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Advances in Surgical Therapy for HPV-Associated Squamous Cell Carcinoma

  • Head and Neck: Human Papilloma Virus Associated Head and Neck Squamous Cell Carcinoma (WK Mydlarz and C Fakhry, Section Editors)
  • Published:
Current Otorhinolaryngology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To review recent surgical advances in the treatment of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC), specifically focusing on treatment strategies, patient outcomes, and surgical technologies.

Recent Findings

Transoral robotic surgery (TORS) has become the surgical technique of choice when treating HPV-OPSCC. Patient-reported outcomes and functional outcomes are increasingly becoming drivers of treatment selection given the excellent prognosis of low-risk HPV-OPSCC. Decreased doses of adjuvant radiation therapy for select patients have been shown to be oncologically safe while offering the potential for improved functional outcomes. Neoadjuvant chemotherapy and immunotherapy have been shown to be safe in this patient population and may offer an advantage to up-front surgery. Finally, new data has identified circulating tumor HPV DNA (ctHPVDNA) as a promising biomarker of response to treatment in HPV-OPSCC.

Summary

The treatment of HPV-OPSCC continues to evolve with surgery playing an increasingly important role. De-escalation of adjuvant treatment for select patients provides excellent oncologic control with the potential for decreased long-term toxicity and remains an area of ongoing investigation. Neoadjuvant therapy (chemotherapy and/or immunotherapy) and or biomarker-driven adjuvant therapy may play a significant role in future treatment paradigms using surgery.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Näsman A, Du J, Dalianis T. A global epidemic increase of an HPV-induced tonsil and tongue base cancer – potential benefit from a pan-gender use of HPV vaccine. J Intern Med. 2019;287(2):134–52.

    Article  Google Scholar 

  2. HPV and Oropharyngeal Cancer. Division of Cancer Prevention and Control [Internet]. 2021. Available from: https://www.cdc.gov/cancer/hpv/basic_info/hpv_oropharyngeal.htm.

  3. Van Dyne EA HS, Saraiya M, Thomas CC, Markowitz LE, Benard VB. Trends in human papillomavirus-associated cancers - United States, 1999–2015. MMWR Morb Mortal Wkly Rep [Internet]. 2018;67:[918–24 pp.].

  4. Fakhry C, Westra WH, Li S, Cmelak A, Ridge JA, Pinto H, et al. Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. J Natl Cancer Inst. 2008;100(4):261–9.

    Article  CAS  Google Scholar 

  5. Amin MB ES, Greene F, Byrd DR, Brookland RK, Washington MK, Gershenwald JE, Compton CC, Hess KR, et al. AJCC Cancer Staging Manual. 8th ed: Springer International Publishing: Am Joint Comm Cancer. 2017.

  6. Schmitt NC, Duvvuri U. Transoral robotic surgery for oropharyngeal squamous cell carcinoma. Curr Opin Otolaryngol Head Neck Surg. 2015;23(2):127–31.

    Article  Google Scholar 

  7. Carnevale C, Ortiz-González I, Ortiz-González A, Bodi-Blanes L, Til-Pérez G. Early T1-T2 stage p16+ oropharyngeal tumours. Role of upfront transoral robotic surgery in de-escalation treatment strategies. A review of the current literature. Oral Oncol. 2021;113:105111.

  8. Golusiński W, Golusińska-Kardach E. Current role of surgery in the management of oropharyngeal cancer. Front Oncol. 2019;9:388.

    Article  Google Scholar 

  9. Iorio GC, Arcadipane F, Martini S, Ricardi U, Franco P. Decreasing treatment burden in HPV-related OPSCC: a systematic review of clinical trials. Crit Rev Oncol Hematol. 2021;160: 103243.

    Article  Google Scholar 

  10. Moore EJ, Van Abel KM, Routman DM, Lohse CM, Price KAR, Neben-Wittich M, et al. Human papillomavirus oropharynx carcinoma: aggressive de-escalation of adjuvant therapy. Head Neck. 2021;43(1):229–37.

    Article  Google Scholar 

  11. Gamez ME, Ma DJ. Deintensification strategies using proton beam therapy for HPV-related oropharyngeal cancer. International Journal of Particle Therapy. 2021;8(1):223–33.

    Article  Google Scholar 

  12. •• Nichols AC, Theurer J, Prisman E, Read N, Berthelet E, Tran E, et al. Radiotherapy versus transoral robotic surgery and neck dissection for oropharyngeal squamous cell carcinoma (ORATOR): an open-label, phase 2, randomised trial. Lancet Oncol. 2019;20(10):1349–59. First randomized control trial to compare TORS vs primary RT and found that patients in the RT arm had better swallow function (though not clinically significant).

    Article  CAS  Google Scholar 

  13. Fitzgerald CWR, Long SM, McLean AT, Cracchiolo JR. Patient-reported outcomes in human papillomavirus-related oropharyngeal cancer. J Surg Oncol. 2021;124(6):967–76.

    Article  Google Scholar 

  14. Parsons JT, Mendenhall WM, Stringer SP, Amdur RJ, Hinerman RW, Villaret DB, et al. Squamous cell carcinoma of the oropharynx: surgery, radiation therapy, or both. Cancer. 2002;94(11):2967–80.

    Article  Google Scholar 

  15. Gooris PJ, Worthington P, Evans JR. Mandibulotomy: a surgical approach to oral and pharyngeal lesions. Int J Oral Maxillofac Surg. 1989;18(6):359–64.

    Article  CAS  Google Scholar 

  16. Dyalram-Silverberg D, Siavash H, Nasir S, Zhang T, Ord R, Lubek J. Complications of the lip split mandibulotomy: The University of Maryland Experience. Oral Maxillofac Surg. 2011;69(9).

  17. Brickman D, Gross ND. Robotic approaches to the pharynx: tonsil cancer. Otolaryngol Clin North Am. 2014;47(3):359–72.

    Article  Google Scholar 

  18. Holsinger FC, Ferris RL. Transoral endoscopic head and neck surgery and its role within the multidisciplinary treatment paradigm of oropharynx cancer: robotics, lasers, and clinical trials. J Clin Oncol. 2015;33(29):3285–92.

    Article  CAS  Google Scholar 

  19. Lang S, Mattheis S, Kansy B. TORS in HPV-positive tumors-the new standard? Recent Results Cancer Res. 2017;206:207–18.

    Article  CAS  Google Scholar 

  20. Chillakuru Y, Benito DA, Strum D, Mehta V, Saini P, Shim T, et al. Transoral robotic surgery versus nonrobotic resection of oropharyngeal squamous cell carcinoma. Head Neck. 2021;43(7):2259–73.

    Article  Google Scholar 

  21. Gal TJ, Slezak JA, Kejner AE, Chen Q, Huang B. Treatment trends in oropharyngeal carcinoma: Surgical technology meets the epidemic. Oral Oncol. 2019;97:62–8.

    Article  CAS  Google Scholar 

  22. Nguyen AT, Luu M, Mallen-St Clair J, Mita AC, Scher KS, Lu DJ, et al. Comparison of survival after transoral robotic surgery vs nonrobotic surgery in patients with early-stage oropharyngeal squamous cell carcinoma. JAMA Oncology. 2020;6(10).

  23. Pongsapich W, Chongkolwatana C, Chuetnok H, Ratanaprasert N. The implementation of TORS for head and neck surgery in Thailand. J Robot Surg. 2021;15(6):955–61.

    Article  Google Scholar 

  24. Lorincz BB, Jowett N, Knecht R. Decision management in transoral robotic surgery: Indications, individual patient selection, and role in the multidisciplinary treatment for head and neck cancer from a European perspective. Head Neck. 2016;38(Suppl 1):E2190–6.

    Article  Google Scholar 

  25. Mandapathil M, Meyer JE. Acceptance and adoption of transoral robotic surgery in Germany. Eur Arch Otorhinolaryngol. 2021;278(10):4021–6.

    Article  Google Scholar 

  26. Amini A, Jasem J, Jones BL, Robin TP, McDermott JD, Bhatia S, et al. Predictors of overall survival in human papillomavirus-associated oropharyngeal cancer using the National Cancer Data Base. Oral Oncol. 2016;56:1–7.

    Article  Google Scholar 

  27. Yeh DH, Tam S, Fung K, MacNeil SD, Yoo J. Winquist E et al Transoral robotic surgery vs radiotherapy for management of oropharyngeal squamous cell carcinoma a systematic review of the literature. Eur J Surg Oncol. 2015;41(12):1603–14.

    Article  CAS  Google Scholar 

  28. Feng AL, Holcomb AJ, Abt NB, Mokhtari TE, Suresh K, McHugh CI, et al. Feeding tube placement following transoral robotic surgery for oropharyngeal squamous cell carcinoma. Otolaryngol Head Neck Surg. 2021:1945998211020302.

  29. Sadeghi N, Li NW, Taheri MR, Easley S, Siegel RS. Neoadjuvant chemotherapy and transoral surgery as a definitive treatment for oropharyngeal cancer: a feasible novel approach. Head Neck. 2016;38(12):1837–46.

    Article  Google Scholar 

  30. • Ma DJ, Price K, Moore EJ, Patel SH, Hinni ML, Chintakuntlawar AV, et al. Two-year results for MC1273, a phase 2 evaluation of aggressive dose de- escalation for adjuvant chemoradiation in HPV+ oropharynx squamous cell carcinoma (OPSCC). Int J Radiat Oncol *Biology*Phys. 2017;99(5):1320. Found that reduced-dose adjuvant CRT demonstrated locoregional control rate similar to historical controls while improving quality of life.

  31. Machtay M, Moughan J, Trotti A, Garden AS, Weber RS, Cooper JS, et al. Factors associated with severe late toxicity after concurrent chemoradiation for locally advanced head and neck cancer: an RTOG analysis. J Clin Oncol. 2008;26(21):3582–9.

    Article  CAS  Google Scholar 

  32. Zakeri K, Dunn L, Lee N. HPV-associated oropharyngeal cancer de-escalation strategies and trials: Past failures and future promise. J Surg Oncol. 2021;124(6):962–6.

    Article  Google Scholar 

  33. Berger MH, Yasaka TM, Haidar YM, Kuan EC, Tjoa T. Insurance status as a predictor of treatment in human papillomavirus positive oropharyngeal cancer. Laryngoscope. 2021;131(4):776–81.

    Article  Google Scholar 

  34. McLeod IK, Melder PC. Da Vinci robot-assisted excision of a vallecular cyst: a case report. Ear Nose Throat J. 2005;84(3):170–2.

    Article  Google Scholar 

  35. O’Malley BW Jr, Weinstein GS, Snyder W, Hockstein NG. Transoral robotic surgery (TORS) for base of tongue neoplasms. Laryngoscope. 2006;116(8):1465–72.

    Article  Google Scholar 

  36. Weinstein GS, O’Malley BW Jr, Snyder W, Sherman E, Quon H. Transoral robotic surgery: radical tonsillectomy. Archives of Otolaryngology-Head & Neck Surgery. 2007;133(12):1220–6.

    Article  Google Scholar 

  37. Weinstein GS, O’Malley BW Jr, Magnuson JS, Carroll WR, Olsen KD, Daio L, et al. Transoral robotic surgery: a multicenter study to assess feasibility, safety, and surgical margins. Laryngoscope. 2012;122(8):1701–7.

    Article  Google Scholar 

  38. Intuitive Surgical Announces Innovative Single Port Platform - the da Vinci SP Surgical System. 2018. https://isrg.gcs-web.com/news-releases/news-release-details/intuitive-surgical-announces-innovative-single-port-platform-da

  39. Lang S, Mattheis S, Hasskamp P, Lawson G, Güldner C, Mandapathil M, et al. A european multicenter study evaluating the flex robotic system in transoral robotic surgery. Laryngoscope. 2017;127(2):391–5.

    Article  Google Scholar 

  40. Ma DJ, Van Abel KM. Treatment de-intensification for HPV-associated oropharyngeal cancer: a definitive surgery paradigm. Semin Radiat Oncol. 2021;31(4):332–8.

    Article  Google Scholar 

  41. •• Ferris RL, Flamand Y, Weinstein GS, Li S, Quon H, Mehra R, et al. Transoral robotic surgical resection followed by randomization to low- or standard-dose IMRT in resectable p16+ locally advanced oropharynx cancer: A trial of the ECOG-ACRIN Cancer Research Group (E3311). J Clin Oncol. 2020;38(15_suppl):6500. Demonstrated that reduced-dose adjuvant RT to 50Gy is oncologically safe in intermediate-risk patients with HPV-OPSCC.

  42. •• Ma DM, Price K, Moore EJ, Patel SH, Hinni ML, Fruth B, et al. MC1675, a phase III evaluation of de-escalated adjuvant radiation therapy (DART) vs. standard adjuvant treatment for human papillomavirus associated oropharyngeal squamous cell carcinoma. Int J Radiat Oncol *Biology*Physics. 2021;111(5):1324. Showed that patients with ENE and pN2 disease had worse progression-free survival.

  43. Harari PM, Harris J, Kies MS, Myers JN, Jordan RC, Gillison ML, et al. Postoperative chemoradiotherapy and cetuximab for high-risk squamous cell carcinoma of the head and neck: Radiation Therapy Oncology Group RTOG-0234. J Clin Oncol. 2014;32(23):2486–95.

    Article  CAS  Google Scholar 

  44. Bernier J, Domenge C, Ozsahin M, Matuszewska K, Lefèbvre JL, Greiner RH, et al. Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med. 2004;350(19):1945–52.

    Article  CAS  Google Scholar 

  45. Cooper JS, Pajak TF, Forastiere AA, Jacobs J, Campbell BH, Saxman SB, et al. Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med. 2004;350(19):1937–44.

    Article  Google Scholar 

  46. Bernier J, Cooper JS, Pajak TF, van Glabbeke M, Bourhis J, Forastiere A, et al. Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (# 9501). Head Neck. 2005;27(10):843–50.

    Article  Google Scholar 

  47. Trifiletti DM, Smith A, Mitra N, Grover S, Lukens JN, Cohen RB, et al. Beyond positive margins and extracapsular extension: evaluating the utilization and clinical impact of postoperative chemoradiotherapy in resected locally advanced head and neck cancer. J Clin Oncol. 2017;35(14):1550–60.

    Article  Google Scholar 

  48. Cramer JD, Hicks KE, Rademaker AW, Patel UA, Samant S. Validation of the eighth edition American Joint Committee on Cancer staging system for human papillomavirus associated oropharyngeal cancer. Head Neck. 2018;40(3):457–66.

    Article  Google Scholar 

  49. Sher DJ, Schwartz DL, Nedzi L, Khan S, Hughes R, Fidler MJ, et al. Comparative effectiveness of induction chemotherapy for oropharyngeal squamous cell carcinoma: a population-based analysis. Oral Oncol. 2016;54:58–67.

    Article  CAS  Google Scholar 

  50. Strohl MP, Wai KC, Ha PK. De-intensification strategies in HPV-related oropharyngeal squamous cell carcinoma-a narrative review. Ann Transl Med. 2020;8(23):1601.

  51. Devisetty K, Wong SJ. Neoadjuvant versus induction chemotherapy: more than semantics. J Clin Oncol. 2013;31(23):2971–2.

    Article  Google Scholar 

  52. • Sadeghi N, Khalife S, Mascarella MA, Ramanakumar AV, Richardson K, Joshi AS, et al. Pathologic response to neoadjuvant chemotherapy in HPV-associated oropharynx cancer. Head Neck. 2020;42(3):417–25. Demonstrated success with neoadjuvant chemotherapy followed by TORS with avoidance of adjuvant RT in select patients, resulting in excellent DFS and swallowing outcomes.

    Article  Google Scholar 

  53. Park YM, Jung CM, Cha D, Kim DH, Kim HR, Keum KC, et al. A new clinical trial of neoadjuvant chemotherapy combined with transoral robotic surgery and customized adjuvant therapy for patients with T3 or T4 oropharyngeal cancer. Ann Surg Oncol. 2017;24(11):3424–9.

    Article  Google Scholar 

  54. Lee E, Gorelik D, Crowder HR, Badger C, Schottler J, Li NW, et al. Swallowing function following neoadjuvant chemotherapy and transoral robotic surgery for oropharyngeal carcinoma: a 2-year follow-up. Otolaryngol Head Neck Surg. 2021:1945998211057430.

  55. Cramer JD, Burtness B, Ferris RL. Immunotherapy for head and neck cancer: recent advances and future directions. Oral Oncol. 2019;99: 104460.

    Article  CAS  Google Scholar 

  56. Nanda R, Chow LQ, Dees EC, Berger R, Gupta S, Geva R, et al. Pembrolizumab in patients with advanced triple-negative breast cancer: phase Ib KEYNOTE-012 Study. J Clin Oncol. 2016;34(21):2460–7.

    Article  CAS  Google Scholar 

  57. Yen CJ, Kiyota N, Hanai N, Takahashi S, Yokota T. Iwae S et al Two-year follow-up of a randomized phase III clinical trial of nivolumab vs the investigator’s choice of therapy in the Asian population for recurrent or metastatic squamous cell carcinoma of the head and neck (CheckMate 141). Head Neck. 2020;42(10):2852–62.

    Article  Google Scholar 

  58. Cohen EEW, Machiels J-PH, Harrington KJ, Burtness B, Shin SW, Gause CK, et al. KEYNOTE-040: a phase III randomized trial of pembrolizumab (MK-3475) versus standard treatment in patients with recurrent or metastatic head and neck cancer. Journal of Clinical Oncology. 2015;33(15_suppl):TPS6084-TPS.

  59. Burtness B, Harrington KJ, Greil R, Soulières D, Tahara M, de Castro Jr G, Psyrri A, Basté N, Neupane P, Bratland Å, Fuereder T. Pembrolizumab alone or with chemotherapy versus cetuximab with chemotherapy for recurrent or metastatic squamous cell carcinoma of the head and neck (KEYNOTE-048): a randomised, open-label, phase 3 study. Lancet. 2019;394(10212):1915–28.

  60. Hecht M, Gostian AO, Eckstein M, Rutzner S, von der Grün J, Illmer T, et al. Safety and efficacy of single cycle induction treatment with cisplatin/docetaxel/ durvalumab/tremelimumab in locally advanced HNSCC: first results of CheckRad-CD8. J Immunother Cancer. 2020;8(2).

  61. • Ferris RL, Spanos WC, Leidner R, Gonçalves A, Martens UM, Kyi C, et al. Neoadjuvant nivolumab for patients with resectable HPV-positive and HPV-negative squamous cell carcinomas of the head and neck in the CheckMate 358 trial. J Immunother Cancer. 2021;9(6):e002568. Found that neoadjuvant immunotherapy was safe in HPV-OPSCC.

    Article  Google Scholar 

  62. Solomon B, Young RJ, Bressel M, Urban D, Hendry S, Thai A, et al. Prognostic significance of PD-L1(+) and CD8(+) immune cells in HPV(+) oropharyngeal squamous cell carcinoma. Cancer Immunol Res. 2018;6(3):295–304.

    Article  CAS  Google Scholar 

  63. • Ferrarotto R, Bell D, Rubin ML, Hutcheson KA, Johnson JM, Goepfert RP, et al. Impact of neoadjuvant durvalumab with or without tremelimumab on CD8(+) tumor lymphocyte density, safety, and efficacy in patients with oropharynx cancer: CIAO Trial Results. Clin Cancer Res. 2020;26(13):3211–9. Demonstrated that neoadjuvant immunotherapy was safe in HPV-OPSCC.

    Article  CAS  Google Scholar 

  64. Leidner R, Crittenden M, Young K, Xiao H, Wu Y, Couey MA, et al. Neoadjuvant immunoradiotherapy results in high rate of complete pathological response and clinical to pathological downstaging in locally advanced head and neck squamous cell carcinoma. J Immunother Cancer. 2021;9(5): e002485.

    Article  Google Scholar 

  65. Ang KK, Harris J, Wheeler R, Weber R, Rosenthal DI, Nguyen-Tan PF, et al. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med. 2010;363(1):24–35.

    Article  CAS  Google Scholar 

  66. Heah H, Goepfert RP, Hutcheson KA, Garden AS, Gunn GB, Fuller CD, et al. Decreased gastrostomy tube incidence and weight loss after transoral robotic surgery for low- to intermediate-risk oropharyngeal squamous cell carcinoma. Head Neck. 2018;40(11):2507–13.

    Article  Google Scholar 

  67. Hutcheson KA, Barrow MP, Lisec A, Barringer DA, Gries K, Lewin JS. What is a clinically relevant difference in MDADI scores between groups of head and neck cancer patients? Laryngoscope. 2016;126(5):1108–13.

    Article  Google Scholar 

  68. •• Palma D NA. A phase II randomized trial of treatment de-escaation for HPV associated oropharyngeal squamous cell carcinoma: radiotherapy vs. trans-oral surgery (ORATOR 2). 2021. Demonstrated that reduce-dose primary RT demonstrated better OS when compared to patients treated with TORS + reduced-dose RT.

  69. Hutcheson KA, Warneke CL, Yao C, Zaveri J, Elgohari BE, Goepfert R, et al. Dysphagia after primary transoral robotic surgery with neck dissection vs nonsurgical therapy in patients with low- to intermediate-risk oropharyngeal cancer. JAMA Otolaryngol Head Neck Surg. 2019;145(11):1053–63.

    Article  Google Scholar 

  70. • Barbon CE, Peterson CB, Dirba DD, Gunn GB, Frank SJ, Ferrarotto R, et al. Comparison of prospective, longitudinal swallowing function after primary intensity-modulated proton therapy (IMPT) or transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma. Int J Radiat Oncol *Biology* Phys. 2020;108(3, Supplement):S160. Demonstrated improved swallowing outcomes in patients treated with TORS versus IMPT.

  71. Amit M, Hutcheson K, Zaveri J, Lewin J, Kupferman ME, Hessel AC, et al. Patient-reported outcomes of symptom burden in patients receiving surgical or nonsurgical treatment for low-intermediate risk oropharyngeal squamous cell carcinoma: a comparative analysis of a prospective registry. Oral Oncol. 2019;91:13–20.

    Article  Google Scholar 

  72. Cullinane C, Fleming C, O’Leary DP, Hassan F, Kelly L, O’Sullivan MJ, et al. Association of circulating tumor DNA with disease-free survival in breast cancer: a systematic review and meta-analysis. JAMA Network Open. 2020;3(11):e2026921.

  73. Zhang J, Dai D, Tian J, Li L, Bai J, Xu Y, et al. Circulating tumor DNA analyses predict disease recurrence in non-muscle-invasive bladder cancer. Front Oncol. 2021;11.

  74. Chera BS, Kumar S, Shen C, Amdur R, Dagan R, Green R, et al. Plasma circulating tumor HPV DNA for the surveillance of cancer recurrence in HPV-associated oropharyngeal cancer. J Clin Oncol. 2020;38(10):1050–8.

    Article  CAS  Google Scholar 

  75. Rungkamoltip P, Temisak S, Piboonprai K, Japrung D, Thangsunan P, Chanpanitkitchot S, et al. Rapid and ultrasensitive detection of circulating human papillomavirus E7 cell-free DNA as a cervical cancer biomarker. Exp Biol Med. 2021;246(6):654–66.

    Article  CAS  Google Scholar 

  76. Routman DM, Kumar S, Chera BS, Jethwa KR, Van Abel KM, Frechette K, et al. Detectable Postoperative circulating tumor human papillomavirus (HPV) DNA and association with recurrence in patients with HPV-associated oropharyngeal squamous cell carcinoma. Int J Radiat Oncol *Biology* Phys. 2022.

  77. O'Boyle CJ, Siravegna G, Varmeh S, Queenan N, Michel A, Pang KCS, et al. Cell-free human papillomavirus DNA kinetics after surgery for human papillomavirus–associated oropharyngeal cancer. Cancer.n/a(n/a).

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  1. Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1445, Houston, TX, USA

    Collin F. Mulcahy & Neil D. Gross

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Dr. Mulcah declares no conflicts of interest. Dr. Gross reports grants and personal fees from Regeneron, personal fees from Sanofi-Genzyme (Ad hoc Scientfic Advisory Board), personal fees from Shattuck Labs (Ad hoc Scientfic Advisory Board), personal fees from PDS Biotechnology (Scientfic Advisory Board), personal fees from Intuitive Surgical, and personal fees from DragonFly Therapeutics, outside the submitted work.

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Mulcahy, C.F., Gross, N.D. Advances in Surgical Therapy for HPV-Associated Squamous Cell Carcinoma. Curr Otorhinolaryngol Rep 10, 475–482 (2022). https://doi.org/10.1007/s40136-022-00421-6

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