The NCCN treatment guidelines for H&N cancers have just been updated and we will have them on the web site in about 5 days when they are fully made public. However OFC's constant
HPV driver to have more people tested will be glad to hear that the new guidelines from the big guys recommend that all posterior OC be tested for HPV16. Here's a quote for the news release, not the actual guidelines.
One of the main changes is a new "suggestion" that the workup for cancer of the oropharynx include testing of the tumor for human papillomavirus (
HPV).
"Immunohistochemical testing for
HPV p16 is recommended," said David G. Pfister, MD, from Memorial Sloan-Kettering Cancer Center in New York City, and chair of the NCCN Head and Neck Cancers Guidelines Committee. "Although not used to guide treatment,
HPV testing is valuable prognostically. The results should not change management decisions," he emphasized.
HPV-related oropharyngeal cancer appears to be a new and distinct disease entity, and is associated with better survival than non-
HPV head and neck cancers, Dr. Pfister noted.
HPV Has a Clear Impact on Prognosis
"Our understanding of the human papillomavirus as a risk factor for head and neck cancer has evolved. Now we see that it has a clear impact on prognosis," Dr. Pfister said in an interview with Medscape Medical News.
Because of their improved prognosis, these patients might require different treatment, he said. "There is a great interest in better understanding
HPV-related cancers and how we treat the disease down the road. Right now we have insufficient data to change how we treat these patients, but clinical trials are being designed to assess the optimal treatment for this group."
The incidence of
HPV-related oropharyngeal cancer has increased noticeably in recent years. In one study, conducted in Sweden, researchers found a progressive proportional increase in
HPV detected in biopsies taken to diagnose oropharyngeal cancer, from 23.3% in the 1970s, to 29% in the 1980s, 57% in the 1990s, 68% in 2000 to 2002, 77% in 2003 to 2205, and 93% in 2006 and 2007 (Int J Cancer. 2009:125:362-366).
