Circulating tumor HPV DNA assessments after surgery for human papilloma virus-associated oropharynx carcinoma.

Autor: Souza SS; Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, United States of America., Stephens EM; School of Medicine, University of California-San Francisco, United States of America., Bourdillon AT; Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, United States of America., Bhethanabotla R; School of Medicine, Drexel University, United States of America., Farzal Z; Division of Head and Neck Oncologic and Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, United States of America., Plonowska-Hirschfeld K; Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, United States of America., Qualliotine JR; Division of Head and Neck Oncologic Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California-San Diego, United States of America., Heaton CM; Division of Head and Neck Oncologic Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California-San Diego, United States of America., Ha PK; Division of Head and Neck Oncologic Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California-San Diego, United States of America., Ryan WR; Division of Head and Neck Oncologic Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California-San Diego, United States of America. Electronic address: william.ryan@ucsf.edu.
Jazyk: angličtina
Zdroj: American journal of otolaryngology [Am J Otolaryngol] 2024 Mar-Apr; Vol. 45 (2), pp. 104184. Date of Electronic Publication: 2023 Dec 09.
DOI: 10.1016/j.amjoto.2023.104184
Abstrakt: Purpose: To understand the utility of circulating tumor human papillomavirus DNA (ctHPVDNA) blood testing for HPV-associated oropharynx squamous cell carcinoma (HPV + OPSCC) after definitive surgery.
Materials and Methods: Prospective cohort study of HPV(+)OPSCC patients with ctHPVDNA test data to assess its accuracy in detecting biopsy-confirmed disease at various post-treatment time points. Eligible patients had p16(+)/HPV(+) OPSCC and ctHPVDNA testing performed at any time pre-operatively and/or postoperatively. In cases of recurrence, patients were excluded from analysis if ctHPVDNA testing was not performed within 6 months of biopsy.
Results: 196 all-treatment-type patients had at least one PT ctHPVDNA test. The initial post-treatment (PT) ctHPVDNA sensitivity, specificity, PPV, and NPV were 69.2 % (9/13), 96.7 % (177/183), 60.0 % (9/15), and 97.8 % (177/181). 61 surgery alone (SA) patients underwent 128 PT tests. The initial PT SA ctHPVDNA sensitivity, specificity, PPV, and NPV were 100 % (2/2), 96.0 % (48/50), 50 % (2/4), and 100 % (48/48). 35 of 61 (57.4 %) SA patients had NCCN-based histopathologic indications for adjuvant (chemo)radiation but declined. 3 of 35 (8.57 %) had a positive PT ctHPVDNA test of which 1 of 3 (33 %) had biopsy-proven recurrence. Prospectively, ten patients had a PreT positive ctHPVDNA, underwent SA, refused adjuvant treatment, had an undetectable ctHPVDNA within 2 weeks of SA, and remained free of disease (mean 10.3 months).
Conclusion: The high specificity and NPV of ctHPVDNA after SA suggest ctHPVDNA may have a role in determining the omission of PT adjuvant (chemo)radiation in select patients.
Competing Interests: Declaration of competing interest None.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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