Human papillomavirus in head and neck cancers: biology, prognosis, hope of treatment, and vaccines

Abstract

Human papillomaviruses (HPVs), especially type 16, are implicated in the development of a subset of head and neck squamous cell cancers (HNSCCs). This subset of oropharyngeal cancers possesses distinct clinical and laboratory features and outcome, and is particularly common in individuals who lack the traditional risk factors of tobacco and alcohol abuse. Moreover, the annual incidence of HPV-related HNSCCs has increased in the USA and Europe in the last few years. As HPV-associated HNSCCs share a better prognosis compared with stage-matched HPV-negative ones, selected patients could be spared the intensive and toxic treatment and be oriented to organ preservation strategies. Preventive HPV vaccines have already been designed against cervical cancer, and a further understanding of HPV-associated carcinogenesis could potentially lead to the development of HPV-targeted therapeutic strategies. This study summarizes the current knowledge regarding the epidemiology, biology, malignant transformation mechanisms, and prognosis of HPV-associated HNSCCs, and underlines the clinical implications of related treatments and prophylactic strategies.