A Potential Tool to Predict Recurrence of HPV-Related Oropharyngeal Carcinoma

A study published in JAMA Oncology presents a new tool that can predict disease recurrence in oropharyngeal cancer patients.

A multi-collaborative study among scientists at 8 different cancer research institutes in the United States has discovered a new tool that can predict recurrence and survival in patients treated for oropharyngeal cancer, which accounts for 2.8% of new cancers in the United States. HPV-related oropharyngeal cancer responds well to surgery, but the success of surgical treatment decreases if the cancer is detected after metastasis.

The scientists conducted a prospective cohort study that included 124 samples from patients diagnosed with incident human papillomavirus—related oropharyngeal carcinoma (HPV-OPC) from 2009 to 2013 at 4 academic tertiary cancer centers in the country. Oral rinse samples from these patients, collected at diagnosis and after treatment, were analyzed for the viral DNA. The primary outcomes measures estimated using the Kaplan-Meir curve were disease-free survival (DFS) and overall survival (OS). Cox regressions analysis predicted association of OS and DFS with HPV detected in the oral rinses.

Follow-up was conducted at regular intervals of 9, 12, 18, and 24 months. Oral HPV 16 DNA was detected in 54% of participants at diagnosis, and in only 5% of participants following treatment. The 2-year DFS was 92% (95% CI, 94% to 100%) and 2-year OS was 98% (95% CI, 93% to 99%). Persistent oral HPV16 DNA was associated with worse DFS and OS, and all 5 participants who were positive for oral HPV16 following treatment relapsed, 3 of whom had recurrent local disease. The scenario was significantly different among participants who were not positive for the virus in their oral rinse—only 8% of this cohort (9 of 199) without persistent oral HPV16 DNA developed recurrent disease and only 1 of them had local disease.

In their paper, published in JAMA Oncology, the authors conclude that their results attest to the value of the viral DNA test in disease prognosis, especially for local recurrence.

Senior study author Gypsyamber D’Souza, PhD, associate professor in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health and a member of the Sidney Kimmel Comprehensive Cancer Center, stated in a press release, “It’s a very small number so we have to be somewhat cautious. The fact that all of the patients with persistent HPV16 DNA in their rinses after treatment later had recurrence meant that this may have the potential to become an effective prognostic tool.”