Human Papillomavirus Types Conferring Poor Cancer Prognosis

In Reply Human papillomavirus (HPV)-related oropharynx cancer (OPC) is well known to have a favorable outcome compared with HPV-unrelated OPC. The use of immunohistochemical analysis to detect tumor overexpression of p16 is regarded as a reliable surrogate marker for HPV-driven OPC and is presently used to define this disease for inclusion within clinical trials, including those studying treatment deescalation. Appropriately, these trials also incorporate additional criteria such as tumor extent to define risk groups. For some patients, however, p16 status and tumor extent have limitations in predicting outcome. It is therefore imperative in the era of deescalation to identify additional potential prognostic factors in HPV-related OPC. We recently reported that HPV-16 was associated with favorable survival compared with other HPV types (HPV-other) (HR, 4.8; P = .003), a finding that could not be readily explained by differences in clinical, demographic, or genomic features. Psyrri et al have highlighted several aspects of our analysis, and we appreciate the opportunity to reply.

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