Human papillomavirus (HPV) related cancers are sexually transmitted diseases. HPV is known to cause cervical,vulvar, anal, penile and a subset of oropharynx cancers. While the incidence rate of oropharynx cancer is increasing in the West, primarily due to the increasing the HPV-positive subset, the status of these cancers in India remains unclear. Globally, HPV prevalence in oropharynx cancervaries dramatically. Whether India, with diverse sociodemographic features, experiences similar variability is not known.Our research program will provide accurate estimates for the HPV-related OPC subset with respect to: incidence,trends (if any) and potential geographic variability across the nation. This is a major research program funded by the Wellcome Trust (UK) India Alliance program by the Department of Biotechnology (DBT).

The recognition of HPV-related cancers in men has triggered the advocacy of male vaccination toprotect against HPV-related genital and oral cancer, particularly in settings of low vaccine uptake among women. It is clear that vaccination must precede infection in order to be effective. Prior to a meaningful discussion on cost-effectiveness of vaccinating boys or the reduction in potential cancer risk, it remains obvious that more evidence regarding the burden of infections is needed. Through a prospective population-based study, we will estimate oral HPV prevalence, incidence and clearance rates among healthy cancer-free men.This project will provide novel insights into the natural history of oral HPV infections and lead to a better understanding of natural immune responses to non-genital HPV infections in men. This is a major research program funded by the Wellcome Trust (UK) India Alliance program by the Department of Biotechnology (DBT).

Oral cancer is the most common malignancy in India for which oral potentially premalignant lesions serve as early indicators of damage. Although it has been recognized for decades that not all oral precancers progress to frank malignancies, no biomarkers exist that can identify patients with a high risk of progression. Further, the overall 5-year survival of oral cancer patients has only improved slightly over the past several decades. Treatment often requires aggressive, multimodality management that results in the loss of oro-facial function, pain, and disfigurement. At present, cancer treatment and prognosis is heavily dependent on stage. Yet, the ability of staging to predict prognosis is limited; patients with tumors of the same clinical and pathologic staging have heterogeneous response to clinical treatment, and different probability of recurrence and survival. Therefore we aim to identify and validate biomarkers of oral cancer risk prediction. This is a major research program funded by the Department of Biotechnology (DBT).

India reports the highest rate of cancers arising at the oral cavity, pharynx and larynx, grouped together as head and neck cancers. The high rate of occurrence has been attributed to the prevalence of tobacco chewing. In addition, smoking and alcohol consumption are also known to cause these cancers. Recently, human papillomavirus (HPV) infection, previously known to cause cervical, vulvar, anal and penile cancers, have been implicated in a subset particularly those arising at the oropharynx. My lab is interested in filling the existing knowledge gaps in this area by estimating the proportion of HPV driven cancers at each of these sites, identifying accurate markers for classification and prognosis of HPV-related cancers and elucidating the interactions between multiple risk factors in risk of this disease. We therefore work in research partnerships with teams comprising clinical oncologists, pathologists, biologists, and epidemiologists. All studies involving patients, tumor tissue and population studies are done through a network of collaborations with Institutes across the country.This research program is funded by the Indian Council of Medical Research (ICMR).

Bivalent and a quadrivalent HPV vaccines are currently available that can prevent infections with HPV types that cause upto 70% of cervical cancers. Since an increase in worldwide HPV vaccination, particularly in low-resource settings like India, could be facilitated if fewer than three doses of vaccine would be as effective as three doses, a multicentre, cluster-randomised trial was initiated in India. Using theadvanced human papillomavirus (HPV) testing facility in our lab, this existing program examines the short term vaccine efficacy in terms of immunogenicity and infection rates after vaccination. This program is funded by the Bill & Melinda Gates Foundation through the International Agency for Research on Cancer (IARC-WHO).

An effective virus-like particle (VLP) based prophylactic vaccine will need to induce a strong humoral and cellular immune response capable of providing long-term protection. Long term immune memory is known to be mediated through a subset of plasma cells that persist as antigen-specific memory B and T cells. Our lab is interested in characterizing long lasting highly specific HPV L1 VLP memory B cells and T cell mediated response to HPV vaccination.