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Review
. 2021 Jun 23:8:677900.
doi: 10.3389/fmolb.2021.677900. eCollection 2021.

The Role of Human Papilloma Virus in Dictating Outcomes in Head and Neck Squamous Cell Carcinoma

Shane Brennan  1 , Anne-Marie Baird  1 , Esther O'Regan  2 , Orla Sheils  1
Affiliations
Review

The Role of Human Papilloma Virus in Dictating Outcomes in Head and Neck Squamous Cell Carcinoma

Shane Brennan et al. Front Mol Biosci. .

Abstract

The Human Papilloma Virus (HPV) is an oncogenic virus which is associated with the development of head and neck squamous cell carcinoma (HNSCC), predominantly within the oropharynx. Approximately 25% of oropharyngeal squamous cell carcinoma (OPSCC) cases worldwide are attributable to HPV infection, with an estimated 65% in the United States. Transmission is via exposure during sexual contact, with distinctive anatomical features of the tonsils providing this organ with a predilection for infection by HPV. No premalignant lesion is identifiable on clinical examination, thus no comparative histological features to denote the stages of carcinogenesis for HPV driven HNSCC are identifiable. This is in contrast to HPV-driven cervical carcinoma, making screening a challenge for the head and neck region. However, HPV proffers a favorable prognosis in the head and neck region, with better overall survival rates in contrast to its HPV negative counterparts. This has resulted in extensive research into de-intensifying therapies aiming to minimize the morbidity induced by standard concurrent chemo-radiotherapy without compromising efficacy. Despite the favorable prognosis, cases of recurrence and/or metastasis of HPV positive HNSCC do occur, and are linked with poor outcomes. HPV 16 is the most frequent genotype identified in HNSCC, yet there is limited research to date studying the impact of other HPV genotype with respect to overall survival. A similar situation pertains to genetic aberrations associated in those with HPV positive HNSCC who recur, with only four published studies to date. Somatic mutations in TSC2, BRIP1, NBN, TACC3, NFE2l2, STK11, HRAS, PIK3R1, TP63, and FAT1 have been identified in recurrent HPV positive OPSCC. Finding alternative therapeutic strategies for this young cohort may depend on upfront identification of HPV genotypes and mutations which are linked with worse outcomes, thus ensuring appropriate stratification of treatment regimens.

Keywords: HPV genotype; HPV—human papillomavirus; cancer recurrence and metastasis; head and neck cancer; oropharyngeal cancer; somatic mutation analysis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Human Papilloma Virus transmission into the host nucleus can result in (A) Viral DNA integration, (B) a hybrid of conjoined viral-DNA and host DNA, (C) independent viral-DNA, not integrated or linked with the host DNA.
FIGURE 2
FIGURE 2
Prevalent HPV genotypes within the Head and Neck region (Goodman et al., 1990; Koskinen et al., 2003; Kreimer et al., 2005; Chaturvedi et al., 2008; Evans and Powell, 2010; Deng et al., 2012; Dufour et al., 2012; Boscolo-Rizzo et al., 2013; Ndiaye et al., 2014; Castellsagué et al., 2016; de Martel et al., 2017; Ursu et al., 2018; Gillison et al., 2019a; Tumban, 2019; Kim et al., 2020).
FIGURE 3
FIGURE 3
The most frequently encountered somatic mutations for HPV positive and HPV negative squamous cell carcinomas of the head and neck region.
See this image and copyright information in PMC

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