Head and Neck Pathology, Год журнала: 2022, Номер 16(4), С. 1251 - 1256
Опубликована: Июнь 30, 2022
Язык: Английский
The Lancet Oncology, Год журнала: 2023, Номер 24(3), С. 239 - 251
Опубликована: Фев. 13, 2023
Язык: Английский
Процитировано
159
Diagnostics, Год журнала: 2024, Номер 14(13), С. 1448 - 1448
Опубликована: Июль 7, 2024
Head and neck cancer (HNC) represents a significant global health challenge, with squamous cell carcinomas (SCCs) accounting for approximately 90% of all HNC cases. These malignancies, collectively referred to as head carcinoma (HNSCC), originate from the mucosal epithelium lining larynx, pharynx, oral cavity. The primary risk factors associated HNSCC in economically disadvantaged nations have been chronic alcohol consumption tobacco use. However, more affluent countries, landscape has shifted identification human papillomavirus (HPV) infection, particularly HPV-16, major factor, especially among nonsmokers. Understanding evolving distinct biological behaviors HPV-positive HPV-negative is critical developing targeted treatment strategies improving patient outcomes this complex diverse group cancers. Accurate diagnosis essential comprehensive model that integrates molecular characteristics, immune microenvironment, clinical outcomes. aim review was summarize current knowledge advances DNA, RNA, protein biomarkers bodily fluids tissues introduced new possibilities minimally or non-invasive diagnosis, monitoring, assessment therapeutic responses.
Язык: Английский
Процитировано
12
Tumour Virus Research, Год журнала: 2022, Номер 14, С. 200245 - 200245
Опубликована: Авг. 14, 2022
Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide with an increasing trend of its incidence. Alcohol consumption, smoking, viral infections, such as mucosal high-risk (HR) human papillomaviruses (HPVs) are major risk factors for HNSCC development. In particular, HR HPVs mainly associated a subset oropharyngeal (OPSCC), while other head sites marginally affected by HPV infection. HPV16 frequently type HNSCC. contrast to cervix, no screening programs or identifiable pre-malignant lesions have been characterized HPV-related Therefore, identification general diagnostic algorithms biomarkers that could facilitate early diagnosis, disease evolution recurrence HPV-driven HNSCCs urgently needed. We herein review role in focus on epidemiology, biology, applied available body fluids tools HNSCCs.
Язык: Английский
Процитировано
35
Oncogene, Год журнала: 2023, Номер 42(40), С. 2939 - 2955
Опубликована: Сен. 4, 2023
Abstract The incidence of human papillomavirus-positive (HPV+) oropharyngeal squamous cell carcinoma (OPSCC) is rising rapidly and has exceeded cervical cancer to become the most common HPV-induced in developed countries. Since patients with HPV + OPSCC respond very favorably standard aggressive treatment, emphasis changed reducing treatment intensity. However, recent multi-center clinical trials failed show non-inferiority de-escalation strategies on a population basis, highlighting need select low-risk likely de-intensified treatments. In contrast, there substantial proportion who develop recurrent disease despite therapy. This supports that not homogeneous disease, but comprises distinct subtypes biological variations. overall goal for this review identify biomarkers may be relevant patient stratification personalized treatment. We discuss as heterogeneous from multifaceted perspectives including behavior, tumor morphology, molecular phenotype. Molecular profiling bulk tumors well single-cell sequencing data are discussed potential driving factors heterogeneity between subgroups. Finally, we evaluate key challenges impede in-depth investigations outline future directions, section racial ethnic differences.
Язык: Английский
Процитировано
13
Frontiers in Pharmacology, Год журнала: 2022, Номер 12
Опубликована: Янв. 20, 2022
More than a decade after the discovery of p16 immunohistochemistry (IHC) as surrogate for human papilloma virus (HPV)-driven head and neck squamous cell carcinoma (HNSCC), p16-IHC has become routinely evaluated biomarker to stratify oropharyngeal (OPSCC) into molecularly distinct subtype with favorable clinical prognosis. Clinical trials treatment de-escalation frequently use combinations biomarkers (p16-IHC, HPV-RNA in situ hybridization, amplification HPV-DNA by PCR) further improve molecular stratification. Implementation these methods routine may be limited case RNA low quality formalin-fixed paraffin-embedded tissue blocks (FFPE) or DNA cross contamination false PCR errors. Advanced technological developments such investigation tumor mutational landscape (NGS), liquid-biopsies (LBx cell-free cfDNA), other blood-based HPV immunity surrogates (antibodies serum) provide novel venues diagnostic uncertainties. Moreover, value HPV/p16-IHC outside oropharynx HNSCC patients needs clarified. With regards therapy, postoperative (adjuvant) definitive (primary) radiochemotherapy constitutes cornerstones curative HNSCC. Side effects chemotherapy bone-marrow suppression could lead radiotherapy interruption compromise therapy outcome. Therefore, reduction its replacement targeted anticancer agents holds promise optimize toxicity profile systemic treatment. Modern gradually adapts dose. Higher doses are administered visible bulk positive lymph nodes, while lower dose is prescribed locoregional volumes empirically suspected invaded cells. Further attempts acute toxicities, example, rates dysphagia feeding tube requirement, ameliorate late toxicities like scars (fibrosis) dry mouth. The main objective current de-intensification therefore reduce and/or treatment-associated preserving outcomes. Deep characterization HPV-driven interactions immune microenvironment instructive development next-generation strategies.
Язык: Английский
Процитировано
20
Cancers, Год журнала: 2025, Номер 17(3), С. 357 - 357
Опубликована: Янв. 22, 2025
The rising incidence of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) necessitates advancements in risk stratification to optimize treatment outcomes and improve the quality life for patients. Despite its favorable prognosis compared HPV-negative OPSCC, current clinical staging biomarkers, such as p16 status, are limited their ability distinguish between high- low-risk patients within HPV-associated OPSCC. This limitation results overtreatment patients, exposing them unnecessary toxicity, undertreatment high-risk who require more aggressive interventions. review critically evaluates methods, including assessments, de-escalation trials, candidate molecular biomarkers stratification. Emerging approaches immune markers, viral genomic integration patterns, other markers offer promising avenues enhanced prognostic accuracy. By integrating advanced tailored may one day be developed balance oncologic efficacy with reduced treatment-related morbidity. underscores need continued research into predictive adaptive strategies better address diverse profiles OPSCC
Язык: Английский
Процитировано
0
Acta Oto-Laryngologica, Год журнала: 2025, Номер unknown, С. 1 - 8
Опубликована: Фев. 10, 2025
Background Current guidelines recommend p16 immunohistochemistry (IHC) for testing human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (OPSCC). The need additional HPV-DNA is debated.
Язык: Английский
Процитировано
0
JCO Clinical Cancer Informatics, Год журнала: 2025, Номер 9
Опубликована: Фев. 1, 2025
PURPOSE Treatment deintensification for human papillomavirus–positive (HPV+)-associated oropharyngeal cancer (OPC) has been the catalyst of experts worldwide. In situ hybridization is optimal to identify HPV+ OPC, but immunohistochemistry its surrogate p16INK4a (p16) standard-of-care given availability and sensitivity. HPV testing not required clinical management, so treatments are often administered on basis p16 status alone. However, prognosis p16/HPV discordant tumors uncertain. MATERIALS AND METHODS This cohort study included 727 consecutive patients with OPC digitized unstructured pathology reports receiving curative radiation therapy at an academic center. Natural language processing (NLP) methods were used classify biomarker compared against manually derived classification. Patients excluded if either or was performed equivocal. Primary end points progression-free survival (PFS), cancer-specific (CSS), overall survival. RESULTS NLP classified from a majority (91%) reports. Accuracy, positive predictive value, sensitivity, F -score NLP-derived 84%/82%, 91%/87%, 90%/89%, 90%/88%, respectively. Four groups identified: p16-positive (p16+)/HPV+ (75%), p16+/HPV-negative (HPV–; 13%), p16-negative (p16–)/HPV– (10%), p16–/HPV+ (2%). There no statistically significant difference in outcomes between p16+/HPV– p16–/HPV– (5-year PFS 76.1% v 68.9%; P = .12; 5-year CSS 81.5% 84.9%; .22). Number needed harm calculations estimated one excess cancer-related death every 10 patients, that expected p16+/HPV+ patients. CONCLUSION head neck high concordance gold-standard categorization, conspicuous portion could be interpreted. constitutes noteworthy minority The inferior suggests alone prognostication insufficient—especially when considering treatment de-escalation.
Язык: Английский
Процитировано
0
Current Oncology Reports, Год журнала: 2025, Номер unknown
Опубликована: Фев. 26, 2025
Abstract Purpose of Review Although it is now firmly established that the presence human papillomavirus (HPV) expression in oropharyngeal cancer associated with a favorable prognosis, implications respect to treatment remain uncertain. However, recognition HPV-positive exquisitely sensitive radiation and chemotherapy has raised questions regarding appropriateness historical paradigms, clinical trials have been conducted assess whether patients can be treated less intensive regimens. The fundamental goal de-escalation preserve high rates cure survival from traditional approaches while reducing incidence both short- long-term side effects. data reporting on relatively limited. Recent Findings While evidence date promising, heterogeneity published studies particularly trial design, approach, inclusion criteria, selection made drawing definitive conclusions difficult. use differing endpoints related disease control quality life also complicated comparison across literature. Summary Multiple uncertainties continue exist current state for cancer, how consider growing context decision-making future subject this review.
Язык: Английский
Процитировано
0
npj Digital Medicine, Год журнала: 2023, Номер 6(1)
Опубликована: Авг. 19, 2023
Abstract Human Papilloma Virus (HPV)-associated oropharyngeal squamous cell cancer (OPSCC) represents an OPSCC subgroup with overall good prognosis a rising incidence in Western countries. Multiple lines of evidence suggest that HPV-associated tumors are not homogeneous tumor entity, underlining the need for accurate prognostic biomarkers. In this retrospective, multi-institutional study involving 906 patients from four centers and one database, we developed deep learning algorithm (OPSCCnet), to analyze standard H&E stains calculation patient-level score associated prognosis, comparing it combined HPV-DNA p16-status. When OPSCCnet HPV-status, showed performance mean area under receiver operator curve (AUROC) = 0.83 (95% CI 0.77-0.9) test cohort ( n 639), which could be increased AUROC 0.88 by filtering cases using fixed threshold on variance probability HPV-positive class - potential surrogate marker HPV-heterogeneity. used as screening tool, outperforming gold HPV testing (OPSCCnet: five-year survival rate: 96% [95% 90–100%]; testing: 80% 71–90%]). This confirmed multivariate analysis three-tier high HR 0.15 0.05–0.44], intermediate 0.58 0.34–0.98] p 0.043, Cox proportional hazards model, 211; 0.29 0.15–0.54] < 0.001, 211). Collectively, our findings indicate analyzing gigapixel hematoxylin eosin (H&E) histological whole-slide images, demonstrated superior over p16/HPV-DNA various clinical scenarios, particularly accurately stratifying these patients.
Язык: Английский
Процитировано
10