Survival and human papillomavirus in oropharynx cancer in TAX 324: A subset analysis from an international phase III trial

M. R. Posner*, J. H. Lorch, O. Goloubeva, M. Tan, L. M. Schumaker, N. J. Sarlis, R. I. Haddad, K. J. Cullen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

354 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1071-1077
Number of pages7
JournalAnnals of Oncology
Volume22
Issue number5
DOIs
StatePublished - May 2011
Externally publishedYes

Keywords

  • Chemoradiotherapy
  • Chemotherapy
  • Head and neck cancer
  • Human papillomavirus
  • Oropharynx cancer
  • Randomized trials

ASJC Scopus subject areas

  • Hematology
  • Oncology

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