Oropharynx cancers caused by human papillomavirus (HPV) have risen dramatically over the years, superseding tobacco use and heavy drinking as the primary driver of new cases. Fortunately, HPV-positive oropharynx cancers have an improved survival rate compared to other head and neck cancers, allowing for less intensive treatment options, especially if diagnosed at early stages. One promising biomarker for early diagnosis and predicting reoccurrence, circulating tumor HPV DNA (ctHPV DNA), is found in the blood of almost 90% of patients with HPV-positive oropharynx cancer and can be detected using commercially available blood assays measuring HPV DNA from tumor cells (TTMV-HPV DNA). However, in a study of 110 HPV-positive oropharynx cancer patients. Investigators from Brigham and Women's Hospital, a founding member of the Mass General Brigham healthcare system, found that TTMV-HPV DNA levels are linked to the presence of cancer in the lymph nodes and are often indetectable in patients without neck masses. This has a tremendous impact on how the test is interpreted and applied for early-stage disease and may mean it is not as effective for screening and early diagnosis of this increasingly common disease.
“ctHPV DNA testing is emerging as a powerful tool in the diagnosis, treatment, and post-treatment surveillance of HPV-positive oropharynx cancer,” said first author Eleni M. Rettig, MD, of Brigham and Women’s Hospital Division of Otolaryngology-Head and Neck Surgery and Dana-Farber Cancer Institute. Rettig is also an affiliated faculty member in the Center for Surgery and Public Health. “It’s increasingly critical to understand both the strengths and limitations of this test.”
Read more in JAMA-Otolaryngology Head and Neck Surgery .
JAMA Otolaryngology–Head & Neck Surgery
Observational study
Cells
Association of Pretreatment Circulating Tumor Tissue–Modified Viral HPV DNA With Clinicopathologic Factors in HPV-Positive Oropharyngeal Cancer
27-Oct-2022
Dr Rettig reported testing support from Naveris for other research studies outside of the submitted work. Dr Schoenfeld reported testing support from Naveris for other research studies; personal fees from ACI Clinical, Astellas, Stimit, Immunitas, LEK Consulting, Castle Biosciences, Genentech, and Merck; and grants from Merck, Debiopharm, Bristol Myers Squibb, and Regeneron paid to his institution outside the submitted work. Dr Guenette reported grants from the Association of University Radiologists GE Radiology Research Academic Fellowship during the conduct of the study. Dr Uppaluri reported personal fees from Merck outside the submitted work. Dr Haddad reported personal fees from Coherus BioSciences, BlueDot, EMD Serono, Merck, Bristol Myers Squibb, Pfizer, GSK, Boehringer Ingelheim, Eisai, Bayer, AstraZeneca, Kura, the National Comprehensive Cancer Network, Nanobiotix, ISA Therapeutics, and Mirati outside the submitted work. Dr Hanna reported personal fees from Naveris during the conduct of the study, as well as nonfinancial support from Naveris outside the submitted work. No other disclosures were reported.