A new study led by University of Minnesota School of Public Health Associate Professor Dr. Heather Nelson finds that antibodies to human papillomavirus (HPV) detectable in blood serum are reliable indicators of the five-year survival of head and neck cancer patients.
[Photo: Dr. Heather Nelson]
The results play into ongoing research evaluating if HPV-related cancers can be treated less aggressively, and suggest the possibility that a future a blood serum test for the presence of HPV antibodies could replace biopsy cancer testing methods.
The study appeared in JAMA Oncology.
“HPV infection is a risk factor for getting head and neck cancer, particularly for tumors that occur in the area of the throat behind the mouth (oropharynx),” said Dr. Nelson. “However, it is well established that if you are an oropharyngeal cancer patient, and you are HPV-positive, you have better outcomes. What our study demonstrates is that being HPV-positive is good for outcomes for the other forms of head and neck cancer, like oral cavity and larynx cancer.”
The study examined blood serum samples and five-year survival among more than 1,000 Boston-area head and neck cancer patients diagnosed between 1999 and 2011. Overall, those who tested positive for antibodies to the tumor-forming HPV E6 or E7 proteins were significantly less likely to die during the five-year follow-up period after diagnosis compared to those who tested negative for the antibodies.
The authors note that those patients with a history of heavy smoking had the worst outcomes, particularly if they had no evidence of HPV infection.
“An important message for head and neck cancer patients is the need to quit smoking to improve their cancer prognosis,” said Dr. Nelson.
The study relates to ongoing trials where doctors are testing whether patients with HPV-associated cancers can be treated less aggressively — and hopefully with fewer negative side-effects — than people with non-HPV-associated cancers. If the trials prove successful, then it will be particularly important to determine whether cancers are HPV-associated.
The study also suggests that HPV testing for head and neck cancer could be done without invasive “biopsy” tissue sampling.
“Our data indicates that assessing a patient’s immune response is likely sufficient for determining HPV-related clinical benefit, and in fact may be a superior method to determine HPV-benefit for particular patient subgroups,” said Dr. Nelson.
Dr. Nelson and her research group are now designing future studies to evaluate whether other viruses elicit a similar immune response that impacts head and neck cancer outcomes.