# HPV-associated oropharyngeal cancer: in search of surrogate biomarkers for early lesions

## TL;DR

This paper explores biomarkers for early detection of HPV-related oropharyngeal cancer, aiming to improve screening and reduce mortality.

## Contribution

The paper reviews the multistep progression from HPV infection to cancer and proposes novel strategies for identifying biomarkers and modeling disease progression.

## Key findings

- HPV infection can persist and progress to oropharyngeal cancer, but the process is not well understood.
- Current biomarkers for early detection of OPSCC are limited and require further investigation.
- New genetic models and in vivo systems are being developed to better study HPV + OPSCC progression.

## Abstract

The incidence of oropharyngeal cancer (OPSCC) has escalated in the past few decades; this has largely been triggered by high-risk human papillomavirus (HPV). Early cancer screening is needed for timely clinical intervention and may reduce mortality and morbidity, but the lack of knowledge about premalignant lesions for OPSCC poses a significant challenge to early detection. Biomarkers that identify individuals at high risk for OPSCC may act as surrogate markers for precancer but these are limited as only a few studies decipher the multistep progression from HPV infection to OPSCC development. Here, we summarize the current literature describing the multistep progression from oral HPV infection, persistence, and tumor development in the oropharynx. We also examine key challenges that hinder the identification of premalignant lesions in the oropharynx and discuss potential biomarkers for oropharyngeal precancer. Finally, we evaluate novel strategies to improve investigations of the biological process that drives oral HPV persistence and OPSCC, highlighting new developments in the establishment of a genetic progression model for HPV + OPSCC and in vivo models that mimic HPV + OPSCC pathogenesis.