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| |  Study Finds HPV Linked to Better Survival in Tonsil and Tongue Cancer ANN ARBOR, Mich -- May 13, 2008 -- Researchers at the University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan, reported finding a series of markers indicating which patients are more likely to survive cancers of the base of the tongue and tonsils. Most notably, the study found that cancers linked to human papillomavirus (HPV) were the most responsive to current chemotherapy and radiation treatments, while tumours that expressed high levels of a certain growth factor receptor were the least responsive and most deadly. The study results appear in 2 papers published online and will appear in the July 1 print issue of the Journal of Clinical Oncology. In the study, researchers treated 66 patients with advanced oropharyngeal cancer, including cancer of the tonsils and the base of the tongue. Study participants were given an initial course of chemotherapy to gauge the tumour's response. Those whose tumour was reduced by more than half of its original size received a full course of chemotherapy and radiation given simultaneously. Patients whose tumours did not respond were referred for surgery. Fifty-four of the 66 participants responded to the initial chemotherapy. Of that group, 62% are alive today without evidence of cancer and 73% fully preserved their organs. Participants whose cancer did not respond to the chemotherapy and radiation went on to receive surgery. The researchers found that even with surgery, only 4 of 11 patients survived. By looking at biopsies taken before treatment, the researchers found that 64% of the tumours were positive for high-risk strains of HPV. Almost all of the HPV-positive tumours responded to initial chemotherapy, and 78% of those patients survived with their organs preserved. Of the HPV-negative study participants, only 4 of 15 survived. In addition, the researchers found that patients whose tumour expressed the marker for epidermal growth factor receptor (EGFR) had worse outcomes. "The combination of markers was an important indicator. Patients whose tumours expressed high levels of EGFR did poorly. But those who had high EGFR and were also HPV-positive had some protection. Patients with high EGFR and low HPV fared the worst. This is a step in the direction of affecting future treatment," said Bhavna Kumar, a research laboratory specialist who was the lead author on both papers. The researchers also found that tumours with low expression of a protein called p53, combined with high expression of another protein, BCLXL, also had poor outcomes. These markers provide additional targets for potential new therapies. The researchers called these and other markers a promising step in the direction of tailored, individualised treatment for a type of cancer that can have dramatic impact on essential abilities such as swallowing and speaking. SOURCE: Journal of Clinical Oncology
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