Simple test could help predict survival for head and neck cancers

In collaboration with the Press Association

Testing for a protein found in head and neck cancers could prove more useful in predicting survival than current methods, according to a study funded by Cancer Research UK.

“This study clearly shows that testing for HPV status using p16 levels can be valuable as one of a number of ways doctors determine their patients' prognosis." - Jessica Kirby, Cancer Research UK

The researchers believe the test could allow doctors to choose treatment tailored to patients.

Publishing their findings in the journal Clinical Oncology, the team found that the presence of a protein called p16 in tumours was strongly linked to better survival irrespective of how advanced the cancer was.

Increasing numbers of head and neck cancers, such as those affecting the tongue and tonsils, are linked to the human papillomaviruses (HPV). These are typically found in younger people and have a better outlook than cases linked to tobacco and alcohol intake. 

One way of testing for HPV-associated oral cancer involves looking for HPV DNA in a tumour sample, but these tests are not always accurate.

Because the p16 molecule usually disappears in tumours not linked with HPV, the University of Manchester team - part of the Manchester Cancer Research Centre – tested whether the presence of p16 could be used as an indicator of HPV status.

The study of 217 head and neck cancer patients looked at differences in clinical characteristics, treatment and survival between p16-positive and p16-negative tumours.

Professor Catharine West, an author on the study, said: “We know that in most cases, p16 is linked to differences in survival. We wanted to see how it compared to other measures such as the stage of disease - which tells us the size and spread of the cancer. 

"Anything that allows us to predict outcome could help doctors plan more personalised treatments for individual patients.”

For those with p16-negative tumours, their survival was linked to how big the tumour had grown, but this was not the case for those with p16-positive tumours.

Professor West said: “Despite presenting with a more advanced stage of cancer, patients whose tumours tested positive for p16 had greater survival when compared with p16-negative patients."

She said that applying this test in clinics could help inform treatment decisions and potentially help doctors choose more appropriate and tailored treatments.

“Many studies have now shown p16 status is strongly linked to survival. Now we have shown the test works better than routine staging for some cancers, we would recommend this test be offered as standard,” added Professor West. 

Jessica Kirby, Cancer Research UK’s senior health information manager, said: “This study clearly shows that testing for HPV status using p16 levels can be valuable as one of a number of ways doctors determine their patients' prognosis. HPV-associated head and neck cancers are becoming much more common over time, and there's a wealth of evidence that patients with HPV-positive tumours tend to have better outcomes than HPV-negative patients.” 

Copyright Press Association 2014 

References

  • Oguejiofor K.K, et al. (2013). The Prognostic Significance of the Biomarker p16 in Oropharyngeal Squamous Cell Carcinoma, Clinical Oncology, 25 (11) 630-638. DOI: