Introduction: Human papilloma virus (HPV)-positive head and neck cancer


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Kevin Harrington1
1The Institute of Cancer Research, London, UK

Abstract

Traditionally, in the Western world, squamous cell cancer of the head and neck (SCCHN) has been viewed as a disease caused by exposure to tobacco products and alcohol. Most patients present later in life with loco-regionally advanced disease in the context of a host of other tobacco/alcohol-related co-morbid conditions. In this classical form of SCCHN, treatment by surgery, radiotherapy and chemotherapy is associated with relatively poor outcomes. Patients frequently develop loco-regional disease recurrence and/or metastatic relapse and this is associated with dismal outcomes.

In contrast, in the last two decades we have witnessed the emergence of a new form of SCCHN that is unrelated to the classical aetiological agents. In this case, disease is caused by infection by high-risk human papilloma virus. The resulting disease (so-called HPV +ve cancer) occurs almost exclusively in the oropharynx in patients who are younger, less likely to have a significant smoking history and who are relatively free of co-morbid conditions. Treatment outcomes in this group of patients are significantly better than in the classical (HPV -ve) population. As a result, new therapeutic approaches are being explored in which HPV +ve and HPV -ve disease will be treated differently.

In this session, the biology of HPV positive disease will be explored and the implications for future treatment strategies will be discussed. In addition, an immunotherapeutic intervention against another virally-induced head and neck cancer (nasopharyngeal cancer) will be presented.