Pajares, BellaTrigo, José MToledo, María DÁlvarez, MartinaGonzález-Hermoso, CarlosRueda, AntonioMedina, José ALuque, Vanessa deJerez, José MAlba, Emilio2013-06-192013-06-192013-01-18Pajares B, Trigo JM, Toledo MD, Álvarez M, González-Hermoso C, Rueda A, et al. Differential outcome of concurrent radiotherapy plus epidermal growth factor receptor inhibitors versus radiotherapy plus cisplatin in patients with human papillomavirus-related head and neck cancer. BMC Cancer. 2013; 13(1):26http://hdl.handle.net/10668/1144Journal Article; Research Support, Non-U.S. Gov't;BACKGROUND Human papillomavirus (HPV)-related head and neck cancer has been associated with an improved prognosis in patients treated with radiotherapy (RT) +/- chemotherapy (CT); however, RT combined with epidermal growth factor receptor (EGFR) inhibitors has not been fully studied in this group of patients. METHODS Immunohistochemical expression of p16 and PCR of HPV16 DNA were retrospectively analyzed in tumor blocks from 108 stage III/IV head and neck cancer patients treated with RT+CT (56) or RT+EGFR inhibitors (52). Disease-free survival (DFS) and overall survival (OS) were analyzed by the Kaplan-Meier method. RESULTS DNA of HPV16 was found in 12 of 108 tumors (11%) and p16 positivity in 18 tumors (17%), with similar rates in both arms of treatment. After a median follow-up time of 35 months (range 6-135), p16-positive patients treated with RT+EGFR inhibitors showed improved survival compared with those treated with RT+CT (2-year OS 88% vs. 60%, HR 0.18; 95% CI 0.04 to 0.88; p = 0.01; and 2-year DFS 75% vs. 47%, HR 0.17; 95% CI 0.03 to 0.8; p = 0.01). However, no differences were observed in p16-negative patients (2-year OS 56% vs. 53%, HR 0.97; 95% CI 0.55 to 1.7; p = 0.9; and 2-year DFS 43% vs. 45%, HR 0.99; 95% CI 0.57 to 1.7; p = 0.9). CONCLUSIONS This is the first study to show that p16-positive patients may benefit more from RT+EGFR inhibitors than conventional RT+CT. These results are hypothesis-generating and should be confirmed in prospective trials.enChemotherapyEGFR inhibitorsHead and neck cancerHuman papillomavirusNeoplasias de Cabeza y CuelloTomografía de Emisión de PositronesRadioterapiaInmunohistoquímicaReacción en Cadena de la PolimerasaFactor de Crecimiento EpidérmicoRadioisótoposRadiofármacosMedical Subject Headings::Diseases::Neoplasms::Neoplasms by Site::Head and Neck NeoplasmsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Techniques, Radioisotope::Radionuclide Imaging::Tomography, Emission-Computed::Positron-Emission TomographyMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::RadiotherapyMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Cytological Techniques::Histocytochemistry::ImmunohistochemistryMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Genetic Techniques::Nucleic Acid Amplification Techniques::Polymerase Chain ReactionMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Radiometry::Radiation DosageMedical Subject Headings::Chemicals and Drugs::Inorganic Chemicals::Chlorine Compounds::CisplatinMedical Subject Headings::Chemicals and Drugs::Enzymes and Coenzymes::Enzymes::Transferases::Phosphotransferases::Phosphotransferases (Alcohol Group Acceptor)::Protein Kinases::Protein-Tyrosine Kinases::Receptor Protein-Tyrosine Kinases::Receptor, Epidermal Growth FactorMedical Subject Headings::Organisms::Viruses::DNA VirusesMedical Subject Headings::Chemicals and Drugs::Inorganic Chemicals::Isotopes::RadioisotopesMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Specialty Uses of Chemicals::Laboratory Chemicals::Indicators and Reagents::RadiopharmaceuticalsMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Publication Characteristics::Publication Formats::Reviewresearch article23331666open access10.1186/1471-2407-13-261471-2407PMC3637564