UCL Cancer Institute, University College London, London, UK.
Division of Surgery and Interventional Science, University College London, London, UK.
Nat Rev Clin Oncol. 2022 May;19(5):306-327. doi: 10.1038/s41571-022-00603-7. Epub 2022 Feb 1.
Human papillomavirus (HPV)-positive (HPV) oropharyngeal squamous cell carcinoma (OPSCC) has one of the most rapidly increasing incidences of any cancer in high-income countries. The most recent (8th) edition of the UICC/AJCC staging system separates HPV OPSCC from its HPV-negative (HPV) counterpart to account for the improved prognosis seen in the former. Indeed, owing to its improved prognosis and greater prevalence in younger individuals, numerous ongoing trials are examining the potential for treatment de-intensification as a means to improve quality of life while maintaining acceptable survival outcomes. In addition, owing to the distinct biology of HPV OPSCCs, targeted therapies and immunotherapies have become an area of particular interest. Importantly, OPSCC is often detected at an advanced stage owing to a lack of symptoms in the early stages; therefore, a need exists to identify and validate possible diagnostic biomarkers to aid in earlier detection. In this Review, we provide a summary of the epidemiology, molecular biology and clinical management of HPV OPSCC in an effort to highlight important advances in the field. Ultimately, a need exists for improved understanding of the molecular basis and clinical course of this disease to guide efforts towards early detection and precision care, and to improve patient outcomes.
人乳头瘤病毒（HPV）阳性（HPV）口咽鳞状细胞癌（OPSCC）是高收入国家中发病率增长最快的癌症之一。国际抗癌联盟/美国癌症联合委员会（UICC/AJCC）分期系统的最新（第 8 版）将 HPV OPSCC 与其 HPV 阴性（HPV）对应物分开，以说明前者的预后改善。事实上，由于其预后改善以及在年轻人中更为普遍，许多正在进行的试验正在研究治疗减量化的潜力，以改善生活质量，同时保持可接受的生存结果。此外，由于 HPV OPSCC 的独特生物学特性，靶向治疗和免疫疗法已成为一个特别关注的领域。重要的是，由于早期阶段缺乏症状，OPSCC 通常在晚期才被发现；因此，需要确定和验证可能的诊断生物标志物，以帮助早期发现。在这篇综述中，我们总结了 HPV OPSCC 的流行病学、分子生物学和临床管理，以强调该领域的重要进展。最终，需要更好地了解这种疾病的分子基础和临床过程，以指导早期检测和精准护理的努力，并改善患者的结局。
