Management of human papillomavirus-induced oropharynx cancer

Oropharynx cancer (OPC) constitutes the most common location for squamous-cell head and neck cancer, and most OPC is caused by the human papilloma virus (HPV). Early-stage (American Joint Committee on Cancer [AJCC] stage I and II) disease should be treated with single modality surgery or radiotherapy whenever possible. More advanced presentations generally require combined-modality therapy with various combinations of surgery, radiotherapy, and chemotherapy or molecularly targeted therapy. All of these approaches expose patients to a substantial risk of serious long-term functional morbidity. HPV-induced OPC has a very favorable prognosis compared with its HPV-negative counterpart irrespective of the treatment platform that is used. Current clinical trials are investigating the concept of therapeutic deintensification with the dual objectives of decreasing toxicity and maintaining efficacy.