Differentiating Treatment Levels for HPV-Linked Oropharyngeal Cancer
Posted: Wednesday, July 31, 2019
According to findings from a multi-institution prospective biomarker trial published in Clinical Cancer Research, a rapid clearance profile of tumor-circulating DNA in patients with human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma predicted the likelihood of disease control. The study sought to determine unique traits that may help to differentiate treatment levels for patients with HPV-associated disease, who have traditionally experienced better outcomes than those with head and neck cancer linked to factors such as smoking.
“What this means is that in the future, dynamic, real-time monitoring of circulating tumor HPV DNA in the blood during treatment may help us better personalize and select treatment–especially the level of radiation and chemotherapy we give the patient,” noted Bhishamjit S. Chera, MD, of the University of North Carolina (UNC), in a UNC Health press release.
The researchers analyzed blood samples taken weekly from 103 patients with HPV-associated oropharyngeal squamous cell carcinoma during chemotherapy and radiation treatment, 67 of whom were evaluable. Of patients with a high baseline copy number (> 200 copies/mL) and a high clearance profile (> 95%) of circulating HPV DNA (n = 19), none experienced persistent or recurrent disease after treatment. Conversely, patients with low levels of circulating HPV DNA (< 200 copies/mL) and an unfavorable clearance profile had an increased risk of persistent or recurrent disease. For patients with an unfavorable DNA clearance profile in addition to adverse clinical risk factors, such as a history of smoking, the risk of recurrent disease was even higher, at an actuarial rate of 35%.
Disclosure: The study authors’ disclosure information may be found at clincancerres.aacrjournals.org.