HPV and beyond—looking out for biomarkers for distinguishing the good prognosis from the bad prognosis group in locally advanced and clinically high risk HNSCC

In their recent editorial Kimple and Harari (1) reviewed the current knowledge of the importance of HPV status of head and neck squamous cell carcinoma (HNSCC) for outcome of radiotherapy. The editorial summarized, among others, a retrospective multicenter study by the German Cancer Consortium Radiation Oncology Group (DKTK-ROG) which demonstrated significant prognostic value of the HPV status in patients with locally advanced HNSCC on the outcome of postoperative radiochemotherapy (PORT-C) (2). The overall aim of the DKTK-ROG head and neck program is to identify and validate biomarkers including biological and clinical parameters as well as imaging data for patient stratification in terms of individualization of radiotherapy by multimodal treatment. The study design includes retrospective explorative analyses in patients who received PORT-C or primary radiochemotherapy (RCT) for biomarker identification. The most promising biomarkers will then be validated in a prospective validation cohort, which is currently recruiting at all eight DKTK-ROG partner sites. Based on these results, interventional studies are under preparation. Biomarker analyses are being performed at all eight DKTK partner sites and are addressing different topics such as HPV status, hypoxia, cancer stem cells, tumor infiltrating lymphocytes, tumor volume, targeted next generation sequencing, transcriptomics and methylome analyses.