Oral Cancer in Men Associated With HPV
May 13, 2008
Two new reports shed additional light on the link between human papillomavirus and oral cancers. HPV can enter the mouth during oral sex, and an earlier study estimated that 38 percent of oral squamous-cell cancers were HPV-associated. But in a bit of good news, the researchers reported that HPV-related oral cancers were among the most responsive to chemotherapy and radiation.
The clinical trial included 51 men and 15 women with advanced cancers of the tonsils or at the base of the tongue. Among 42 patients whose tumors were examined through biopsy, 27 tumors were HPV-positive, nearly two-thirds. Among the 51 men, 22 were HPV-positive.
Patients were initially given a course of induction chemotherapy to shrink the tumor. Patients whose tumor did not shrink by at least 50 percent, 12 patients, were then given surgery, though most did not survive their cancer.
Among the remaining 54 patients, 49 responded to a further course of chemotherapy combined with radiation. Among responders, 78 percent did not need further surgery and 70 percent lived more than four years. Almost half were positive for HPV, and all but three of the 24 were men.
Patients in the small study whose tumors were HPV-positive were significantly more likely to respond to treatment, survive cancer, and survive overall, researchers reported. In addition, the researchers found four genetic markers in the biopsies that were predictive of successful treatment. Treatment was less successful for smokers and women.
"The high risk of HPV-associated cancers in men suggests that vaccinating all adolescents is something that should strongly be considered," said lead author Dr. Francis P. Worden of the University of Michigan.
The studies, "Chemoselection as a Strategy for Organ Preservation in Advanced Oropharynx Cancer" and "EGFR, p16, HPV Titer, Bcl-xL and p53, Sex, and Smoking as Indicators of Response to Therapy and Survival in Oropharyngeal Cancer," were published online ahead of print in the Journal of Clinical Oncology (2008;doi: 10.1200/JCO.2007.12.7597 and doi:10.1200./JCO.2007.12.7662, respectively).
New York Times
5.13.2008; Nicholas Bakalar
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.