goben A, Reitmajer K, Sroussi H, Kaste LM. The Health System and Policy Implications of Changing Epidemiology for Oral Cavity and Oropharyngeal Cancers in the United States From 1995 to 2016. Epidemiol Rev 2018; 39:132-147. [PMID: 28402398 DOI: 10.1093/epirev/mxw001] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 09/26/2016] [Indexed: 12/19/2022] Open
Abstract
Oral cavity and oropharyngeal cancers are typically grouped under the general term, "oral cancer." Yet, the incidence of oropharyngeal cancers is increasing in the United States, while the incidence of oral cavity cancers has declined. These 2 distinct but conflated groups of oral cancers are attributed to different risk factors. Incidence and survival trends were examined across US population groups and by anatomical subsite. Disparities in incidence and survival by sex, race/ethnicity, and subsite were identified. Risk factors are complex, interactive, and not fully identified. Cancer control research illustrates health disparities in access to care and patient outcomes. Database and supplemental searches yielded 433 articles published between 1995 and 2016 characterizing aspects of oral cancer epidemiology relating to incidence, survival, risk, disparities, and cancer control. Oral cavity cancer survival in black men remains the most intractable burden. Although understanding of oral cancer etiology is improving, application to policy is limited. Cancer control efforts are diverse, sporadic, limited in scope, and generally lacking in success, and they need stratification by oral cavity cancers/oropharyngeal cancers. Further intervention and epidemiologic research, improved workforce capacity, and integrated care delivery are identified as important directions for public health policy. Sustained, multilevel campaigns modeled on tobacco control success are suggested.
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37
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Chen X, Yan B, Lou H, Shen Z, Tong F, Zhai A, Wei L, Zhang F. Immunological network analysis in HPV associated head and neck squamous cancer and implications for disease prognosis. Mol Immunol 2018; 96:28-36. [PMID: 29477933 DOI: 10.1016/j.molimm.2018.02.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 01/28/2018] [Accepted: 02/02/2018] [Indexed: 01/06/2023]
Abstract
Human papillomavirus-positive (HPV+) head and neck squamous cell cancer (HNSCC) exhibits a better prognosis than HPV-negative (HPV-) HNSCC. This difference may in part be due to enhanced immune activation in the HPV+ HNSCC tumor microenvironment. To characterize differences in immune activation between HPV+ and HPV- HNSCC tumors, we identified and annotated differentially expressed genes based upon mRNA expression data from The Cancer Genome Atlas (TCGA). Immune network between immune cells and cytokines was constructed by using single sample Gene Set Enrichment Analysis and conditional mutual information. Multivariate Cox regression analysis was used to determine the prognostic value of immune microenvironment characterization. A total of 1673 differentially expressed genes were functionally annotated. We found that genes upregulated in HPV+ HNSCC are enriched in immune-associated processes. And the up-regulated gene sets were validated by Gene Set Enrichment Analysis. The microenvironment of HPV+ HNSCC exhibited greater numbers of infiltrating B and T cells and fewer neutrophils than HPV- HNSCC. These findings were validated by two independent datasets in the Gene Expression Omnibus (GEO) database. Further analyses of T cell subtypes revealed that cytotoxic T cell subtypes predominated in HPV+ HNSCC. In addition, the ratio of M1/M2 macrophages was much higher in HPV+ HNSCC. The infiltration of these immune cells was correlated with differentially expressed cytokine-associated genes. Enhanced infiltration of B cells and CD8+ T cells were identified as independent protective factors, while high neutrophil infiltration was a risk enhancing factor for HPV+ HNSCC patients. A schematic model of immunological network was established for HPV+ HNSCC to summarize our findings.
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Affiliation(s)
- Xiaohang Chen
- Department of Microbiology, Harbin Medical University, 157 Baojian Road, Harbin 150081, China
| | - Bingqing Yan
- Department of Microbiology, Harbin Medical University, 157 Baojian Road, Harbin 150081, China
| | - Huihuang Lou
- Department of Microbiology, Harbin Medical University, 157 Baojian Road, Harbin 150081, China
| | - Zhenji Shen
- Department of Microbiology, Harbin Medical University, 157 Baojian Road, Harbin 150081, China
| | - Fangjia Tong
- Department of Microbiology, Harbin Medical University, 157 Baojian Road, Harbin 150081, China
| | - Aixia Zhai
- Department of Microbiology, Harbin Medical University, 157 Baojian Road, Harbin 150081, China; Wu Lien-Teh Institute, Harbin Medical University, 157 Baojian Road, Harbin 150081, China
| | - Lanlan Wei
- Department of Microbiology, Harbin Medical University, 157 Baojian Road, Harbin 150081, China; Wu Lien-Teh Institute, Harbin Medical University, 157 Baojian Road, Harbin 150081, China.
| | - Fengmin Zhang
- Department of Microbiology, Harbin Medical University, 157 Baojian Road, Harbin 150081, China; Wu Lien-Teh Institute, Harbin Medical University, 157 Baojian Road, Harbin 150081, China.
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38
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Stangl S, Tontcheva N, Sievert W, Shevtsov M, Niu M, Schmid TE, Pigorsch S, Combs SE, Haller B, Balermpas P, Rödel F, Rödel C, Fokas E, Krause M, Linge A, Lohaus F, Baumann M, Tinhofer I, Budach V, Stuschke M, Grosu AL, Abdollahi A, Debus J, Belka C, Maihöfer C, Mönnich D, Zips D, Multhoff G. Heat shock protein 70 and tumor-infiltrating NK cells as prognostic indicators for patients with squamous cell carcinoma of the head and neck after radiochemotherapy: A multicentre retrospective study of the German Cancer Consortium Radiation Oncology Group (DKTK-ROG). Int J Cancer 2017; 142:1911-1925. [PMID: 29235112 PMCID: PMC5873418 DOI: 10.1002/ijc.31213] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 11/03/2017] [Accepted: 11/28/2017] [Indexed: 12/28/2022]
Abstract
Tumor cells frequently overexpress heat shock protein 70 (Hsp70) and present it on their cell surface, where it can be recognized by pre-activated NK cells. In our retrospective study the expression of Hsp70 was determined in relation to tumor-infiltrating CD56+ NK cells in formalin-fixed paraffin embedded (FFPE) tumor specimens of patients with SCCHN (N = 145) as potential indicators for survival and disease recurrence. All patients received radical surgery and postoperative cisplatin-based radiochemotherapy (RCT). In general, Hsp70 expression was stronger, but with variable intensities, in tumor compared to normal tissues. Patients with high Hsp70 expressing tumors (scores 3-4) showed significantly decreased overall survival (OS; p = 0.008), local progression-free survival (LPFS; p = 0.034) and distant metastases-free survival (DMFS; p = 0.044), compared to those with low Hsp70 expression (scores 0-2), which remained significant after adjustment for relevant prognostic variables. The adverse prognostic value of a high Hsp70 expression for OS was also observed in patient cohorts with p16- (p = 0.001), p53- (p = 0.0003) and HPV16 DNA-negative (p = 0.001) tumors. The absence or low numbers of tumor-infiltrating CD56+ NK cells also correlated with significantly decreased OS (p = 0.0001), LPFS (p = 0.0009) and DMFS (p = 0.0001). A high Hsp70 expression and low numbers of tumor-infiltrating NK cells have the highest negative predictive value (p = 0.00004). In summary, a strong Hsp70 expression and low numbers of tumor-infiltrating NK cells correlate with unfavorable outcome following surgery and RCT in patients with SCCHN, and thus serve as negative prognostic markers.
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Affiliation(s)
- Stefan Stangl
- Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany.,Department of Radiation Sciences (DRS), Helmholtz Zentrum Munich (HMGU), Institute of Innovative Radiotherapy (iRT), Munich, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Munich, Germany
| | | | - Wolfgang Sievert
- Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany.,Department of Radiation Sciences (DRS), Helmholtz Zentrum Munich (HMGU), Institute of Innovative Radiotherapy (iRT), Munich, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Munich, Germany
| | - Maxim Shevtsov
- Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany.,Department of Radiation Sciences (DRS), Helmholtz Zentrum Munich (HMGU), Institute of Innovative Radiotherapy (iRT), Munich, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Munich, Germany
| | - Minli Niu
- Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany
| | - Thomas E Schmid
- Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany.,Department of Radiation Sciences (DRS), Helmholtz Zentrum Munich (HMGU), Institute of Innovative Radiotherapy (iRT), Munich, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Munich, Germany
| | - Steffi Pigorsch
- Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany.,Department of Radiation Sciences (DRS), Helmholtz Zentrum Munich (HMGU), Institute of Innovative Radiotherapy (iRT), Munich, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Munich, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany.,Department of Radiation Sciences (DRS), Helmholtz Zentrum Munich (HMGU), Institute of Innovative Radiotherapy (iRT), Munich, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Munich, Germany
| | - Bernhard Haller
- Institute of Medical Informatics, Statistics and Epidemiology, Technische Universität München (TUM), Munich, Germany
| | - Panagiotis Balermpas
- Department of Radiotherapy and Oncology, Goethe University Frankfurt, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Frankfurt, Frankfurt, Germany
| | - Franz Rödel
- Department of Radiotherapy and Oncology, Goethe University Frankfurt, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Frankfurt, Frankfurt, Germany
| | - Claus Rödel
- Department of Radiotherapy and Oncology, Goethe University Frankfurt, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Frankfurt, Frankfurt, Germany
| | - Emmanouil Fokas
- Department of Radiotherapy and Oncology, Goethe University Frankfurt, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Frankfurt, Frankfurt, Germany
| | - Mechthild Krause
- OncoRay - National Centre for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Dresden, Germany.,Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiooncology, Berlin, Germany
| | - Annett Linge
- OncoRay - National Centre for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Dresden, Germany
| | - Fabian Lohaus
- OncoRay - National Centre for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Dresden, Germany
| | - Michael Baumann
- OncoRay - National Centre for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Dresden, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Heidelberg, Germany
| | - Inge Tinhofer
- Department of Radiooncology and Radiotherapy, Charite University Hospital Berlin, Berlin, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Berlin, Germany
| | - Volker Budach
- Department of Radiooncology and Radiotherapy, Charite University Hospital Berlin, Berlin, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Berlin, Germany
| | - Martin Stuschke
- Department of Radiotherapy, Medical Faculty, University of Duisburg-Essen, Essen, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Essen, Germany
| | - Anca-Ligia Grosu
- Department of Radiation Oncology, Medical Faculty, Medical Centre, University of Freiburg, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Freiburg, Germany
| | - Amir Abdollahi
- German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Heidelberg, Germany
| | - Jürgen Debus
- German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Heidelberg, Germany.,Department of Radiation Oncology, Heidelberg Ion Therapy Centre (HIT), Heidelberg Institute of Radiation Oncology (HIRO), University of Heidelberg Medical School, Heidelberg, Germany.,National Centre for Radiation Research Oncology (NCRO), University of Heidelberg Medical School, Heidelberg, Germany
| | - Claus Belka
- German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Munich, Germany.,National Centre for Radiation Research Oncology (NCRO), University of Heidelberg Medical School, Heidelberg, Germany.,Department of Radiation Oncology, University Hospital LMU Munich, Munich, Germany.,Clinical Cooperation Group (CCG) Personalized Radiotherapy in Head and Neck Cancer, Helmholtz Zentrum, Munich, Germany
| | - Cornelius Maihöfer
- German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Munich, Germany.,National Centre for Radiation Research Oncology (NCRO), University of Heidelberg Medical School, Heidelberg, Germany.,Department of Radiation Oncology, University Hospital LMU Munich, Munich, Germany.,Clinical Cooperation Group (CCG) Personalized Radiotherapy in Head and Neck Cancer, Helmholtz Zentrum, Munich, Germany
| | - David Mönnich
- Department of Radiation Oncology, Faculty of Medicine and University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany.,DKTK Consortium Tübingen, Tübingen, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Tübingen, Germany
| | - Daniel Zips
- Department of Radiation Oncology, Faculty of Medicine and University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany.,DKTK Consortium Tübingen, Tübingen, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Tübingen, Germany
| | - Gabriele Multhoff
- Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany.,Department of Radiation Sciences (DRS), Helmholtz Zentrum Munich (HMGU), Institute of Innovative Radiotherapy (iRT), Munich, Germany.,German Cancer Research Centre (DKFZ), Heidelberg and German Research Consortium (DKTK), Munich, Germany
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39
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Karabajakian A, Reverdy T, Gau M, Fayette J. Nivolumab in recurrent/metastatic head and neck cancers. Future Oncol 2017; 14:603-609. [PMID: 29130342 DOI: 10.2217/fon-2017-0440] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Head and neck cancer is an immunosuppressive disease, with a high proportion expressing PD-L1. Until recently, options were lacking in second line. Prognosis is poor especially for patients who progress during chemotherapy with survival often inferior to 6 months. Nivolumab is the only anti-PD-1 agent to prolong survival in the second-line setting and is now the standard option since the CheckMate-141 trial. Treatment is generally well tolerated, patients seem to have a better quality of life when compared with chemotherapy. Markers of efficacy are lacking even if some data are emerging. Different combinations of immunotherapy are ongoing. Hyperprogression is a phenomenon associated with poor outcome and might be the consequence of anti-PD-1 treatment but this is yet to be proven.
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Affiliation(s)
- Andy Karabajakian
- Centre de Lutte Contre le Cancer Léon Bérard, Lyon-I University, Lyon, France
| | - Thibaut Reverdy
- Centre de Lutte Contre le Cancer Léon Bérard, Lyon-I University, Lyon, France
| | - Max Gau
- Centre de Lutte Contre le Cancer Léon Bérard, Lyon-I University, Lyon, France
| | - Jérôme Fayette
- Centre de Lutte Contre le Cancer Léon Bérard, Lyon-I University, Lyon, France
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40
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Razzaghi H, Saraiya M, Thompson TD, Henley SJ, Viens L, Wilson R. Five-year relative survival for human papillomavirus-associated cancer sites. Cancer 2017; 124:203-211. [PMID: 29105738 DOI: 10.1002/cncr.30947] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 04/21/2017] [Accepted: 04/28/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) vaccines can potentially prevent greater than 90% of cervical and anal cancers as well as a substantial proportion of vulvar, vaginal, penile, and oropharyngeal cancers caused by certain HPV types. Because more than 38,000 HPV-associated cancers are diagnosed annually in the United States, current studies are needed to understand how relative survival varies for each of these cancers by certain demographic characteristics, such as race and age. METHODS The authors examined high-quality data from 27 population-based cancer registries covering approximately 59% of the US population. The analyses were limited to invasive cancers that were diagnosed during 2001 through 2011 and followed through 2011 and met specified histologic criteria for HPV-associated cancers. Five-year relative survival was calculated from diagnosis until death for these cancers by age, race, and sex. RESULTS The 5-year age-standardized relative survival rate was 64.2% for cervical carcinomas, 52.8% for vaginal squamous cell carcinomas (SCCs), 66% for vulvar SCCs, 47.4% for penile SCCs, 65.9% for anal SCCs, 56.2% for rectal SCCs, and 51.2% for oropharyngeal SCCs. Five-year relative survival was consistently higher among white patients compared with black patients for all HPV-associated cancers across all age groups; the greatest differences by race were observed for oropharyngeal SCCs among those aged <60 years and for penile SCCs among those ages 40 to 49 years compared with other age groups. CONCLUSIONS There are large disparities in relative survival among patients with HPV-associated cancers by sex, race, and age. HPV vaccination and improved access to screening (of cancers for which screening tests are available) and treatment, especially among groups that experience higher incidence and lower survival, may reduce disparities in survival from HPV-associated cancers. Cancer 2018;124:203-211. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
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Affiliation(s)
- Hilda Razzaghi
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service Program, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mona Saraiya
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Trevor D Thompson
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - S Jane Henley
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Laura Viens
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Reda Wilson
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Lu Z, Zhang H, Tao Y, Li X, Li G. MDM4 genetic variants predict HPV16-positive tumors of patients with squamous cell carcinoma of the oropharynx. Oncotarget 2017; 8:86710-86717. [PMID: 29156829 PMCID: PMC5689719 DOI: 10.18632/oncotarget.21414] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 08/30/2017] [Indexed: 11/25/2022] Open
Abstract
The increasing incidence of squamous cell carcinoma of the oropharynx (SCCOP) is majorly attributed to the human papillomavirus (HPV) infection. Both HPV and MDM4 play a critical role in inhibition of p53 activity, thus affecting HPV tumor status of SCCOP. Three polymorphisms in MDM4 were genotyped from blood genomic DNA samples and HPV16 status in tumor specimens was examined. Odds ratio (OR) and 95% confidence intervals (CIs) in univariate and multivariable logistic regression models were calculated for the associations between these polymorphisms and HPV16 status. Three MDM4 variant genotypes were significantly associated with HPV16 tumor status among SCCOP patients compared with the common homozygous genotypes (OR, 0.6; 95% CI, 0.4–1.0 for rs10900598; OR, 1.6, 95% CI; 1.1–2.4 for rs1380576; and OR, 1.8, 95% CI, 1.1–2.9 for rs11801299; respectively). When we combined all risk genotypes of the 3 polymorphisms, the patients carrying 1-3 MDM4 risk genotypes were approximately 2.5 time as likely to have an HPV16-positive tumor than those with no risk genotypes (OR, 2.5, 95% CI, 1.6–3.9). Additionally, modifying effect of MDM4 risk genotypes was more pronounced among non-Hispanic white, never-smokers, and never-drinkers. Potential functional polymorphisms in MDM4 may serve as biomarkers for predicting tumor HPV16 status among SCCOP patients, particularly in non-Hispanic white, never-smokers and never-drinkers. However, validation of these results in larger studies is needed.
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Affiliation(s)
- Zhongming Lu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China.,Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.,Department of Otolaryngology-Head and Neck Surgery, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, China
| | - Hua Zhang
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.,Department of Otolaryngology-Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 264000, China
| | - Ye Tao
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.,Department of Otolaryngology-Head and Neck Surgery, The 2nd Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
| | - Xiangping Li
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Guojun Li
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.,Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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42
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Skillington SA, Kallogjeri D, Lewis JS, Piccirillo JF. Prognostic Importance of Comorbidity and the Association Between Comorbidity and p16 in Oropharyngeal Squamous Cell Carcinoma. JAMA Otolaryngol Head Neck Surg 2017; 142:568-75. [PMID: 27077485 DOI: 10.1001/jamaoto.2016.0347] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
IMPORTANCE Comorbidity affects the prognosis of patients with cancer through the direct effects of the comorbid illness and by influencing the patients' ability to tolerate treatment and mount a host response. However, the prognostic importance of comorbidity in oropharyngeal squamous cell carcinoma is not well characterized in the era of human papillomavirus infection. OBJECTIVE To determine the prognostic importance of comorbidity in both p16-positive and p16-negative oropharyngeal squamous cell carcinoma and to explore the relationship between comorbidity and p16. DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort study of 305 patients at a single tertiary referral center diagnosed as having oropharyngeal squamous cell carcinoma between June 1996 and June 2010, but without a history of head and neck cancer or distant metastasis at time of diagnosis. The data were analyzed from August 1, 2014, through April 30, 2015. EXPOSURES Patients were grouped according to p16 status. MAIN OUTCOMES AND MEASURES Overall survival, defined as the time from diagnosis to death from any cause. Disease-free survival, defined as the time from diagnosis to either death from any cause or the first documented local, regional, or distant recurrence. RESULTS Of the 305 patients who met eligibility criteria, 230 were p16-positive, 70 were p16-negative, and 5 were not evaluable for p16 status. The final cohort of 300 patients had a mean (SD) age of 56.3 (9.3) years and 262 (87%) were male. In Kaplan-Meier analysis, the 5-year overall survival rates were 71% (95% CI, 65%-76%) for 232 patients with no comorbidity to mild comorbidity and 49% (95% CI, 36%-61%) for 63 patients with moderate to severe comorbidity. In multivariate Cox proportional hazards analysis, moderate to severe comorbidity was associated with an increased risk of death from any cause (adjusted hazards ratio [aHR], 1.52 [95% CI, 0.99-2.32]) and increased risk of death or recurrence (aHR, 1.71 [95% CI, 1.13-2.59]). After stratifying by p16 status and controlling for other variables, moderate to severe comorbidity was significantly associated with increased risk of death from any cause among p16-negative patients (aHR, 1.90 [95% CI, 1.03-3.50]) but not among p16-positive patients (aHR, 1.11 [95% CI, 0.61-2.02]). CONCLUSIONS AND RELEVANCE Comorbidity is important to consider when assessing the prognosis of patients with oropharyngeal squamous cell carcinoma and is of greater prognostic value in p16-negative than p16-positive cancer.
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Affiliation(s)
- S Andrew Skillington
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Dorina Kallogjeri
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - James S Lewis
- Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, Missouri3Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jay F Piccirillo
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri4Editor, JAMA Otolaryngology-Head & Neck Surgery
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Skillington SA, Kallogjeri D, Lewis JS, Piccirillo JF. The Role of Adjuvant Chemotherapy in Surgically Managed, p16-Positive Oropharyngeal Squamous Cell Carcinoma. JAMA Otolaryngol Head Neck Surg 2017; 143:253-259. [PMID: 27918781 DOI: 10.1001/jamaoto.2016.3353] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Importance Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) has a favorable prognosis, and p16 immunohistochemistry is a surrogate marker of high-risk HPV infection and strong prognosticator. Given this favorable prognosis, treatment de-escalation for p16-positive OPSCC is now being considered with the goal of decreasing treatment-associated morbidity without compromising tumor control. The role of adjuvant chemotherapy in this setting is becoming increasingly unclear. Objective To compare survival between surgically managed patients with p16-positive OPSCC who received adjuvant chemoradiotherapy and patients who received adjuvant radiotherapy alone. Design, Setting, and Participants This was a cohort study of patients with OPSCC diagnosed from June 1996 to June 2010, with follow-up through December 2014, at a single tertiary referral center. One hundred ninety-five surgically managed, p16-positive patients without a history of head and neck cancer or distant metastasis at time of diagnosis were included. Exposures Patients were dichotomized into adjuvant radiotherapy and adjuvant chemoradiotherapy groups. Main Outcomes and Measures Overall survival was the primary outcome, and disease-free survival was the secondary outcome. Propensity-weighted multivariate Cox proportional hazards analysis was conducted to quantify the effect of adjuvant chemotherapy on survival. Results The study included 195 patients with p16-positive, surgically managed OPSCC. Median duration of follow-up was 87 months (interquartile range, 68-116 months). Ninety patients received adjunct chemoradiotherapy (mean age, 54.3 years), 88 patients received adjuvant radiotherapy (mean age, 56.4 years), and 17 patients received surgery alone. The 5-year overall survival rate for patients who received adjuvant chemoradiotherapy was 82% (95% CI, 73%-90%) and 84% (95% CI, 76%-91%) for patients who received adjuvant radiotherapy alone. The 5-year disease-free survival rate for patients who received adjuvant chemoradiotherapy was 79% (95% CI, 71%-88%) and 79% (95% CI, 70%-88%) for patients who received radiotherapy alone. After weighting cases by the inverse probability of receiving adjuvant chemotherapy and controlling for age, comorbidity, smoking, pathological T stage, and pathological N stage, the receipt of adjuvant chemotherapy was not significantly associated with disease-free survival (adjusted hazard ratio, 0.91; 95% CI, 0.59-1.42) but was associated with a statistically insignificant yet clinically meaningful increase in all-cause mortality (adjusted hazard ratio, 1.46; 95% CI, 0.91-2.33). Conclusions and Relevance Among patients with p16-positive OPSCC managed surgically with adjuvant radiotherapy, the addition of adjuvant chemotherapy provided no additional disease-free survival benefit and was associated with worse overall survival. These results should help inform future clinical trials aiming to deescalate treatment for p16-positive patients.
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Affiliation(s)
- S Andrew Skillington
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Dorina Kallogjeri
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - James S Lewis
- Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, Missouri3Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jay F Piccirillo
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri4Editor, JAMA Otolaryngology-Head & Neck Surgery, Chicago, Illinois
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44
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Tsuchida K, Sugai T, Uesugi N, Ishida K, Matsuura K, Sato I, Shiga K, Sato H. Expression of cell cycle-related proteins in oropharyngeal squamous cell carcinoma based on human papilloma virus status. Oncol Rep 2017. [PMID: 28627689 DOI: 10.3892/or.2017.5720] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The molecular association between human papilloma virus (HPV) and cell cycle-related (CCR) proteins is not fully understood in oropharyngeal squamous cell carcinoma (OPSCC). Herein, we examined the expression levels of CCRs in OPSCCs based on HPV status. In situ hybridization (ISH)- and polymerase chain reaction (PCR)-based assays were used to detect HPV status in 98 OPSCCs, and CCRs were detected by immunostaining. Of 98 tumors, 47 had HPV-positive tumors by either ISH- or PCR-based assays. Concordance analysis between ISH- and PCR-based tests showed a good agreement in OPSCC. Expression of p16 was moderate, consistent with HPV positivity as determined by ISH-based analysis. High p53-, phospho (p)-Rb-, SKP2-, cyclin D1-, and p-c-myc-positive rates were correlated with HPV-negative tumors, whereas high p16- and p27-positive rates were associated with HPV-positive tumors. The positive rates for p21 and cyclin A did not differ between HPV-positive and HPV-negative tumors. Finally, Ki-67 positivity was commonly observed for both types of OPSCCs. Although expression of p16 is thought to be a marker of HPV infection, ISH- or PCR-based tests should be used for HPV detection. In addition, our results regarding CCRs may be helpful for understanding the carcinogenesis of OPSCC.
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Affiliation(s)
- Koudai Tsuchida
- Department of Molecular Diagnostic Pathology, School of Medicine, Iwate Medical University, Morioka, Iwate 020-8505, Japan
| | - Tamotsu Sugai
- Department of Molecular Diagnostic Pathology, School of Medicine, Iwate Medical University, Morioka, Iwate 020-8505, Japan
| | - Noriyuki Uesugi
- Department of Molecular Diagnostic Pathology, School of Medicine, Iwate Medical University, Morioka, Iwate 020-8505, Japan
| | - Kazuyuki Ishida
- Department of Molecular Diagnostic Pathology, School of Medicine, Iwate Medical University, Morioka, Iwate 020-8505, Japan
| | - Kazuto Matsuura
- Department of Head and Neck Surgery, Miyagi Cancer Center, Natori, Miyagi 981-1293, Japan
| | - Ikuro Sato
- Department of Pathology, Miyagi Cancer Center, Natori, Miyagi 981-1293, Japan
| | - Kiyoto Shiga
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Iwate Medical University, Morioka, Iwate 020-8505, Japan
| | - Hiroaki Sato
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Iwate Medical University, Morioka, Iwate 020-8505, Japan
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45
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Yan L, Mingxin C, Jiashun W, Xiaolei G, Xinhua L. [Analysis of the current status of research on human papillomavirus-associated head and neck cancers based on recent Chinese literature]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2017; 35:301-310. [PMID: 28675017 PMCID: PMC7030435 DOI: 10.7518/hxkq.2017.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 12/29/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To analyze the current status of research on human papillomavirus (HPV)-associated head and neck cancers in China using national and international references. METHODS We searched for bibliographies in the electronic databases of Sichuan University, including Chinese Biological and Medical Database (CBM), China Science and Technology Journal Database (VIP), and Wanfang Journal Database. Then, data was selected and extracted to analyze the basic characteristics of HPV-related head and neck cancers, the general prevalence of HPV, and the effects of various clinic pathological indicators on HPV patients. RESULTS The general prevalence of HPV was 34.05% among civil patients with head and neck cancers. Our analysis of different clinical and pathological indices that affect HPV-associated oral squamous cell carcinomas revealed that non-smoking and non-drinking groups had higher HPV infection rates compared with smoking (P=0.002) and drinking (P<
0.005) groups. In addition, N2-N3 stage patients had higher detectable rates than N0-N1 stage patients (P=0.027). CONCLUSIONS The majority of civil research studies on HPV-associated head and neck cancers are concentrated on clinical studies. Thus, the molecular neuropathology and signaling pathway of HPV should be further explored in the future to advance prognostic methods. Moreover, the perspective view of therapeutic vaccines and molecular-targeting treatments should receive close attention.
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Affiliation(s)
- Liu Yan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Cao Mingxin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Wu Jiashun
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Gao Xiaolei
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Liang Xinhua
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Swick AD, Prabakaran PJ, Miller MC, Javaid AM, Fisher MM, Sampene E, Ong IM, Hu R, Iida M, Nickel KP, Bruce JY, Wheeler DL, Kimple RJ. Cotargeting mTORC and EGFR Signaling as a Therapeutic Strategy in HNSCC. Mol Cancer Ther 2017; 16:1257-1268. [PMID: 28446642 DOI: 10.1158/1535-7163.mct-17-0115] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 04/06/2017] [Accepted: 04/17/2017] [Indexed: 12/11/2022]
Abstract
Head and neck squamous cell carcinomas (HNSCC) are frequently altered along the PI3K/AKT/mTORC signaling axis. Despite excellent preclinical data, the use of compounds targeting this pathway as monotherapy has been underwhelming in initial clinical trials, and identification of predictive biomarkers remains challenging. To investigate mTORC-specific inhibition, we tested catalytic mTORC (AZD8055) and PI3K/mTORC (NVP-BEZ-235) inhibitors ± cetuximab in a panel of HNSCC cell lines and patient-derived xenografts (PDX). Cell lines were assayed for response to all agents and siRNA knockdown of targets by multiple approaches. All cell lines showed similar response to both drug and siRNA inhibition of both PI3K and mTORC pathways, with anti-EGFR combination producing modest additive effect. Five PDX models that presented PIK3CA mutation or intrinsic cetuximab resistance were treated with a combination of cetuximab and AZD8055. In vivo single-agent mTORC inhibition inhibited growth of one PIK3CA-mutant cancer, but had little effect on any PIK3CAWT or a second PIK3CA-mutant model. In all models, the combination therapy showed greater growth delay than monotherapy. The uniform ability of PI3K and mTORC inhibition to suppress the growth of HNSCC cells highlights the pathway's role in driving proliferation. Although single-agent therapy was largely ineffective in vivo, improved response of combination treatment in an array of PDXs suggests the potential for adding a catalytic mTORC inhibitor to cetuximab therapy. Overall, these results add to a growing body of evidence, suggesting that approaches that attempt to match biomarkers to the optimal therapy in HNSCC remain complex and challenging. Mol Cancer Ther; 16(7); 1257-68. ©2017 AACR.
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Affiliation(s)
- Adam D Swick
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Prashanth J Prabakaran
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Margot C Miller
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Amal M Javaid
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Michael M Fisher
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Emmanuel Sampene
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Irene M Ong
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.,University of Wisconsin Carbone Cancer Center, Madison, Wisconsin
| | - Rong Hu
- Department of Pathology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Mari Iida
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Kwangok P Nickel
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Justine Y Bruce
- University of Wisconsin Carbone Cancer Center, Madison, Wisconsin.,Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Deric L Wheeler
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.,University of Wisconsin Carbone Cancer Center, Madison, Wisconsin
| | - Randall J Kimple
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. .,University of Wisconsin Carbone Cancer Center, Madison, Wisconsin
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Blasco MA, Svider PF, Tenbrunsel T, Vellaichamy G, Yoo GH, Fribley AM, Raza SN. Recent trends in oropharyngeal cancer funding and public interest. Laryngoscope 2017; 127:1345-1350. [PMID: 28397339 DOI: 10.1002/lary.26471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 10/12/2016] [Accepted: 11/17/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS The incidence of oropharyngeal cancer (OPC) has increased in the United States. This has been driven by an increase in human papillomavirus (HPV)-positive OPC. Our objective is to determine trends in National Institutes (NIH)-supported research funding and public interest in OPC. METHODS The NIH Research Portfolio Online Reporting Tools database was evaluated for projects related to OPC between 2004 and 2015. Projects were evaluated for total funding, relation to HPV, principal investigator departmental affiliation and degree, and NIH agency or center responsible for grant. The Google Trends database was evaluated for relative Internet search popularity of oropharyngeal cancer and related search terms between 2004 and 2015. RESULTS In terms of NIH funding, 100 OPC-related projects representing 242 grant years and $108.5 million were funded between 2004 and 2015. Total NIH funding for OPC projects increased from $167,406 in 2004 to $16.2 million in 2015. Funding for HPV-related OPC increased from less than $2 million yearly between 2004 and 2010 up to $12.7 million in 2015. Principal investigators related to radiation oncology ($41.8 million) and with doctor of medicine degrees ($52.8 million) received the largest share of total funding. Relative Internet search popularity for oropharyngeal cancer has increased from 2004 to 2015 compared to control cancer search terms. CONCLUSION Increased public interest and NIH funding has paralleled the rising incidence of OPC. NIH funding has been driven by projects related to the role of HPV in OPC. LEVEL OF EVIDENCE 2c. Laryngoscope, 127:1345-1350, 2017.
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Affiliation(s)
- Michael A Blasco
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A
| | - Peter F Svider
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A
| | - Troy Tenbrunsel
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A
| | - Gautham Vellaichamy
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A
| | - George H Yoo
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A.,Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, U.S.A
| | - Andrew M Fribley
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A.,Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan, U.S.A.,Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, U.S.A.,Molecular Therapeutics Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, U.S.A
| | - S Naweed Raza
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A.,Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, U.S.A
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Smith EA, Kumar B, Komurov K, Smith SM, Brown NV, Zhao S, Kumar P, Teknos TN, Wells SI. DEK associates with tumor stage and outcome in HPV16 positive oropharyngeal squamous cell carcinoma. Oncotarget 2017; 8:23414-23426. [PMID: 28423581 PMCID: PMC5410314 DOI: 10.18632/oncotarget.15582] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 02/12/2017] [Indexed: 01/25/2023] Open
Abstract
Oropharyngeal squamous cell carcinomas (OPSCC) are common, have poor outcomes, and comprise two biologically and clinically distinct diseases. While OPSCC that arise from human papillomavirus infections (HPV+) have better overall survival than their HPV- counterparts, the incidence of HPV+ OPSCC is increasing dramatically, affecting younger individuals which are often left with life-long co-morbidities from aggressive treatment. To identify patients which do poorly versus those who might benefit from milder regimens, risk-stratifying biomarkers are now needed within this population. One potential marker is the DEK oncoprotein, whose transcriptional upregulation in most malignancies is associated with chemotherapy resistance, advanced tumor stage, and worse outcomes. Herein, a retrospective case study was performed on DEK protein expression in therapy-naïve surgical resections from 194 OPSCC patients. We found that DEK was associated with advanced tumor stage, increased hazard of death, and interleukin IL6 expression in HPV16+ disease. Surprisingly, DEK levels in HPV16- OPSCC were not associated with advanced tumor stage or increased hazard of death. Overall, these findings mark HPV16- OPSCC as an exceptional malignancy were DEK expression does not correlate with outcome, and support the potential prognostic utility of DEK to identify aggressive HPV16+ disease.
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Affiliation(s)
- Eric A. Smith
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA
| | - Bhavna Kumar
- Department of Otolaryngology–Head and Neck Surgery, The Ohio State University, Columbus, OH, 43210, USA
- The Ohio State University, Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Kakajan Komurov
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA
| | - Stephen M. Smith
- Department of Pathology, The Ohio State University, Columbus, OH, 43210, USA
| | - Nicole V. Brown
- Center for Biostatistics, The Ohio State University, Columbus, OH, 43210, USA
| | - Songzhu Zhao
- Center for Biostatistics, The Ohio State University, Columbus, OH, 43210, USA
| | - Pawan Kumar
- Department of Otolaryngology–Head and Neck Surgery, The Ohio State University, Columbus, OH, 43210, USA
- The Ohio State University, Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Theodoros N. Teknos
- Department of Otolaryngology–Head and Neck Surgery, The Ohio State University, Columbus, OH, 43210, USA
- The Ohio State University, Comprehensive Cancer Center, Columbus, OH 43210, USA
| | - Susanne I. Wells
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA
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49
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Westrich JA, Warren CJ, Pyeon D. Evasion of host immune defenses by human papillomavirus. Virus Res 2017; 231:21-33. [PMID: 27890631 PMCID: PMC5325784 DOI: 10.1016/j.virusres.2016.11.023] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 11/10/2016] [Accepted: 11/12/2016] [Indexed: 12/13/2022]
Abstract
A majority of human papillomavirus (HPV) infections are asymptomatic and self-resolving in the absence of medical interventions. Various innate and adaptive immune responses, as well as physical barriers, have been implicated in controlling early HPV infections. However, if HPV overcomes these host immune defenses and establishes persistence in basal keratinocytes, it becomes very difficult for the host to eliminate the infection. The HPV oncoproteins E5, E6, and E7 are important in regulating host immune responses. These oncoproteins dysregulate gene expression, protein-protein interactions, posttranslational modifications, and cellular trafficking of critical host immune modulators. In addition to the HPV oncoproteins, sequence variation and dinucleotide depletion in papillomavirus genomes has been suggested as an alternative strategy for evasion of host immune defenses. Since anti-HPV host immune responses are also considered to be important for antitumor immunity, immune dysregulation by HPV during virus persistence may contribute to immune suppression essential for HPV-associated cancer progression. Here, we discuss cellular pathways dysregulated by HPV that allow the virus to evade various host immune defenses.
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Affiliation(s)
- Joseph A Westrich
- Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Cody J Warren
- Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, CO 80045, USA; Current address: BioFrontiers Institute, University of Colorado Boulder, Boulder, CO 80303, USA
| | - Dohun Pyeon
- Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, CO 80045, USA; Department of Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA.
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50
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Ragin C, Liu JC, Jones G, Shoyele O, Sowunmi B, Kennett R, Groen HJM, Gibbs D, Blackman E, Esan M, Brandwein MS, Devarajan K, Bussu F, Chernock R, Chien CY, Cohen MA, Samir EM, Mikio S, D'Souza G, Funchain P, Eng C, Gollin SM, Hong A, Jung YS, Krüger M, Lewis J, Morbini P, Landolfo S, Rittà M, Straetmans J, Szarka K, Tachezy R, Worden FP, Nelson D, Gathere S, Taioli E. Prevalence of HPV Infection in Racial-Ethnic Subgroups of Head and Neck Cancer Patients. Carcinogenesis 2016; 38:218-229. [PMID: 28025390 DOI: 10.1093/carcin/bgw203] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Indexed: 12/13/2022] Open
Abstract
The landscape of HPV infection in racial/ethnic subgroups of head and neck cancer (HNC) patients has not been evaluated carefully. In this study, a meta-analysis examined the prevalence of HPV in HNC patients of African ancestry. Additionally, a pooled analysis of subject-level data was also performed to investigate HPV prevalence and patterns of p16 (CDNK2A) expression amongst different racial groups. Eighteen publications (N = 798 Black HNC patients) were examined in the meta-analysis, and the pooled analysis included 29 datasets comprised of 3,129 HNC patients of diverse racial/ethnic background. The meta-analysis revealed that the prevalence of HPV16 was higher among Blacks with oropharyngeal cancer than Blacks with non-oropharyngeal cancer. However, there was great heterogeneity observed among studies (Q test P<0.0001). In the pooled analysis, after adjusting for each study, year of diagnosis, age, gender and smoking status, the prevalence of HPV16/18 in oropharyngeal cancer patients was highest in Whites (61.1%), followed by 58.0% in Blacks and 25.2% in Asians (P<0.0001). There was no statistically significant difference in HPV16/18 prevalence in non-oropharyngeal cancer by race (P=0.682). With regard to the pattern of HPV16/18 status and p16 expression, White patients had the highest proportion of HPV16/18+/p16+ oropharyngeal cancer (52.3%), while Asians and Blacks had significantly lower proportions (23.0% and 22.6%, respectively) [P <0.0001]. Our findings suggest that the pattern of HPV16/18 status and p16 expression in oropharyngeal cancer appears to differ by race and this may contribute to survival disparities.
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Affiliation(s)
- Camille Ragin
- Cancer Prevention and Control Program, Fox Chase Cancer Center - Temple Health, Philadelphia, PA, USA
- Department of Epidemiology & Biostatistics, Temple University, College of Public Health, Philadelphia, PA, USA
| | - Jeffrey C Liu
- Department of Otolaryngology, Temple University; and Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Gieira Jones
- Department of Epidemiology & Biostatistics, Temple University, College of Public Health, Philadelphia, PA, USA
| | - Olubunmi Shoyele
- Department of Pathology and Laboratory Medicine, Western Connecticut Health Network, Danbury Hospital, Danbury, CT, USA
| | - Bukola Sowunmi
- Cancer Prevention and Control Program, Fox Chase Cancer Center - Temple Health, Philadelphia, PA, USA
| | - Rachel Kennett
- Cancer Prevention and Control Program, Fox Chase Cancer Center - Temple Health, Philadelphia, PA, USA
| | - Harry J M Groen
- Department of Epidemiology & Biostatistics, Temple University, College of Public Health, Philadelphia, PA, USA
| | - Denise Gibbs
- Cancer Prevention and Control Program, Fox Chase Cancer Center - Temple Health, Philadelphia, PA, USA
| | - Elizabeth Blackman
- Cancer Prevention and Control Program, Fox Chase Cancer Center - Temple Health, Philadelphia, PA, USA
- Department of Epidemiology & Biostatistics, Temple University, College of Public Health, Philadelphia, PA, USA
| | - Michael Esan
- Cancer Prevention and Control Program, Fox Chase Cancer Center - Temple Health, Philadelphia, PA, USA
| | - Margaret S Brandwein
- Department of Pathology and Anatomical Sciences, SUNY at the University at Buffalo, Buffalo, NY, USA
| | - Karthik Devarajan
- Department of Biostatistics, Fox Chase Cancer Center - Temple Health, Philadelphia, PA, USA
| | - Francesco Bussu
- Institute of Otolaryngology, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Rome, Italy
| | - Rebecca Chernock
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO, USA
| | - Chih-Yen Chien
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Marc A Cohen
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - El-Mofty Samir
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO, USA
| | - Suzuki Mikio
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Gypsyamber D'Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Pauline Funchain
- Genomic Medicine Institute, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA
| | - Charis Eng
- Genomic Medicine Institute, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA
| | - Susanne M Gollin
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA USA
| | - Angela Hong
- Central Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Yuh-S Jung
- Department of Otolaryngology, Research Institute and Hospital, National Cancer Center, Gyeonggi-do, Korea
| | - Maximilian Krüger
- Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - James Lewis
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, 37232, USA
| | - Patrizia Morbini
- Department of Molecular Medicine, Unit of Pathology, University of Pavia, and à IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
| | - Santo Landolfo
- Department of Sciences of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Massimo Rittà
- Department of Sciences of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Jos Straetmans
- Department of Otorhinolaryngology-Head and Neck Surgery, GROW Institute, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Krisztina Szarka
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Hungary
| | - Ruth Tachezy
- Department of Immunology, Institute of Hematology and Blood Transfusion National Reference Laboratory for Papillomaviruses, Prague, Czech Republic
| | - Francis P Worden
- Department of Internal Medicine, Division of Hematology-Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Deborah Nelson
- Department of Epidemiology & Biostatistics, Temple University, College of Public Health, Philadelphia, PA, USA
| | - Samuel Gathere
- Non Communicable Diseases Research Programme, Kenya Medical Research Institute, Nairobi, Kenya
| | - Emanuela Taioli
- Departments of Population Health Science and Policy, of Thoracic Surgery, and Institute For Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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