One Virus, Two Diseases: SHRO-Led Review Reveals Gaps in HPV Cancer Treatment

Philadelphia, PA - July 2025 – A newly published narrative review in BMC Medicine sheds light on a striking paradox in cancer care: the same virus, human papillomavirus (HPV), is responsible for both cervical cancer and an increasing number of throat cancers, specifically oropharyngeal squamous cell carcinoma (OPSCC), yet the two diseases behave in fundamentally different ways. The review, led by scientists from the Sbarro Health Research Organization (SHRO) at Temple University, urges the medical community to address the critical treatment divide.

“It's as if the virus speaks the local language of each tissue” - said Dr. Antonio Giordano, President of SHRO. “Our review maps what we know and, more importantly, what we still don’t”. HPV-positive oropharyngeal tumors require less radiation and are unusually sensitive to it, which allows oncologists to reduce treatment intensity and limit side effects. Cervical tumors, on the other hand, still require aggressive chemoradiotherapy and brachytherapy.

“There’s a real risk of over- or under-treatment if we don’t base care on biology” - said Dr. Canio Martinelli, lead clinician and gynecologist-scientist at SHRO - “We must align treatment with biology, not assumptions”. The review outlines how these differences extend deep into the biology of the tumors. Cervical cancers tend to hide from the immune system, while throat tumors often attract immune attention by expressing markers like PD-L1, making them more responsive to immunotherapy. “Pinpointing those immune moods could guide the next generation of combined therapies” - explained Dr. Salvatore Cortellino, molecular biologist at SHRO.

The way HPV inserts its DNA into the human genome also varies between tissues, influencing DNA repair, tumor progression, and the potential for metastasis. According to Prof. Alfredo Ercoli, surgical oncologist and adjunct professor at Temple University: “real-time mapping of these integration hotspots could become a future operating-room compass for sparing healthy tissue”.

The paper also calls for greater parity in clinical research. While de-escalation trials have already reduced radiation doses for HPV-related throat cancers, without compromising survival, similar trials are still lacking for cervical cancer. “Equal evidence, not equal doses, should set the standard” - emphasized Dr. Silvana Parisi, radiation specialist at the University of Messina. HPV vaccination is making significant progress in reducing infection rates, yet breakthrough cancers continue to affect more than 600,000 people annually worldwide. By highlighting how one virus can create two biologically distinct diseases, this review offers a strategic research agenda aimed at more personalized and effective care. 

“Linking viral genetics to tissue context is the missing piece” - Giordano concluded. “Once we have it, radiation and immunotherapy can be calibrated—not guessed, for every HPV-positive patient”.