Tailored immunotherapy for HPV positive head and neck squamous cell cancer

Human papilloma virus (HPV) associated oropharynx carcinoma (OPC) is increasingly common, with a distinct biology from HPV negative OPC. In spite of this better prognosis, morbidity is significant and treatment related after effects can be debilitating. Because the foreign viral proteins that drive HPV+ cancers are known, there are multiple options for tailored immune therapies. Herein we review the immunologic basis for disease and emerging immune therapies. The oncogenesis of HPV+ SCCHN goes beyond cell cycle deregulation, and relies on the immune escape through (E5, E6, and E7) downregulating antigen processing, interferon response, as well as STAT-1 signaling. Individual susceptibilities to HPV infection may vary. The treatment of HPV+ cancers has had a wide range of successes and failures. Perhaps the shining example of immunoprevention has been the L1 protein vaccines developed for cervical cancer prevention, however this vaccine has not been beneficial for people already infected. Therefore multiple strategies have been employed in the cancer therapeutic realm for people with existing disease. These agents range from peptides, to viral vectors, to adoptive cell therapy. In this review we consider the work done in both SCCHN and cervical cancer, as these therapeutic targets are the similar. The listed studies are not exhaustive, but rather illustrate experimental design and approach.