“There are already national clinical trials ongoing investigating the reduction of radiation therapy and chemotherapy intensity in favorable HPV positive oropharynx cancer patients,” said Shlomo Koyfman, director of head and neck and skin cancer radiation at Cleveland Clinic and a study collaborator. “However, properly selecting the ideal patients for this treatment reduction has been a challenge. This imaging classifier can help us better select patients for these novel treatment paradigms.”

Collaboration among 10 institutions


Corredor said other researchers are already testing whether reducing the intensity of treatment can benefit some patients. But this new work, if validated in human trials, could provide a tool for physicians to make better decisions about who should get chemo or radiation, he said.

“Maybe we can reduce intensity of treatment for some people and give them a better quality of life because chemo and radiation often have very strong side effects,” Corredor said.

Nearly two dozen other scientists contributed, including six others from Case Western Reserve.

“We have been able to visually assess patient’s tumor microscopically for a very long time, but now, with this technology, can actually extract meaningful information from the morphology for prognosis and prediction,” said James Lewis Jr., a professor of Pathology, Microbiology and Immunology at Vanderbilt University Medical Center and a research collaborator.

Also involved were scientists and physicians from the Cleveland and San Francisco Veterans Affair (VA) Medical Centers; Baylor College of Medicine; Southern California Permanente Medical Group; University of Texas Southwestern Medical Center; University of California, San Diego Health; and Washington University in St. Louis.

HPV, head and neck cancer

Head and neck cancers total more than a half-million cases and 300,000 deaths a year, making them the sixth leading cancer worldwide, according to the World Health Organization.

HPV is the most common sexually transmitted infection (STI)—affecting about 43 million people in 2018, according to the Centers for Disease Control. Further, HPV accounts for roughly 75% of oropharyngeal cancer cases in the United States.

The imaging biomarker isolated by the Case Western Reserve-led team from routine digital pathology slides would reveal the HPV-associated cancer patients who could avoid the harsher treatment, instead receiving either lower doses of radiation or no radiation at all.

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