Resolution of Squamous-Cell Carcinoma by Restoring T-Cell Receptor Signaling.

Ye, Peiying; Bergerson, Jenna R E; Brownell, Isaac; Starrett, Gabriel J; Abraham, Roshini S; Anderson, Megan V; Martin, Triscia; MacMath, Derek et al. · N Engl J Med · 2025

case_report · Level V

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Abstract

Cutaneous squamous-cell carcinoma (SCC) is primarily caused by oncogenesis mediated by ultraviolet radiation, and β-human papillomavirus (β-HPV) is believed to be a mere facilitator that is dispensable for the maintenance of cutaneous SCC. Here, we describe a woman with benign and malignant HPV-related diseases that include a recurrent, unresectable, invasive cutaneous SCC with β-HPV19 genomic integration in the context of germline pathogenic mutations in <i>ZAP70</i>, an adapter required for T-cell receptor (TCR) signal transduction. Restoration of the integrity of TCR signaling by allogeneic hematopoietic-cell transplantation led to the resolution of all HPV-related diseases, thereby revealing a direct role of β-HPV in skin carcinogenesis in hosts with defective adaptive T-cell responses. (Funded by the National Institutes of Health.).

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