SCOTTSDALE, ARIZ. – Patients positive for the human papillomavirus have nearly twice the overall survival rate from recurrent oropharyngeal cancers as HPV-negative patients, Dr. Carole Fakhry reported at the 2014 Multidisciplinary Head and Neck Cancer Symposium.
Two years after a diagnosis of recurrence, 54.6% of HPV-positive patients were alive, compared with 27.6% of HPV-negative patients (P less than .001), according to a retrospective analysis of data from two clinical trials of 181 patients with stage III-IV oropharyngeal squamous cell carcinomas and known HPV status (measured by p16 protein expression).
"Tumor p16 status is independently associated with overall survival among oropharyngeal cancer patients with disease progression," said Dr. Fakhry of Johns Hopkins Medicine in Baltimore.
Dr. Carole Fakhry
The analysis shows that "unquestionably, HPV-positive patients have a different molecular disease than their HPV-negative, tobacco-related counterparts. They are different with respect to specific tumor suppressor genes, and they are different in respect to specific activating oncogenes," noted Dr. Ezra Cohen of the University of California San Diego Moores Cancer Center, who was the invited discussant.
Dr. Fakhry and her colleagues looked at data on patients treated in the RTOG 0129 and 0522 trials.
Median time to progression was similar between the groups (8.2 months for HPV+ patients and 7.3 months for HPV–; P = .67), with the majority of disease progressions occurring within the first year (65% and 63%, respectively), reported Dr. Fakhry at the symposium, cosponsored by the American Society for Radiation Oncology and American Society of Clinical Oncology.
Factors associated with better overall survival in multivariate analysis included HPV+ status, salvage surgery, local-regional vs. distant progression, lower T stage at enrollment, and less than 20 smoking pack-years.
The study was supported by the National Cancer Institute and Bristol-Myers Squibb. Dr. Fakhry reported having no financial disclosures. Dr. Cohen disclosed serving as a consultant and adviser to BMS.