De-Escalated Therapy and Early Treatment of Recurrences in HPV-Associated Head and Neck Cancer: The Potential for Biomarkers to Revolutionize Personalized Therapy

Wendell G Yarbrough; Travis P Schrank; Barbara A Burtness; Natalia Issaeva

doi:10.3390/v16040536

De-Escalated Therapy and Early Treatment of Recurrences in HPV-Associated Head and Neck Cancer: The Potential for Biomarkers to Revolutionize Personalized Therapy

Viruses. 2024 Mar 29;16(4):536. doi: 10.3390/v16040536.

Authors

Wendell G Yarbrough^{1

2

3}, Travis P Schrank^{1

3}, Barbara A Burtness^{4

5}, Natalia Issaeva^{1

2

3}

Affiliations

¹ Department of Otolaryngology/Head and Neck Surgery, UNC School of Medicine, Chapel Hill, NC 27599, USA.
² Department of Pathology and Lab Medicine, UNC School of Medicine, Chapel Hill, NC 27599, USA.
³ Lineberger Comprehensive Cancer Center, UNC School of Medicine, Chapel Hill, NC 27599, USA.
⁴ Department of Medicine, Medical Oncology, Yale School of Medicine, New Haven, CT 06510, USA.
⁵ Yale Cancer Center, Yale School of Medicine, New Haven, CT 06510, USA.

Abstract

Human papillomavirus-associated (HPV+) head and neck squamous cell carcinoma (HNSCC) is the most common HPV-associated cancer in the United States, with a rapid increase in incidence over the last two decades. The burden of HPV+ HNSCC is likely to continue to rise, and given the long latency between infection and the development of HPV+ HNSCC, it is estimated that the effect of the HPV vaccine will not be reflected in HNSCC prevalence until 2060. Efforts have begun to decrease morbidity of standard therapies for this disease, and its improved characterization is being leveraged to identify and target molecular vulnerabilities. Companion biomarkers for new therapies will identify responsive tumors. A more basic understanding of two mechanisms of HPV carcinogenesis in the head and neck has identified subtypes of HPV+ HNSCC that correlate with different carcinogenic programs and that identify tumors with good or poor prognosis. Current development of biomarkers that reliably identify these two subtypes, as well as biomarkers that can detect recurrent disease at an earlier time, will have immediate clinical application.

Keywords: HNSCC; HPV; biomarkers; cancer subtypes; head and neck cancer; head and neck squamous cell carcinoma; liquid biopsy; therapy de-escalation; therapy deintensification.

Publication types

Review
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Biomarkers, Tumor*
Head and Neck Neoplasms* / therapy
Head and Neck Neoplasms* / virology
Humans
Neoplasm Recurrence, Local / virology
Papillomaviridae / classification
Papillomaviridae / genetics
Papillomavirus Infections* / diagnosis
Papillomavirus Infections* / therapy
Papillomavirus Infections* / virology
Precision Medicine* / methods
Squamous Cell Carcinoma of Head and Neck* / therapy
Squamous Cell Carcinoma of Head and Neck* / virology

Substances

Biomarkers, Tumor

Grants and funding

This research was supported in part by: NIH NIDCR R01DE031297—Dissecting NF-kB Pathway in HPV-Associated Head and Neck Cancer, NIH NIDCR R01DE027942—Exploring Mechanisms of Therapeutic Demethylation Effects in HPV-Associated Head and Neck Cancer, NIH NIDCR U01DE029754—Observational Study to Validate Circulating HPVDNA and Prognostic Genomic Biomarkers for Diagnosis and Treatment of HPV-Associated OPSCC and NIH NIDCR P50DE030707—Yale Head and Neck Cancer SPORE: Overcoming Treatment Resistance in Head & Neck Cancer.