Smoking, T4 tumors up distant mets in HPV+ oropharyngeal CA

(HealthDay)—For patients with human papillomavirus (HPV)-positive oropharyngeal cancer, active smokers and those with T4 tumors have increased rates of distant metastases, according to a study published online Feb. 11 in Head & Neck.

Michael A. Weller, M.D., from the Cleveland Clinic, and colleagues examined predictors of distant metastases in patients with stage III to IVb HPV-positive oropharyngeal cancer treated with cisplatin-based chemoradiotherapy (CRT) or cetuximab-based bioradiotherapy (bio-RT).

The researchers found that the rates of distant metastases were increased for active smokers compared with never/former smokers (22 versus 5 percent), for those with T4 versus T1 to T3 tumors (15 versus 6 percent), and with use of cetuximab-based bio-RT versus CRT (23 versus 5 percent). On multivariate analyses, all factors remained significant.

"Patients with HPV-positive oropharyngeal cancer with T4 tumors and/or are active smokers have substantial rates of distant metastases (>20 percent), and trials investigating intensified systemic therapies may be considered in this population," the authors write. "Retrospective observations from this patient cohort demonstrate an increased rate of distant metastases in patients treated with cetuximab when compared with patients treated with cisplatin, but until further data are available, this should be considered hypothesis generating."