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Expert Point of View: Quynh-Thu Le, MD, FACR, FASTRO


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According to Quynh-Thu Le, MD, FACR, FASTRO, Professor and Chair of Radiation Oncology at Stanford, these results suggest that monitoring circulating human papillomavirus (HPV) DNA may lead to the detection of relapse prior to imaging. In an interview with The ASCO Post, Dr. Le also noted that several questions were raised during the postpresentation discussion.

Quynh-Thu Le, MD, FACR, FASTRO

Quynh-Thu Le, MD, FACR, FASTRO

“It would be beneficial to know how this platform compares to other clinically available HPV DNA detection platforms,” she said. “In addition, posttreatment surveillance studies of other virally related cancers, such as Epstein-Barr virus DNA in nasopharyngeal carcinoma, have shown that measurements can fluctuate from detectable to undetectable. Is this the same for HPV DNA?”

“Finally, it remains to be seen how practitioners should use these data clinically,” she continued. “We need large prospective studies to address many of the following unknowns, including the optimal frequency of measuring HPV DNA after definitive therapy; how best to address the fluctuation pattern of HPV DNA levels during surveillance (for example, when to act when one sees a positive result? should one image right away or repeat the test? if it is the latter, when should one repeat the test?); and most importantly whether the use of HPV DNA for cancer surveillance is better than the standard of care in terms of improving survival and/or reducing cost for patients and society.” 

DISCLOSURE: Dr. Le has served as a consultant for Coherus, Nanobiotix, and Roche.


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