Circulating Tumour DNA as a Complementary Tool for Treatment Evaluation in HPV-Associated Head and Neck Squamous Cell Carcinoma: An Observational Cohort Study

IF 1.5 4区 医学 Q2 OTORHINOLARYNGOLOGY
Anna Oldaeus Almerén, Max Waenerlund, Fredrik Landström, Mathias von Beckerath, Alvida Qvick, Jessica Carlsson, Gisela Helenius
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引用次数: 0

Abstract

Objectives

HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) and head and neck carcinoma of unknown primary (HNCUP) are increasing. Despite good prognosis, recurrence rates range from 10% to 25%. Surveillance with clinical controls and imaging is not always reliable. Circulating tumour human papillomavirus DNA (ctHPV-DNA) has emerged as a potential biomarker for treatment evaluation and detection of recurrence. We aimed to investigate the correlation between ctHPV-DNA in HPV+ OPSCC/HNCUP and radiologic tumour burden. Additionally, we sought to assess whether ctHPV-DNA could serve as a tool in treatment evaluation.

Design

A prospective observational cohort study.

Setting

This multicenter study involved three otolaryngology units located in central Sweden. We utilised HPV genotype-specific assays for droplet digital PCR (ddPCR) to detect ctHPV-DNA in plasma at diagnosis and follow-up. ctHPV-DNA levels were correlated to radiological tumour burden and radiological response using the Kendall Rank correlation coefficient and the Kruskal–Wallis test.

Participants

Patients with HPV+ OPSCC/HNCUP undergoing definitive (chemo)radiotherapy and enrolled in the CIRCOS study.

Results

Out of 54 patients, 51 were eligible for analyses. At baseline, ctHPV-DNA was detectable in 88%. A majority of patients with a favourable radiological evaluation according to RECIST had a corresponding undetectable ctHPV-DNA at follow-up. The levels of ctHPV-DNA at baseline correlated with total tumour volume and nodal volume ( = 0.39, p < 0.01, respectively  = 0.26, p < 0.01).

Conclusion

ctHPV-DNA shows correlation with tumour burden. This study strengthens the role of ctHPV-DNA as a promising biomarker for treatment evaluation in HPV-related OPC/HNCUP. With further research on serial plasma sampling, ctHPV-DNA could complement radiological treatment evaluation in HPV+ OPSCC/HNCUP.

Trial Registration: NCT05904327 [ClinicalTrials.gov]

Abstract Image

循环肿瘤DNA作为hpv相关头颈部鳞状细胞癌治疗评估的补充工具:一项观察性队列研究
目的:hpv阳性的口咽鳞状细胞癌(OPSCC)和头颈部不明原发癌(HNCUP)呈上升趋势。尽管预后良好,但复发率为10%至25%。临床对照和影像学监测并不总是可靠的。循环肿瘤人乳头瘤病毒DNA (ctHPV-DNA)已成为治疗评估和复发检测的潜在生物标志物。我们的目的是研究HPV+ OPSCC/HNCUP中ctHPV-DNA与放射学肿瘤负荷的相关性。此外,我们试图评估ctHPV-DNA是否可以作为治疗评估的工具。设计:前瞻性观察队列研究。背景:这项多中心研究涉及位于瑞典中部的三个耳鼻喉科单位。我们利用HPV基因型特异性检测滴数PCR (ddPCR)检测诊断和随访时血浆中的ctHPV-DNA。利用Kendall Rank相关系数和Kruskal-Wallis检验,ctHPV-DNA水平与放射学肿瘤负荷和放射学反应相关。参与者:接受最终(化疗)放疗的HPV+ OPSCC/HNCUP患者,并参加了CIRCOS研究。结果:54例患者中,51例符合分析条件。基线时,88%的人检测到ctHPV-DNA。根据RECIST,大多数放射学评价良好的患者在随访时相应检测不到ctHPV-DNA。基线时ctHPV-DNA水平与肿瘤总体积和结体积相关(rτ = 0.39, p)。结论:ctHPV-DNA与肿瘤负荷相关。该研究加强了ctHPV-DNA作为hpv相关OPC/HNCUP治疗评估的有希望的生物标志物的作用。通过对连续血浆取样的进一步研究,ctHPV-DNA可以补充HPV+ OPSCC/HNCUP的放射治疗评价。试验注册:NCT05904327 [ClinicalTrials.gov]。
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来源期刊
Clinical Otolaryngology
Clinical Otolaryngology 医学-耳鼻喉科学
CiteScore
4.00
自引率
4.80%
发文量
106
审稿时长
>12 weeks
期刊介绍: Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.
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