Advances in biomarkers and treatment strategies for HPV-associated head and neck cancer

Understanding the etiology of human papillomavirus (HPV)-driven oropharyngeal squamous cell carcinoma (OPSCC) is becoming a matter of increasing necessity and urgency as the incidence of HPV(+) OPSCC continues to rise and now exceeds that of HPV-associated cervical cancers [1]. HPV(+) head and neck cancers, over 90% of which are caused by HPV type 16, are clinically and epidemiologically distinct from those not associated with HPV. Moreover, HPV(+) and HPV(？) OPSCCs display distinct mutation and methylation landscapes and different protein expression profiles [2, 3]. Regardless of treatment strategy, HPV-positivity confers a favorable prognosis with 5-year survival rates of 75-80% versus 45-50% among HPV-negative patients [4]. Despite these differences, treatment guidelines recommend similar treatment regardless of HPV status. Efforts to de-escalate therapy for HPV(+) patients are now not only being prioritized to maintain cure rates, but also to decrease treatment-related side effects