Abstract
Objective: We sought to further define prognostic and predictive value of human papillomavirus (HPV) status in metastatic squamous cell carcinoma of the oropharynx (OPC). Materials and methods: A Surveillance, Epidemiology, and End Results custom database identified 5940 adult patients, >18-years-old, with primary SCCHN and known HPV status, diagnosed from 2013 to 2014. Wilcoxon rank-sum and Mantel-Haenszel χ2 tests compared distributions of continuous and categorical covariates. Fine-Gray competing risks regressions estimated hazard ratios by HPV status, and predictive analyses were performed including the interaction term HPV status × Receipt of Chemotherapy. Results: 182 of 5940 patients (4.0%) had metastatic OPC at diagnosis (106/3925 [2.7%] HPV+ and 76/1894 [4.0%] HPV−). HPV+ disease was prognostic for improved 20-month cancer-specific mortality (CSM) (47.1% vs 72.5%, HR 0.43, 95% CI 0.26–0.74, p = 0.002) on univariable analysis. HPV status was predictive of response to chemotherapy—adjusted HRs for receipt of chemotherapy were 0.11 (95% CI 0.03–0.37) and 0.34 (95% CI 0.18–0.64) for HPV+ versus HPV− disease, respectively (PHPV status∗Chemotherapy = 0.036). Conclusion: HPV status has known prognostic value in locally advanced OPC, but data on metastatic OPC are sparse. In this work, we demonstrate that HPV status is strongly prognostic for CSM in metastatic OPC and show for the first time that HPV status predicts for response to chemotherapy.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 69-74 |
| Number of pages | 6 |
| Journal | Oral Oncology |
| Volume | 86 |
| DOIs | |
| State | Published - Nov 2018 |
| Externally published | Yes |
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Keywords
- Head and neck cancer
- Human papillomavirus
- Metastatic squamous cell cancer
- Predictive biomarker
- Systemic therapy
ASJC Scopus subject areas
- Oral Surgery
- Oncology
- Cancer Research
Cite this
HPV status predicts for improved survival following chemotherapy in metastatic squamous cell carcinoma of the oropharynx. / Pike, Luke R.G.; Hwang, William L.; Royce, Trevor J.; Sanford, Nina N.; Mahal, Brandon A.
In: Oral Oncology, Vol. 86, 11.2018, p. 69-74.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - HPV status predicts for improved survival following chemotherapy in metastatic squamous cell carcinoma of the oropharynx
AU - Pike, Luke R.G.
AU - Hwang, William L.
AU - Royce, Trevor J.
AU - Sanford, Nina N.
AU - Mahal, Brandon A.
PY - 2018/11
Y1 - 2018/11
N2 - Objective: We sought to further define prognostic and predictive value of human papillomavirus (HPV) status in metastatic squamous cell carcinoma of the oropharynx (OPC). Materials and methods: A Surveillance, Epidemiology, and End Results custom database identified 5940 adult patients, >18-years-old, with primary SCCHN and known HPV status, diagnosed from 2013 to 2014. Wilcoxon rank-sum and Mantel-Haenszel χ2 tests compared distributions of continuous and categorical covariates. Fine-Gray competing risks regressions estimated hazard ratios by HPV status, and predictive analyses were performed including the interaction term HPV status × Receipt of Chemotherapy. Results: 182 of 5940 patients (4.0%) had metastatic OPC at diagnosis (106/3925 [2.7%] HPV+ and 76/1894 [4.0%] HPV−). HPV+ disease was prognostic for improved 20-month cancer-specific mortality (CSM) (47.1% vs 72.5%, HR 0.43, 95% CI 0.26–0.74, p = 0.002) on univariable analysis. HPV status was predictive of response to chemotherapy—adjusted HRs for receipt of chemotherapy were 0.11 (95% CI 0.03–0.37) and 0.34 (95% CI 0.18–0.64) for HPV+ versus HPV− disease, respectively (PHPV status∗Chemotherapy = 0.036). Conclusion: HPV status has known prognostic value in locally advanced OPC, but data on metastatic OPC are sparse. In this work, we demonstrate that HPV status is strongly prognostic for CSM in metastatic OPC and show for the first time that HPV status predicts for response to chemotherapy.
AB - Objective: We sought to further define prognostic and predictive value of human papillomavirus (HPV) status in metastatic squamous cell carcinoma of the oropharynx (OPC). Materials and methods: A Surveillance, Epidemiology, and End Results custom database identified 5940 adult patients, >18-years-old, with primary SCCHN and known HPV status, diagnosed from 2013 to 2014. Wilcoxon rank-sum and Mantel-Haenszel χ2 tests compared distributions of continuous and categorical covariates. Fine-Gray competing risks regressions estimated hazard ratios by HPV status, and predictive analyses were performed including the interaction term HPV status × Receipt of Chemotherapy. Results: 182 of 5940 patients (4.0%) had metastatic OPC at diagnosis (106/3925 [2.7%] HPV+ and 76/1894 [4.0%] HPV−). HPV+ disease was prognostic for improved 20-month cancer-specific mortality (CSM) (47.1% vs 72.5%, HR 0.43, 95% CI 0.26–0.74, p = 0.002) on univariable analysis. HPV status was predictive of response to chemotherapy—adjusted HRs for receipt of chemotherapy were 0.11 (95% CI 0.03–0.37) and 0.34 (95% CI 0.18–0.64) for HPV+ versus HPV− disease, respectively (PHPV status∗Chemotherapy = 0.036). Conclusion: HPV status has known prognostic value in locally advanced OPC, but data on metastatic OPC are sparse. In this work, we demonstrate that HPV status is strongly prognostic for CSM in metastatic OPC and show for the first time that HPV status predicts for response to chemotherapy.
KW - Head and neck cancer
KW - Human papillomavirus
KW - Metastatic squamous cell cancer
KW - Predictive biomarker
KW - Systemic therapy
UR - http://www.scopus.com/inward/record.url?scp=85053419280&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85053419280&partnerID=8YFLogxK
U2 - 10.1016/j.oraloncology.2018.09.007
DO - 10.1016/j.oraloncology.2018.09.007
M3 - Article
C2 - 30409322
AN - SCOPUS:85053419280
VL - 86
SP - 69
EP - 74
JO - Oral Oncology
JF - Oral Oncology
SN - 1368-8375
ER -