Dr. Burtness on Treatment Approaches in HPV-Positive Head and Neck Cancer

Barbara Burtness, MD, professor of Medicine, Yale Cancer Center, discusses current treatment approaches for patients with human pappillomavirus (HPV)-positive head and neck cancer, as well as potential changes for those regimens.

According to Burtness, the most clear-cut body of evidence about biomarker selection in head and neck cancer can be found in those patients who are HPV-positive. HPV-positive head and neck cancer is considered to be a much more treatment-responsive disease, she says. Oncologists can identify certain patients who have non-bulky tumors and do not have a lifetime history of exposure to tobacco. These patients have a very high likelihood of having durable complete responses and potentially being cured by chemoradiation alone.

This raises the question, then, of whether or not physicians are possibly overtreating these patients. Burtness questions whether 7 weeks of radiation with concurrent chemotherapy is simply too difficult a treatment regimen for these HPV-positive patients with head and neck cancer.

One clinical trial demonstrated that, for patients who are responsive to upfront chemotherapy and are not heavy smokers, the ability to achieve cure seemed equally promising with less and more intensive forms of radiation therapy. Burtness says the researchers hope to take these findings forward with a comparative trial in the near future.