The molecular characteristics of recurrent/metastatic HPV-positive head and neck squamous cell carcinoma: A systematic review of the literature

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY Clinical Otolaryngology Pub Date : 2024-04-24 DOI:10.1111/coa.14161

Susanne Flach, Pavithran Maniam, Shi Ying Hey, Jaiganesh Manickavasagam

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Abstract

Objectives

About 17% of patients with human papillomavirus (HPV)-positive head and neck squamous cell carcinoma (HNSCC), which is mainly comprised of oropharyngeal SCC (OPSCC), will experience disease recurrence, which is often considered incurable when manifested at a metastatic and/or recurrent stage. We conducted a critical qualitative systematic review.

Our objectives were to provide an overview of the molecular landscape of recurrent/metastatic HPV-positive HNSCC as well as novel molecular biomarkers.

Design

A literature review was conducted to identify studies reporting on the molecular characteristics of recurrent/metastatic HPV-positive HNSCC, novel molecular biomarkers and treatment options. The reviews of abstracts, full articles, and revision of the included studies, followed by data extraction and quality assessment were performed by three independent assessors. All primary literature, such as retrospective, prospective, and clinical trials as well as basic research studies were considered, and the final search was conducted at the end of February 2023. The level of evidence was rated using the guidelines published by the Oxford Centre for Evidence-based Medicine and quality was assessed using the Newcastle-Ottawa Scale criteria.

Results and Conclusions

The literature search resulted in the identification of 1991 articles. A total of 181 full articles were screened, and 66 articles were included in this analysis. Several studies reported that recurrent/metastatic HPV-positive HNSCC had higher rates of TP53 mutation and were genomically similar to HPV-negative HNSCC. The detection of circulating tumour tissue-modified HPV DNA (ctHPVDNA) as a specific biomarker has shown promising results for monitoring treatment response and recurrence in the subset of HPV-positive HNSCC. In addition, evidence for targeted therapy in recurrent/metastatic HPV-positive HNSCC has emerged, including agents that inhibit overexpressed EGFR. Studies of combination immunotherapy are also underway.

Our review outlines the latest evidence on the distinct molecular profiles of recurrent/metastatic HPV-positive HNSCC as well as the clinical potential of ctHPVDNA testing in routine practice. More controlled and longitudinal studies are needed to identify additional molecular targets and to assess the performance and benefits of novel molecular biomarkers in clinical practice.

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复发性/转移性人乳头瘤病毒阳性头颈部鳞状细胞癌的分子特征：文献系统综述

目的约17%的人乳头状瘤病毒（HPV）阳性头颈部鳞状细胞癌（HNSCC）患者（主要包括口咽SCC（OPSCC））会出现疾病复发，当出现转移和/或复发阶段时通常被认为是无法治愈的。我们进行了一项批判性定性系统综述。我们的目的是概述复发/转移性HPV阳性HNSCC的分子情况以及新型分子生物标记物。设计我们进行了文献综述，以确定报道复发/转移性HPV阳性HNSCC分子特征、新型分子生物标记物和治疗方案的研究。由三位独立评审员对纳入研究的摘要、全文进行审阅和修订，然后进行数据提取和质量评估。所有主要文献，如回顾性、前瞻性和临床试验以及基础研究均在考虑之列，最终检索于 2023 年 2 月底完成。证据水平根据牛津循证医学中心发布的指南进行评定，质量则根据纽卡斯尔-渥太华量表标准进行评估。共筛选出 181 篇完整文章，其中 66 篇文章被纳入本次分析。有几项研究报告称，复发性/转移性HPV阳性HNSCC的TP53突变率较高，在基因组学上与HPV阴性HNSCC相似。循环肿瘤组织修饰 HPV DNA（ctHPVDNA）作为一种特异性生物标记物，在监测 HPV 阳性 HNSCC 亚群的治疗反应和复发方面显示出良好的效果。此外，针对复发/转移性 HPV 阳性 HNSCC 的靶向治疗证据已经出现，包括抑制表皮生长因子受体过度表达的药物。我们的综述概述了复发性/转移性HPV阳性HNSCC不同分子特征的最新证据，以及ctHPVDNA检测在常规实践中的临床潜力。我们需要进行更多的对照和纵向研究，以确定更多的分子靶点，并评估新型分子生物标记物在临床实践中的表现和益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.