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\begin{document}

\title{The molecular characteristics of recurrent/metastatic HPV-positive head
and neck squamous cell carcinoma: A systematic review of the literature}



\author[1]{Susanne Flach}%
\author[2]{Pavithran Maniam}%
\author[3]{Shi Ying Hey}%
\author[4]{Jai Manickavasagm}%
\affil[1]{Ludwig-Maximilians-Universitat Munchen}%
\affil[2]{Newcastle University}%
\affil[3]{Guy's and St Thomas' NHS Foundation Trust}%
\affil[4]{Ninewells Hospital and Medical School}%


\vspace{-1em}



  
  \date{May 21, 2024}


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\begin{abstract}
Background Up to 25\% of patients with HPV-positive head and neck
squamous cell carcinoma (HNSCC), which is mainly comprised of
oropharyngeal SCC (OPSCC), will experience disease recurrence, which is
often considered incurable when manifested at a metastatic and/or
recurrent stage. Objectives To provide an overview of the molecular
landscape of recurrent/metastatic HPV-positive HNSCC, novel molecular
biomarkers and current trends in treatment options. Type of review A
critical qualitative systematic review. Design A literature review was
conducted to identify studies reporting on the molecular characteristics
of recurrent/metastatic HPV-positive HNSCC, novel molecular biomarkers
and treatment options. The reviews of abstracts, full articles, and
revision of the included studies, followed by data extraction and
quality assessment were performed by three independent assessors.
Results The literature search resulted in the identification of 1995
articles. Sixty-six articles were selected for inclusion in the
systematic review. Several studies reported that recurrent/metastatic
HPV-positive HNSCC had higher rates of \emph{TP53} mutation and were
genomically similar to HPV-negative HNSCC. The detection of circulating
tumour tissue-modified HPV DNA (ctHPVDNA) as a specific biomarker has
shown promising results for monitoring treatment response and recurrence
in the subset of HPV-positive HNSCC. Conclusions Our review outlines the
latest evidence on the distinct molecular profiles of
recurrent/metastatic HPV-positive HNSCC as well as the clinical
potential of ctHPVDNA testing in routine practice. More controlled and
longitudinal studies are needed to identify additional molecular targets
and to assess the performance and benefits of novel molecular biomarkers
in clinical practice.%
\end{abstract}%



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