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The rationale for HPV-related oropharyngeal cancer de-escalation treatment strategies

The treatment paradigms for head and neck squamous cell cancer (HNSCC) are changing due to the emergence of human papillomavirus-associated tumors (HPV-related), possessing distinct molecular profiles and responses to therapy. Retrospective studies have suggested that HPV-related HNSCCs are more fre...

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Autores principales: Wierzbicka, Małgorzata, Szyfter, Krzysztof, Milecki, Piotr, Składowski, Krzysztof, Ramlau, Rodryg
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4631307/
https://www.ncbi.nlm.nih.gov/pubmed/26557780
http://dx.doi.org/10.5114/wo.2015.54389
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author Wierzbicka, Małgorzata
Szyfter, Krzysztof
Milecki, Piotr
Składowski, Krzysztof
Ramlau, Rodryg
author_facet Wierzbicka, Małgorzata
Szyfter, Krzysztof
Milecki, Piotr
Składowski, Krzysztof
Ramlau, Rodryg
author_sort Wierzbicka, Małgorzata
collection PubMed
description The treatment paradigms for head and neck squamous cell cancer (HNSCC) are changing due to the emergence of human papillomavirus-associated tumors (HPV-related), possessing distinct molecular profiles and responses to therapy. Retrospective studies have suggested that HPV-related HNSCCs are more frequently cured than those caused by tobacco. Current clinical trials focus on the reduction of treatment-related toxicity and the development of HPV-targeted therapies. New treatment strategies include: 1) dose reduction of radiotherapy, 2) the use of cetuximab instead of cisplatin for chemo-radiation 3) less invasive surgical options, i.e. trans-oral robotic surgery and trans-oral laser microlaryngoscopy, and 4) more specific treatment attempts, including immunotherapeutic strategies, thanks to increasing comprehension of the molecular background of HPV-related HNSCC. Whereas recently published data shed light on immune mechanisms, other studies have focused on specific vaccination against HPV-related HNSCC. A crucial problem is patient selection to the chosen bias. Truly HPV-related cancers (p16-positive and HPV DNA-positive) with biomarkers for good response to therapy could be included in randomized trials aiming for less severe and better tailored therapy.
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spelling pubmed-46313072015-11-10 The rationale for HPV-related oropharyngeal cancer de-escalation treatment strategies Wierzbicka, Małgorzata Szyfter, Krzysztof Milecki, Piotr Składowski, Krzysztof Ramlau, Rodryg Contemp Oncol (Pozn) Original Paper The treatment paradigms for head and neck squamous cell cancer (HNSCC) are changing due to the emergence of human papillomavirus-associated tumors (HPV-related), possessing distinct molecular profiles and responses to therapy. Retrospective studies have suggested that HPV-related HNSCCs are more frequently cured than those caused by tobacco. Current clinical trials focus on the reduction of treatment-related toxicity and the development of HPV-targeted therapies. New treatment strategies include: 1) dose reduction of radiotherapy, 2) the use of cetuximab instead of cisplatin for chemo-radiation 3) less invasive surgical options, i.e. trans-oral robotic surgery and trans-oral laser microlaryngoscopy, and 4) more specific treatment attempts, including immunotherapeutic strategies, thanks to increasing comprehension of the molecular background of HPV-related HNSCC. Whereas recently published data shed light on immune mechanisms, other studies have focused on specific vaccination against HPV-related HNSCC. A crucial problem is patient selection to the chosen bias. Truly HPV-related cancers (p16-positive and HPV DNA-positive) with biomarkers for good response to therapy could be included in randomized trials aiming for less severe and better tailored therapy. Termedia Publishing House 2015-09-28 2015 /pmc/articles/PMC4631307/ /pubmed/26557780 http://dx.doi.org/10.5114/wo.2015.54389 Text en Copyright © 2015 Termedia http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Paper
Wierzbicka, Małgorzata
Szyfter, Krzysztof
Milecki, Piotr
Składowski, Krzysztof
Ramlau, Rodryg
The rationale for HPV-related oropharyngeal cancer de-escalation treatment strategies
title The rationale for HPV-related oropharyngeal cancer de-escalation treatment strategies
title_full The rationale for HPV-related oropharyngeal cancer de-escalation treatment strategies
title_fullStr The rationale for HPV-related oropharyngeal cancer de-escalation treatment strategies
title_full_unstemmed The rationale for HPV-related oropharyngeal cancer de-escalation treatment strategies
title_short The rationale for HPV-related oropharyngeal cancer de-escalation treatment strategies
title_sort rationale for hpv-related oropharyngeal cancer de-escalation treatment strategies
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4631307/
https://www.ncbi.nlm.nih.gov/pubmed/26557780
http://dx.doi.org/10.5114/wo.2015.54389
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