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Abstract
Recent studies have suggested that immune cells as part of tumor's microenvironment could partly explain the better outcome in HPV-associated oropharyngeal carcinoma. We performed a systematic review of the literature focused on differences in immune-infiltrate in HPV+ versus HPV- oropharyngeal cancers. This comprehensive search yielded 4308 original papers, of which 20 satisfied our eligibility criteria. Increase in both circulating and tumor infiltrating CD8+ lymphocytes is mainly seen in HPV+ oropharyngeal carcinoma. Interestingly, the survival benefit associated with increase in immune cells is equal both in HPV+ and HPV- oropharyngeal cancer. Based on these results, our review underscores the role of the immune system in the biological and clinical behavior of oropharyngeal squamous cell carcinomas (OPSCC) and might open doors to further investigate immune modulatory treatment options in OPSCC patients.
Lay Abstract: In the last few years it has become clear that oropharyngeal carcinomas can be caused by an HPV infection. Overall, HPV+ carcinomas have a better outcome. Recent studies suggest that could be partly explained by immune cells in the tumor's microenvironment of HPV+ carcinomas. Following a systematic review of the literature focusing on immunological difference between HPV+ and HPV- oropharyngeal cancers, we found a survival benefit associated with increase in immune cells in both HPV+ and HPV-. We found an increase in CD8+ lymphocytes primarily in HPV+ carcinomas. Our review underscores the role of the immune system in the biological and clinical behavior of these cancers.
Supplementary data
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
Author contributions
The literature search was performed by Sanne Evelien Matlung and Pauline Maria Wilhelmina van Kempen. Study design was carried out by Sanne Evelien Matlung, Pauline Maria Wilhelmina van Kempen and Stefan Martin Willems. All co-authors contributed in writting of the paper.