Patients with oropharyngeal cancer whose tumors contained the human papillomavirus (HPV) have a more positive prognosis than those with HPV-negative disease, according to a study led by Maura Gillison, MD, PhD, professor of internal medicine and epidemiology in the Division of Hematology and Oncology at the Ohio State University in Columbus, and presented at the ASCO Annual Meeting.
The study is the largest and most definitive study to date of patients with stage III or IV oropharyngeal cancer. Although researchers are unsurewhy HPV positive patients have better outcomes, they do know that these patients tend to be younger, have smaller tumors at diagnosis, and are less likely to smoke than HPV-negative patients.
Dr. Gillison and her colleagues compared survival outcomes for both sets of patients as part of a Radiation Therapy Oncology Group phase 3 clinical trial. They analyzed 206 patients with HPV-positive cancers and 117 with HPV-negative cancers. All received radiation and chemotherapy.
Among their findings:
After 2 years, 87.9% of patients with HPV-positive tumors were still alive, compared with 65.8% of patients with HPV-negative tumors.
The incidence of second primary cancers among HPV-positive patients was less than half that of HPV-negative patients at 5 years (9.0% versus 18.5%.)
“Clinical trials should be stratified by HPV status,” Dr. Gillison says. “The big question is whether HPV-positive patients will have the same survival with less intense treatment.”