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HPV in head and neck cancer

U-M researchers find best way to detect HPV, which will help with treatment choices

A hand is holding a microscope slide

Researchers study tumor slides to look for markers of HPV

As researchers have found that the majority of throat cancers are linked to HPV, the human papillomavirus, they have also found that patients with HPV-positive cancer tend to respond better to treatments than those with HPV-negative cancers. In fact, research is ongoing to see if reducing the intensity of these treatments in HPV-positive patients could result in equally good outcomes with fewer toxic side effects.

But there’s a problem in the meantime: Multiple methods of detecting HPV are used at hospitals throughout the country, with some tests missing several high-risk HPV variations.

“It is critically important to verify high-risk HPV in patients’ tumors prior to deciding on therapy,” says Heather Walline, Ph.D., research fellow in otolaryngology at the University of Michigan Health System and lead author of a new study published in JAMA Otolaryngology.

“Many HPV-positive head and neck cancer patients are young, and the side effects of our current treatments adversely affect their quality of life. If surgery alone or surgery plus radiation is less toxic but equally effective, some patients may be able to avoid some of these side effects,” she says.

Walline and colleagues from the U-M Comprehensive Cancer Center looked at the three most common tests to detect HPV and found that one called PCR-MA most consistently identified all of the high-risk types of HPV with the fewest false-positives. The authors recommend that this test be consistently used.

“Many clinicians and researchers are under the mistaken impression that HPV16 is the only HPV type important in head and neck cancer. We have shown that other high-risk types are also present in these tumors,” Walline says. “Furthermore, the current HPV vaccines target high-risk types HPV16 and HPV18. We suspect that other high-risk HPV types may begin to emerge as major players as the effect of the vaccine begins to eliminate HPV16 and HPV18 as cancer threats.”

In the study, the researchers found that HPV16 was most common, but 10 other types of HPV accounted for up to half of tumors.

Overall, 86 percent of oropharynx, 50 percent of nasopharynx and 26 percent of oral cavity tumors were positive for a high-risk HPV.

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Dr. Thomas Carey from the head and neck oncology program stands in the labThe Head and Neck Oncology Program at the University of Michigan Comprehensive Cancer Center provides advanced diagnostic techniques, management and rehabilitation for patients with cancers of the head and neck. The program works in collaboration with specialists in otolaryngology, radiation oncology, hematology/oncology, speech and language pathology, hospital dentistry and other related fields.

 

The University of Michigan Comprehensive Cancer is celebrating its 25th anniversary, 1988 to 2013The University of Michigan Comprehensive Cancer Center’s 1,000 doctors, nurses, care givers and researchers are united by one thought: to deliver the highest quality, compassionate care while working to conquer cancer through innovation and collaboration. The center is among the top-ranked national cancer programs, and #1 in Michigan for cancer patient care. Seventeen multidisciplinary clinics offer one-stop access to teams of specialists for personalized treatment plans, part of the ideal patient care experience. Patients also benefit through access to promising new cancer therapies.