Elsevier

Annals of Oncology

Volume 22, Issue 5, May 2011, Pages 1071-1077
Annals of Oncology

original articles
head and neck cancer
Survival and human papillomavirus in oropharynx cancer in TAX 324: a subset analysis from an international phase III trial

https://doi.org/10.1093/annonc/mdr006Get rights and content
Under an Elsevier user license
open archive

Abstract

Background

The association between human papillomavirus (HPV) and overall survival (OS) in oropharynx cancer (OPC) was retrospectively examined in TAX 324, a phase III trial of sequential therapy for locally advanced head and neck cancer.

Methods

Accrual for TAX 324 was completed in 2003 and data updated through 2008. Pretherapy tumor biopsies were studied by PCR for human papillomavirus type 16 and linked to OS, progression-free survival (PFS) and demographics.

Results

Of 264 patients with OPC, 111 (42%) had evaluable biopsies; 56 (50%) were HPV+ and 55 (50%) were HPV-. HPV+ patients were significantly younger (54 versus 58 years, P = 0.02), had T1/T2 primary cancers (49% versus 20%, P = 0.001), and had a performance status of zero (77% versus 49%, P = 0.003). OS and PFS were better for HPV+ patients (OS, hazard ratio = 0.20, P < 0.0001). Local–regional failure was less in HPV+ patients (13% versus 42%, P = 0.0006); at 5 years, 82% of HPV+ patients were alive compared with 35% of HPV- patients (P < 0.0001).

Conclusions

HPV+ OPC has a different biology compared with HPV- OPC; 5-year OS, PFS, and local–regional control are unprecedented. These results support the possibility of selectively reducing therapy and long-term morbidity in HPV+ OPC while preserving survival and approaching HPV- disease with more aggressive treatment.

Keywords

chemoradiotherapy
chemotherapy
head and neck cancer
human papillomavirus
oropharynx cancer
randomized trials

Cited by (0)