In a study reported in the Journal of Clinical Oncology, Bhishamjit S. Chera, MD, and colleagues found that surveillance for circulating tumor human papillomavirus (HPV) DNA was accurate in identifying disease recurrence in patients with curatively treated HPV-associated oropharyngeal squamous cell carcinoma.
Bhishamjit S. Chera, MD
Study Details
The prospective study involved 115 patients from three sites who received curative intent chemoradiotherapy. Patients underwent 3-month post-chemoradiotherapy positron emission tomography/computed tomography scans and were clinically evaluated every 2 to 4 months in years 1 and 2 and every 6 months in years 3 to 5, with chest imaging being performed every 6 months. Blood specimens were collected every 6 to 9 months for analysis for plasma circulating tumor HPV DNA.
Positive and Negative Predictive Value
A total of 1,006 blood samples from the 115 patients were analyzed. With median follow-up of 23 months (range = 6.1–54.7 months), disease recurrence was identified in 15 patients (13%). No recurrences were observed among 87 patients with negative circulating tumor HPV DNA results at all posttreatment time points, yielding a negative predictive value of 100%. Among 28 patients with positive circulating tumor HPV DNA results during surveillance, 15 had biopsy-proven recurrence. Among 16 patients with two consecutive positive circulating tumor HPV DNA results, 15 developed biopsy-proven recurrence; thus, the positive predictive value of two consecutive positive circulating tumor HPV DNA tests was 94%. The median lead time between a positive circulating tumor HPV DNA result and biopsy-proven recurrence was 3.9 months (range = 0.37–12.9 months).
KEY POINTS
- Circulating tumor HPV DNA surveillance was associated with a negative predictive value for recurrence of 100%.
- Two consecutive positive results were associated with a positive predictive value of 94%.
The investigators concluded, “Detection of circulating tumor HPV DNA in two consecutive plasma samples during posttreatment surveillance has high [positive predictive value] and [negative predictive value] for identifying disease recurrence in patients with HPV-associated oropharyngeal cancer and may facilitate earlier initiation of salvage therapy.”
Dr. Chera, of the Department of Radiation Oncology, University of North Carolina Hospitals, Chapel Hill, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by University Cancer Research Fund, Burroughs Wellcome Fund, National Institutes of Health/National Cancer Institute, and others. For full disclosures of the study authors, visit ascopubs.org.
