Oropharyngeal Cancer: Current status of human papillomavirus vaccination

Abstract

Human papillomavirus (HPV) is recognized as a major risk factor for head and neck can­cer worldwide. In recent decades, there has been evidence of an increase in the number of cases directly related to HPV infection, particularly in Western countries. HPV-related oropharyngeal cancer has now surpassed cervical cancer as the most frequent HPV-related cancer in the USA. Current projections estimate an upward trend for the next decade, with predictions of more than 30,000 cases per year by 2029. Prophylactic HPV vaccines have demonstrated efficacy against HPV 16 and HPV 18 infection of the oral cavity. Therefore, it is expected that early vaccination, preferably before the onset of sexual activity, could effec­tively prevent infection by the most oncogenic HPV types, leading to a significant decrease in HPV-associated oropharyngeal cancers. Accordingly, the FDA has recently expanded the indications for Gardasil-9® to include the prevention of head and neck cancer. This article reviews the epidemiology and pathogenesis of HPV-related cancers, the development and approval of prophylactic HPV vaccines, and the use and efficacy of HPV vaccines world­wide. In addition, we discuss advances in the development of therapeutic HPV vaccines, as well as associated challenges.