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HPV as a Carcinomic Driver in Head and Neck Cancer: a De-escalated Future?

  • Head and Neck Cancer (PL Swiecicki, Section Editor)
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

Patients with HPV-associated oropharyngeal squamous cell carcinoma have improved prognosis relatively to those with tumors not driven by HPV. Both definitive radiotherapy (typically with concurrent chemotherapy) and transoral robotic surgery (with adjuvant therapies based on pathologic risk factors) are both acceptable treatment options for patients. The decision on which treatment is optimal depends on individual patient factors and should be made in a multi-disciplinary setting with input from a radiation oncologist, head and neck surgeon, and medical oncologist. Where appropriate, patients in this setting should be considered for enrollment on clinical studies evaluating de-escalation of treatment intensity given the very favorable outcomes and high toxicity profile associated with conventional therapies. However, caution is needed given negative data for de-escalation in the definitive chemotherapy and radiation setting. It remains unclear what the prognostic significance of HPV status is in patients with squamous cell carcinomas of the head and neck outside of the oropharynx.

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Authors and Affiliations

  1. Department of Radiation Oncology, Winship Cancer Institute, Emory University, 550 Peachtree St NE, Atlanta, GA, 30308, USA

    James E. Bates MD

  2. Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, 1365 Clifton Road, Atlanta, GA, 30307, USA

    Conor E. Steuer MD

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Correspondence to James E. Bates MD.

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Conflict of Interest

James E. Bates has received compensation for participation on an advisory board for Galera Therapeutics. Conor E. Steuer has received compensation for service as a consultant from Caris Life Sciences, and has received compensation for participation on advisory boards from BerGenBio, ARMO BioSciences, AbbVie, Eli Lilly, Sanofi, and Mirati Therapeutics.

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This article is part of the Topical Collection on Head and Neck Cancer

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Bates, J.E., Steuer, C.E. HPV as a Carcinomic Driver in Head and Neck Cancer: a De-escalated Future?. Curr. Treat. Options in Oncol. 23, 325–332 (2022). https://doi.org/10.1007/s11864-022-00950-8

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