HPV-driven Cancers and Somatic Mutations in These Cancers

HPV Can Lead to Different Types of Cancer at Different Sites

Human papillomavirus (HPV) is mostly transmitted through sexual activities. Most of the infection (90%) is transient and the virus becomes undetectable within two years. The virus stays in the host cells in the rest of the infection, pertinent infection. Although not all pertinent infection will cause cancer, HPV-infection could lead to the following cancers:

• Cervical cancer
•  Oropharyngeal cancer
• Head and neck cancer
•  Anal cancer
• Penile cancer
• Vaginal cancer
• Vulvar cancer

Not All HPV Viruses Cause Cancer

There are more than 150 subtypes of HPV by genotyping and only a small number of the subtypes are high-risk HPV that cause cancer. Among these high-risk HPV subtypes, HPV 16 is the one that causes most of cancer (50 to 90%). Therefore, it is important to understand if one carries high-risk HPV.

Mechanisms for HPV to Cause Cancer

HPV causes cancer by its interaction with the host cells. Two HPV oncoproteins play critical roles in causing cancer: E6 and E7 proteins. They bind to two tumor suppressor proteins, P53 and Rb, respectively and interfere with multiple normal cellular functions including tumor suppression and cell cycle regulations. In addition, the E6 and E7 proteins promote chromosomal instabilities and multiple cancer driver gene mutations including the most common mutations in PIK3CA (codon 542 and 545) and mutations in EGFR, KRAS and many others. The details for the mechanism can be found in this review.

Understanding and detecting the genetic mutations in the HPV-driven cancer cells are important for targeted therapies and disease monitoring. Finding the potential biomarkers among these mutations and designing a diagnostic gene panel will help early cancer detection and improvement of cancer prognosis.

HPV Testing and Understanding of Cancer Risks

It is important to test high-risk HPV infection and understand the cancer risks. Our cost-effective QuantiVirus™ HPV E6/E7 mRNA test (RUO and CE/IVD) identifies pertinent infections by detecting the E6 and E7 gene expression of 14 high-risk HPV subtypes (link to a 2017 publication) and further determines if the subtype is HPV 16 or 18. The test uses either saliva or FFPE samples without isolating mRNA. The test has been successfully used for HPV genotyping for both cervical cancer and head and neck cancer patient samples.