Epigenetics and human papillomavirus-associated cancers: mechanisms, biomarkers, and clinical perspectives

Human papillomavirus-induced cancers result from a synergy between genetic mutations and epigenetic reprogramming. The latter affects both the viral and host genomes, resulting in methylomic signatures, histone alterations and aberrant regulation of non-coding RNAs. These mechanisms contribute to tumor progression and provide new biomarkers for screening, risk stratification, and therapeutic monitoring. In a context where, despite vaccination campaigns, the incidence of HPV-positive cancers remains high particularly for oropharyngeal sites, the integration of these markers into precision medicine approaches appears essential. Future strategies will likely rely on a combination of vaccination, screening based on robust epigenetic panels, and the development of targeted epigenetic therapies, either alone or in combination with immunotherapy, to improve the prevention and management of HPV-associated cancers.