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HPV linked to better survival in tonsil, tongue cancer, U-M study finds
Date:5/12/2008

best to treat patients with tumors that stem from tobacco and alcohol use as opposed to tumors linked to HPV. We now know theyre two different cancers, says study author Francis Worden, M.D., assistant professor of internal medicine at the U-M Medical School.

In this study, researchers treated 66 patients with advanced oropharyngeal cancer, which includes cancer of the tonsils and the base of the tongue. Study participants were given an initial course of chemotherapy to gauge the tumors response. Those whose tumor was reduced by more than half of its original size received a full course of chemotherapy and radiation given simultaneously. Patients whose tumors did not respond were referred for surgery.

Fifty-four of the 66 participants responded to the initial chemotherapy. Of that group, 62 percent are alive today without evidence of cancer, and 73 percent 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.

For most patients, the chemoradiation was very effective. But a subset of patients still do not do well. Our next step was to look at the biomarkers to see if we could determine which patients were responding to treatment, based on the tumor biology, says Carey, who is also associate chair and professor of otolaryngology and pharmacology at the U-M Medical School.

By looking biopsies taken before treatment, the researchers found 64 percent of the tumors were positive for high-risk strains of HPV. Almost all of the HPV-positive tumors responded to initial chemotherapy and 78 percent of those patients survived with their organs preserved. Of the HPV-negative study participants, only four of 15 survived. In addition, the researchers found that patients whose tumor expressed a marker called EGFR had worse outcomes.

The combination of markers was an importa
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Contact: Nicole Fawcett
nfawcett@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert

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