Journal article

Publication year: 2020

Pages: 1114-1122

Journal: British Journal of Cancer

Volume number: 123

Issue number: 7

ISSN: 0007-0920

eISSN: 1532-1827

Open access status: Hybrid

DOI Link: https://doi.org/10.1038/s41416-020-0964-x

Publisher: Springer Nature [academic journals on nature.com]

Abstract: 
Background A remarkably better prognosis is associated with oropharyngeal squamous cell carcinomas (OPSCC) driven by human papillomaviruses (HPV) compared with HPV-negative OPSCC. Consequently, de-escalation of standard treatment has been suggested. Due to modest specificity rates, debates are ongoing, whether p16(INK4a), a surrogate marker for HPV-driven OPSCC, is sufficient to correctly identify those tumours and avoid substantial HPV misattribution and thus undertreatment of patients by de-escalation. Robust data estimating the proportion of potentially undertreated patients are missing. Methods We assessed a large-scale cohort of consecutively included OPSCC diagnosed between 2000 and 2017 for HPV-DNA, HPV genotypes, p16(INK4a)expression and multiple tumour- and patient-related risk factors, and investigated their impact on patients' survival in comprehensive uni- and multivariate analyses. Results Aetiological relevance of HPV (p16(INK4a)- and high-risk HPV-DNA-positivity) was detected in 27.1% (n = 192) of OPSCC, with HPV(16)being the most abundant HPV type (94.6%). In 5.5% patients (n = 39), p16(INK4a)overexpression but no HPV-DNA was detected. Principal component and survival analyses revealed that 60.6% of these p16(INK4a)-positive OPSCC lacking HPV-DNA did not resemble HPV16-driven but HPV-negative OPSCC regarding risk-factor profile and overall survival. Notably, this group represented 10.6% of all p16(INK4a)-overexpressing OPSCC. Conclusions p16(INK4a)as a single marker appears insufficient to indicate OPSCC patients suitable for treatment de-escalation.

Harvard Citation style: Wagner, S., Prigge, E., Wuerdemann, N., Reder, H., Bushnak, A., Sharma, S., et al. (2020) Evaluation of p16^INK4aexpression as a single marker to select patients with HPV-driven oropharyngeal cancers for treatment de-escalation, British Journal of Cancer, 123(7), pp. 1114-1122. https://doi.org/10.1038/s41416-020-0964-x

APA Citation style: Wagner, S., Prigge, E., Wuerdemann, N., Reder, H., Bushnak, A., Sharma, S., Obermueller, T., Doeberitz, M., Dreyer, T., Gattenloehner, S., Wolf, G., Pons-Kuehnemann, J., Wittekindt, C., & Klussmann, J. (2020). Evaluation of p16^INK4aexpression as a single marker to select patients with HPV-driven oropharyngeal cancers for treatment de-escalation. British Journal of Cancer. 123(7), 1114-1122. https://doi.org/10.1038/s41416-020-0964-x