Prognostic significance of human papillomavirus in recurrent or metastatic head and neck cancer: An analysis of Eastern Cooperative Oncology Group trials

Athanassios Argiris, S. Li, M. Ghebremichael, A. M. Egloff, L. Wang, Arlene A. Forastiere, B. Burtness, Ranee Mehra

Research output: Contribution to journalArticle

Abstract

Background: The purpose of this article was to study the association of human papillomavirus (HPV) with clinical outcomes in patients with recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN). Patients and methods: Archival baseline tumor specimens were obtained from patients treated on two clinical trials in recurrent or metastatic SCCHN: E1395, a phase III trial of cisplatin and paclitaxel versus cisplatin and 5-fluorouracil, and E3301, a phase II trial of irinotecan and docetaxel. HPV DNAwas detected by in situ hybridization (ISH) with a wide-spectrum probe. p16 status was evaluated by immunohistochemistry. Clinical outcomes of interest were objective response, progression-free survival (PFS) and overall survival (OS). Results: We analyzed 64 patients for HPV ISH and 65 for p16. Eleven tumors (17%) were HPV+, 12 (18%) were p16+, whereas 52 (80%) were both HPV- and p16-. The objective response rate was 55% for HPV-positive versus 19% for HPV-negative (P = 0.022), and 50% for p16-positive versus 19% for p16-negative (P = 0.057). The median survival was 12.9 versus 6.7 months for HPV-positive versus HPV-negative patients (P = 0.014), and 11.9 versus 6.7 months for p16- positive versus p16-negative patients (P = 0.027). After adjusting for other covariates, hazard ratio for OS was 2.69 (P = 0.048) and 2.17 (P = 0.10), favoring HPV-positive and p16-positive patients, respectively. The other unfavorable risk factor for OS was loss of ≥5% weight in previous 6 months (P = 0.0021 and 0.023 for HPV and p16 models, respectively). Conclusion: HPV is a favorable prognostic factor in recurrent or metastatic SCCHN that should be considered in the design of clinical trials in this setting.

Original languageEnglish (US)
Article numbermdu167
Pages (from-to)1410-1416
Number of pages7
JournalAnnals of Oncology
Volume25
Issue number7
DOIs
StatePublished - 2014

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Head and Neck Neoplasms
irinotecan
Survival
docetaxel
In Situ Hybridization
Clinical Trials
Human papillomavirus 18
Fluorouracil
Cisplatin
Disease-Free Survival
Weight Loss
Neoplasms
Immunohistochemistry

Keywords

  • Head and neck cancer
  • Human papillomavirus

ASJC Scopus subject areas

  • Oncology
  • Hematology

Cite this

Prognostic significance of human papillomavirus in recurrent or metastatic head and neck cancer : An analysis of Eastern Cooperative Oncology Group trials. / Argiris, Athanassios; Li, S.; Ghebremichael, M.; Egloff, A. M.; Wang, L.; Forastiere, Arlene A.; Burtness, B.; Mehra, Ranee.

In: Annals of Oncology, Vol. 25, No. 7, mdu167, 2014, p. 1410-1416.

Research output: Contribution to journalArticle

Argiris, Athanassios ; Li, S. ; Ghebremichael, M. ; Egloff, A. M. ; Wang, L. ; Forastiere, Arlene A. ; Burtness, B. ; Mehra, Ranee. / Prognostic significance of human papillomavirus in recurrent or metastatic head and neck cancer : An analysis of Eastern Cooperative Oncology Group trials. In: Annals of Oncology. 2014 ; Vol. 25, No. 7. pp. 1410-1416.
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abstract = "Background: The purpose of this article was to study the association of human papillomavirus (HPV) with clinical outcomes in patients with recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN). Patients and methods: Archival baseline tumor specimens were obtained from patients treated on two clinical trials in recurrent or metastatic SCCHN: E1395, a phase III trial of cisplatin and paclitaxel versus cisplatin and 5-fluorouracil, and E3301, a phase II trial of irinotecan and docetaxel. HPV DNAwas detected by in situ hybridization (ISH) with a wide-spectrum probe. p16 status was evaluated by immunohistochemistry. Clinical outcomes of interest were objective response, progression-free survival (PFS) and overall survival (OS). Results: We analyzed 64 patients for HPV ISH and 65 for p16. Eleven tumors (17{\%}) were HPV+, 12 (18{\%}) were p16+, whereas 52 (80{\%}) were both HPV- and p16-. The objective response rate was 55{\%} for HPV-positive versus 19{\%} for HPV-negative (P = 0.022), and 50{\%} for p16-positive versus 19{\%} for p16-negative (P = 0.057). The median survival was 12.9 versus 6.7 months for HPV-positive versus HPV-negative patients (P = 0.014), and 11.9 versus 6.7 months for p16- positive versus p16-negative patients (P = 0.027). After adjusting for other covariates, hazard ratio for OS was 2.69 (P = 0.048) and 2.17 (P = 0.10), favoring HPV-positive and p16-positive patients, respectively. The other unfavorable risk factor for OS was loss of ≥5{\%} weight in previous 6 months (P = 0.0021 and 0.023 for HPV and p16 models, respectively). Conclusion: HPV is a favorable prognostic factor in recurrent or metastatic SCCHN that should be considered in the design of clinical trials in this setting.",
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T1 - Prognostic significance of human papillomavirus in recurrent or metastatic head and neck cancer

T2 - An analysis of Eastern Cooperative Oncology Group trials

AU - Argiris, Athanassios

AU - Li, S.

AU - Ghebremichael, M.

AU - Egloff, A. M.

AU - Wang, L.

AU - Forastiere, Arlene A.

AU - Burtness, B.

AU - Mehra, Ranee

PY - 2014

Y1 - 2014

N2 - Background: The purpose of this article was to study the association of human papillomavirus (HPV) with clinical outcomes in patients with recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN). Patients and methods: Archival baseline tumor specimens were obtained from patients treated on two clinical trials in recurrent or metastatic SCCHN: E1395, a phase III trial of cisplatin and paclitaxel versus cisplatin and 5-fluorouracil, and E3301, a phase II trial of irinotecan and docetaxel. HPV DNAwas detected by in situ hybridization (ISH) with a wide-spectrum probe. p16 status was evaluated by immunohistochemistry. Clinical outcomes of interest were objective response, progression-free survival (PFS) and overall survival (OS). Results: We analyzed 64 patients for HPV ISH and 65 for p16. Eleven tumors (17%) were HPV+, 12 (18%) were p16+, whereas 52 (80%) were both HPV- and p16-. The objective response rate was 55% for HPV-positive versus 19% for HPV-negative (P = 0.022), and 50% for p16-positive versus 19% for p16-negative (P = 0.057). The median survival was 12.9 versus 6.7 months for HPV-positive versus HPV-negative patients (P = 0.014), and 11.9 versus 6.7 months for p16- positive versus p16-negative patients (P = 0.027). After adjusting for other covariates, hazard ratio for OS was 2.69 (P = 0.048) and 2.17 (P = 0.10), favoring HPV-positive and p16-positive patients, respectively. The other unfavorable risk factor for OS was loss of ≥5% weight in previous 6 months (P = 0.0021 and 0.023 for HPV and p16 models, respectively). Conclusion: HPV is a favorable prognostic factor in recurrent or metastatic SCCHN that should be considered in the design of clinical trials in this setting.

AB - Background: The purpose of this article was to study the association of human papillomavirus (HPV) with clinical outcomes in patients with recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN). Patients and methods: Archival baseline tumor specimens were obtained from patients treated on two clinical trials in recurrent or metastatic SCCHN: E1395, a phase III trial of cisplatin and paclitaxel versus cisplatin and 5-fluorouracil, and E3301, a phase II trial of irinotecan and docetaxel. HPV DNAwas detected by in situ hybridization (ISH) with a wide-spectrum probe. p16 status was evaluated by immunohistochemistry. Clinical outcomes of interest were objective response, progression-free survival (PFS) and overall survival (OS). Results: We analyzed 64 patients for HPV ISH and 65 for p16. Eleven tumors (17%) were HPV+, 12 (18%) were p16+, whereas 52 (80%) were both HPV- and p16-. The objective response rate was 55% for HPV-positive versus 19% for HPV-negative (P = 0.022), and 50% for p16-positive versus 19% for p16-negative (P = 0.057). The median survival was 12.9 versus 6.7 months for HPV-positive versus HPV-negative patients (P = 0.014), and 11.9 versus 6.7 months for p16- positive versus p16-negative patients (P = 0.027). After adjusting for other covariates, hazard ratio for OS was 2.69 (P = 0.048) and 2.17 (P = 0.10), favoring HPV-positive and p16-positive patients, respectively. The other unfavorable risk factor for OS was loss of ≥5% weight in previous 6 months (P = 0.0021 and 0.023 for HPV and p16 models, respectively). Conclusion: HPV is a favorable prognostic factor in recurrent or metastatic SCCHN that should be considered in the design of clinical trials in this setting.

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