High-risk non-16 human papillomavirus genotypes in head and neck squamous cell carcinoma.

Authors

null

Michael Wotman

Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY

Michael Wotman , Rocco Ferrandino , Brandon Gold , Nicole Albstein , Naomi Alpert , Jacqueline Junn , William Westra , Marshall R. Posner

Organizations

Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, Icahn School of Medicine at Mount Sinai, New York, NY, Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, NY

Research Funding

No funding received

Background: Oropharyngeal cancer patients with Human Papillomavirus (HPV)-associated disease have more favorable outcomes. HPV16 is the primary genotype in this population. Our knowledge of the impact of high-risk non-16 HPV (HRN16) subtypes on survival is limited. The objective of this study is to investigate the incidence, demographics, and survival outcomes of HRN16 genotypes in patients with HPV-positive head and neck squamous cell carcinoma (HNSCC). Methods: This is a retrospective chart review of patients diagnosed with HPV+ HNSCC from 2012-2021 at the Mount Sinai Health System. Genotyping was performed with polymerase chain reaction (PCR). Demographic, clinical and tumor data was extracted from electronic medical records.The primary outcomes are overall survival (OS) and event-free survival (EFS) for patients with non-metastatic disease at presentation, treated with curative-intent, with > 6 months follow-up.Survival analysis was performed by Kaplan-Meier method. Results: 733 patients had HPV+ HNSCC, and 109 (14.9%) are HRN16 subtypes. Mean age at diagnosis is 62.4 years. Most individuals are non-Hispanic white males, non-active smokers, social drinkers, and have good performance status (Table). A majority has non-metastatic oropharyngeal cancer treated with standard of care (SOC) definitive therapy. The predominate genotypes are HPV35 (39.4%, n = 41), HPV33 (27.9%, n = 29), and HPV18 (14.4%, n = 15). Survival analysis demonstrated no significant differences in OS (log-rank p = 0.90) and EFS (log-rank p = 0.19) among the different HRN16 subtypes. There was a trend for better EFS for HPV35. Conclusions: HRN16 genotype may not meaningfully impact patient outcomes in HNSCC. Larger multivariate analyses may identify specific site and genotype differences in survival comparedwith HPV16-assoicated disease and indicate if patients with selected HRN16 subtypes are candidates for treatment de-escalation.

Demographic, Clinical and Tumor Characteristics.

Variable
N
%
Mean Age at diagnosis, years (SE)
62.4 (1.0)
Gender
 Male
83
79.8
 Female
21
20.2
Race
 White
59
56.7
 Black/African American
16
15.4
 Other
23
22.1
Ethnicity
 Hispanic/Latino
10
9.6
 Non-Hispanic/Latino
77
74.0
Smoking Status
 Never
44
42.3
 Former
45
43.3
 Active
15
14.4
Alcohol Use
 Never
19
18.3
 Former
15
14.4
 Active
56
53.8
Mean Charlson Comorbidity Score (SE)
4.8 (0.2)
ECOG Status
 Fully Active (0)
77
74.0
 Restricted/Limited/Completely Disabled
14
13.5
Subsite
 Oropharynx
68
65.4
 Nasal Cavity and Paranasal Sinuses
16
15.4
 Other Site (Oral Cavity, Nasopharynx, Larynx, Hypopharynx)
11
10.6
 Unknown Primary
9
8.7
Histology
 Squamous Cell
96
92.3
 Other (Small Cell, Multiphenotypic)
8
7.7
Overall Stage
 I
7
6.7
 II
7
6.7
 III
11
10.6
 IVA
53
51.0
 IVB
13
12.5
 IVC
4
3.8
Genotype
 18
15
14.4
 33
29
27.9
 35
41
39.4
 Other
19
18.3
Treatment Intent
 Curative
93
89.4
 Palliative
3
2.9
 None
2
1.9
On Protocol
 No
75
72.1
 Yes
8
7.7

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Head and Neck Cancer

Track

Head and Neck Cancer

Sub Track

Biologic Correlates

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr e18052)

DOI

10.1200/JCO.2022.40.16_suppl.e18052

Abstract #

e18052

Abstract Disclosures

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