ReviewFrontiers in genetics2026
Therapeutic resistance in HPV-positive oropharyngeal squamous cell carcinoma: molecular mechanisms, clinical challenges, and precision strategies.
Review in Frontiers in genetics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
4 authors.
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Abstract
Human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) exhibits exceptional sensitivity to chemoradiotherapy, with 5-year overall survival exceeding 80%, thereby providing a compelling rationale for treatment de-escalation. However, 15%-20% of patients develop therapeutic resistance and locoregional recurrence, resulting in markedly inferior outcomes. This Review systematically dissects the molecular architecture of treatment resistance in HPV-positive OPSCC, with particular emphasis on mechanisms conferring resistance to radiotherapy, platinum-based chemotherapy, and EGFR-targeted therapy (cetuximab). We delineate core drivers - aberrant DNA damage response (DDR) signaling, epigenetic reprogramming, cancer stem cell (CSC) plasticity, and non-coding RNA networks-and pinpoint actionable vulnerabilities. The contributions and limitations of patient-derived organoids, genetically engineered mouse models, and pivotal clinical trials (notably RTOG 1016) are critically appraised. We address persistent controversies, including the complex relationship between de-escalation and resistance, and highlight the lack of integrative resistance biomarkers. Finally, we propose a roadmap to bridge translational gaps and accelerate the development of precision strategies that circumvent resistance.
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