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Current Cancer Therapy Reviews

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ISSN (Print): 1573-3947
ISSN (Online): 1875-6301

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Short Communication

Impact of Human Papillomavirus (HPV) Infection on the Treatment Outcome of Concomitant Chemoradiotherapy (CRT) in Cervical Cancer

Author(s): Atar Singh Kushwah, Kirti Srivastava, Rajnikant Mishra and Monisha Banerjee*

Volume 20, Issue 3, 2024

Published on: 27 September, 2023

Page: [320 - 326] Pages: 7

DOI: 10.2174/1573394719666230807161948

Price: $65

Abstract

Background: Human Papilloma Virus (HPV) infection and its persistence are responsible for the development of cervical cancer (CaCx). Chemoradiotherapy (CRT) is the only treatment option, especially in advanced stages. However, it is not influenced by the status of HPV infection. CRT controls cancer growth along with mild to severe adverse effects.

Objective: The aim of this study was to assess the HPV-associated risk factors and correlate them with chemoradiation therapy (CRT) response in cervical cancer.

Methods: The study was undertaken in 103 histologically positive CaCx patients. Anthrodemographic and obstetric characterizations were conducted by face-to-face interviews, and HPV testing was done by conventional PCR. All the patients received a 40-50Gy total effective dose using tele- and brachytherapy. The treatment response, survivorship and statistical analysis were made using GraphPad Prism 9 and SPSS (ver.25.0).

Results: Out of 103 patients, 84% were HPV infected, and 16% CaCx were HPV-negative. Advanced age, lower-middle socioeconomic status (SES), illiteracy, and patients from rural backgrounds were significantly higher in CaCx patients with HPV infection. Multiparity, irregular menstrual cycle, poor menstrual hygiene, and use of contraception were significantly associated with HPV positivity. Patients with HPV infection showed a better clinical response (P =0.031), alive vital status (P =0.007), and 59 months of median survival (P <0.001) with a poor hazard ratio (HR 0.29 at 95% CI).

Conclusion: HPV-infected CaCx patients showed better response to definitive chemoradiation therapy compared to HPV-negative with a poor hazard ratio. Therefore, HPV testing can potentially stratify CaCx patients for more effective therapeutic regimens, treatment assessments and follow-ups.

Keywords: Cervical cancer, chemoradiotherapy (CRT), CaCx Patients, human papillomavirus (HPV) infection, treatment outcome, overall survival.

« Previous
[1]
Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71(3): 209-49.
[http://dx.doi.org/10.3322/caac.21660] [PMID: 33538338]
[2]
Bouvard V, Baan R, Straif K, et al. A review of human carcinogens-Part B: Biological agents. Lancet Oncol 2009; 10(4): 321-2.
[http://dx.doi.org/10.1016/S1470-2045(09)70096-8] [PMID: 19350698]
[3]
Okunade KS. Human papillomavirus and cervical cancer. J Obstet Gynaecol 2020; 40(5): 602-8.
[http://dx.doi.org/10.1080/01443615.2019.1634030] [PMID: 31500479]
[4]
Senapati R, Senapati NN, Dwibedi B. Molecular mechanisms of HPV mediated neoplastic progression. Infect Agent Cancer 2016; 11(1): 59.
[http://dx.doi.org/10.1186/s13027-016-0107-4] [PMID: 27933097]
[5]
Gupta MK, Singh R, Banerjee M. Cytokine gene polymorphisms and their association with cervical cancer: A North Indian study. Egypt J Med Hum Genet 2016; 17(2): 155-63.
[http://dx.doi.org/10.1016/j.ejmhg.2015.10.005]
[6]
Kushwah AS, Gupta MK, Singh R, Banerjee M. Cytokine gene variants and treatment outcome of cisplatin-based concomitant chemoradiotherapy in cervical cancer. Br J Biomed Sci 2020; 77(2): 81-6.
[http://dx.doi.org/10.1080/09674845.2020.1714164] [PMID: 31935340]
[7]
Kaushik M, Chandra Joshi R, Kushwah AS, et al. Cytokine gene variants and socio-demographic characteristics as predictors of cervical cancer: A machine learning approach. Comput Biol Med 2021; 134: 104559.
[http://dx.doi.org/10.1016/j.compbiomed.2021.104559] [PMID: 34147008]
[8]
Yang HJ. Aberrant DNA methylation in cervical carcinogenesis. Chin J Cancer 2013; 32(1): 42-8.
[http://dx.doi.org/10.5732/cjc.012.10033] [PMID: 22943599]
[9]
Parkin DM, Bray F. Chapter 2: The burden of HPV-related cancers. Vaccine. 2006; 24(Suppl. 3). S11-S25, 11-25.
[http://dx.doi.org/10.1016/j.vaccine.2006.05.111] [PMID: 16949997]
[10]
Al Moustafa AE, Foulkes WD, Wong A, et al. Cyclin D1 is essential for neoplastic transformation induced by both E6/E7 and E6/E7/ErbB-2 cooperation in normal cells. Oncogene 2004; 23(30): 5252-6.
[http://dx.doi.org/10.1038/sj.onc.1207679] [PMID: 15229656]
[11]
Duensing S, Münger K. Mechanisms of genomic instability in human cancer: Insights from studies with human papillomavirus oncoproteins. Int J Cancer 2004; 109(2): 157-62.
[http://dx.doi.org/10.1002/ijc.11691] [PMID: 14750163]
[12]
Huang Q, Su X, Ai L, Li M, Fan CY, Weiss LM. Promoter hypermethylation of multiple genes in primary gastric lymphoma. Leuk Lymphoma 2007; 48(10): 1988-96.
[http://dx.doi.org/10.1080/10428190701573224] [PMID: 17852707]
[13]
Spierings D, McStay G, Saleh M, et al. Connected to death: The (unexpurgated) mitochondrial pathway of apoptosis. Science 2005; 310(5745): 66-7.
[http://dx.doi.org/10.1126/science.1117105] [PMID: 16210526]
[14]
Vousden KH, Prives C. P53 and Prognosis. Cell 2005; 120(1): 7-10.
[http://dx.doi.org/10.1016/j.cell.2004.12.027] [PMID: 15652475]
[15]
Green DR. Apoptotic pathways: Ten minutes to dead. Cell 2005; 121(5): 671-4.
[http://dx.doi.org/10.1016/j.cell.2005.05.019] [PMID: 15935754]
[16]
Xu Y, Teng F, Huang S, et al. Changes of saliva microbiota in nasopharyngeal carcinoma patients under chemoradiation therapy. Arch Oral Biol 2014; 59(2): 176-86.
[http://dx.doi.org/10.1016/j.archoralbio.2013.10.011] [PMID: 24370189]
[17]
Dunst J, Rödel C, Zietman A, Schrott KM, Sauer R, Shipley WU. Bladder preservation in muscle-invasive bladder cancer by conservative surgery and radiochemotherapy. Semin Surg Oncol 2001; 20(1): 24-32.
[http://dx.doi.org/10.1002/ssu.1013] [PMID: 11291129]
[18]
Ekhart C, Rodenhuis S, Smits PHM, Beijnen JH, Huitema ADR. An overview of the relations between polymorphisms in drug metabolising enzymes and drug transporters and survival after cancer drug treatment. Cancer Treat Rev 2009; 35(1): 18-31.
[http://dx.doi.org/10.1016/j.ctrv.2008.07.003] [PMID: 18771857]
[19]
Lando M, Holden M, Bergersen LC, et al. Gene dosage, expression, and ontology analysis identifies driver genes in the carcinogenesis and chemoradioresistance of cervical cancer. PLoS Genet 2009; 5(11): e1000719.
[http://dx.doi.org/10.1371/journal.pgen.1000719] [PMID: 19911042]
[20]
Castellsagué X, Bosch FX, Muñoz N, et al. Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners. N Engl J Med 2002; 346(15): 1105-12.
[http://dx.doi.org/10.1056/NEJMoa011688] [PMID: 11948269]
[21]
Singh N, Hussain S, Kakkar N, Singh SK, Sobti RC, Bharadwaj M. Implication of high risk Human papillomavirus HR-HPV infection in prostate cancer in Indian population- A pioneering case-control analysis. Sci Rep 2015; 5(1): 7822.
[http://dx.doi.org/10.1038/srep07822] [PMID: 25592643]
[22]
Kushwah AS, Mishra R, Srivastava K, Mishra S, Banerjee M. Anthro-demographic, clinico-pathological and biochemical risk factors in cervical cancer. Int J Health Sci 2022; 6(S8): 3641-53.
[http://dx.doi.org/10.53730/ijhs.v6nS8.12925]
[23]
Chaudhuri S, Paul KK, Maiti A. Menstrual hygiene practices among women aged 15-49 years attending a medical college hospital in Kolkata: A cross-sectional study. J Family Med Prim Care 2020; 9(9): 4699-704.
[http://dx.doi.org/10.4103/jfmpc.jfmpc_718_20] [PMID: 33209786]
[24]
Raychaudhuri S, Mandal S. Socio-demographic and behavioural risk factors for cervical cancer and knowledge, attitude and practice in rural and urban areas of North Bengal, India. Asian Pac J Cancer Prev 2012; 13(4): 1093-6.
[http://dx.doi.org/10.7314/APJCP.2012.13.4.1093] [PMID: 22799287]
[25]
Weinstein JN, Collisson EA, Mills GB, et al. The cancer genome atlas pan-cancer analysis project. Nat Genet 2013; 45(10): 1113-20.
[http://dx.doi.org/10.1038/ng.2764] [PMID: 24071849]
[26]
Pilch H, Günzel S, Schäffer U, et al. The presence of HPV DNA in cervical cancer: Correlation with clinico-pathologic parameters and prognostic significance: 10 years experience at the department of obstetrics and gynecology of the Mainz University. Int J Gynecol Cancer 2001; 11(1): 39-48.
[http://dx.doi.org/10.1046/j.1525-1438.2001.011001039.x] [PMID: 11285032]
[27]
Huang LW, Chao SL, Hwang JL. Human papillomavirus-31-related types predict better survival in cervical carcinoma. Cancer 2004; 100(2): 327-34.
[http://dx.doi.org/10.1002/cncr.20003] [PMID: 14716768]
[28]
Kumar R, Narayanan GS, Ganesh MS. Comparison of treatment response in cervical carcinoma patients infected with human papillomavirus 16 and human papillomavirus 18 who are treated with chemoradiation. J Cancer Res Ther 2021; 17(1): 204-10.
[http://dx.doi.org/10.4103/jcrt.JCRT_177_19] [PMID: 33723156]
[29]
Hang D, Jia M, Ma H, et al. Independent prognostic role of human papillomavirus genotype in cervical cancer. BMC Infect Dis 2017; 17(1): 391.
[http://dx.doi.org/10.1186/s12879-017-2465-y] [PMID: 28583086]
[30]
Wang CC, Lai CH, Huang YT, Chao A, Chou HH, Hong JH. HPV genotypes predict survival benefits from concurrent chemotherapy and radiation therapy in advanced squamous cell carcinoma of the cervix. Int J Radiat Oncol Biol Phys 2012; 84(4): e499-506.
[http://dx.doi.org/10.1016/j.ijrobp.2012.06.031] [PMID: 22889667]
[31]
Li P, Tan Y, Zhu LX, et al. Prognostic value of HPV DNA status in cervical cancer before treatment: A systematic review and meta-analysis. Oncotarget 2017; 8(39): 66352-9.
[http://dx.doi.org/10.18632/oncotarget.18558] [PMID: 29029517]
[32]
Novotný J, Bandúrová V, Strnad H, et al. Analysis of HPV-positive and HPV-negative head and neck squamous cell carcinomas and paired normal mucosae reveals cyclin D1 deregulation and compensatory effect of cyclin D2. Cancers 2020; 12(4): 792-810.
[http://dx.doi.org/10.3390/cancers12040792] [PMID: 32224897]

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