Oropharyngeal cancer and HPV

At present, there are no high-impact biomarkers for deciding the course of treatment in patients with head and neck cancer. While smoking and alcohol abuse are among the most common risk factors for head and neck cancer, in the last decade, the human papillomavirus (HPV) has also been implicated in oropharyngeal carcinogenesis. HPV-related oropharyngeal cancer (OPC) is reported to be associated with a better prognosis and lower relapse rate, with increased sensitivity to both radiotherapy and chemotherapy, than HPV-unrelated OPC. However, it is mentioned in the NCCN guideline that the results of HPV testing should not change management decisions in patients with head and neck cancer, except in the context of a clinical trial. Several phase III clinical trials are currently underway to determine whether treatment can be de-intensified by replacing cisplatin with cetuximab in patients diagnosed as having HPV-related OPC. We present an overview of the current state of HPV as a biomarker of HPV-related OPC.