A Hidden Epidemic of “Intermediate Risk” Oropharynx Cancer

Laryngoscope Investigative Otolaryngology

article

Vlad C. Sandulache¹  David C. Wilde¹  Erich M. Sturgis³  Elizabeth Y. Chiao⁴  Andrew G. Sikora¹ 

[1] Bobby R. Alford Department of Otolaryngology–Head and Neck Surgery, Baylor College of Medicine;ENT Section, Michael E. DeBakey Veterans Affairs Medical Center;Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center;Department of Medicine, Baylor College of Medicine

关键词: Oropharynx;    HPV;    tobacco;    radiation;    tumor immune microenvironment.;   

DOI  :  10.1002/lio2.316

学科分类：环境科学（综合）

来源: Wiley

【 摘 要 】

Objectives: Oropharyngeal squamous cell carcinoma (OPSCC) incidence is rapidly increasing in the United States and around the world, driven in large part by infection with the human papillomavirus (HPV). HPV associated OPSCC (HPV+OPSCC) has been shown to have improved response to treatment relative to tobacco-associated OPSCC. However, improvement in patient survival has not been uniform. Subsets of OPSCC patients in the US and around the world continue to have poor oncologic outcomes. Although the drivers of this phenomenon remain unclear, there is increasing evidence that tobacco exposure plays an important role in modulating HPV+OPSCC clinical outcomes. Methods: We conducted a review of the literature. Results: We discuss the potential biological and epidemiological interplay between tobacco and HPV exposure in the context of OPSCC. Multiple retrospective and prospective cohorts show that HPV+OPSCC patients with a history of tobacco exposure have response to treatment and clinical outcomes distinct from HPV+OPSCC non-smokers which poses clinical and scientific challenges to be addressed over the next decade. Conclusions: The interaction between tobacco exposure and HPV infection in the context of OPSCC has significant implications for both standard of care treatment regimens and development of novel therapeutic approaches, in particular those which incorporate immunomodulatory agents.

【 授权许可】

CC BY|CC BY-NC-ND