Reyes Amanda, Maroongroge Sean, Afkhami Michelle, Villaflor Victoria, Amini Arya, Sampath Sagus, Maghami Ellie, Gernon Thomas, Patel Krupal, Li Xiaochen, Shreenivas Aditya
Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA 91010, USA.
Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA 91010, USA.
Cancers (Basel). 2025 Aug 27;17(17):2802. doi: 10.3390/cancers17172802.
The relationship between detectable circulating tumor DNA levels and clinical outcome following definitive therapy in patients with human papillomavirus (HPV)-mediated oropharyngeal squamous cell carcinoma has not been well established. In this retrospective analysis of patients with HPV-positive oropharyngeal squamous cell carcinoma seen from 2016 to 2024 at a single institution, 88 patients met inclusion criteria with baseline-positive tumor tissue-modified viral HPV DNA (TTMV-HPV DNA) testing and post-treatment testing performed. Of the 88 patients included in the survival analysis, 77 had undetectable tumor tissue-modified viral human papillomavirus DNA after treatment, while 11 had positive (detectable) tumor tissue-modified viral human papillomavirus DNA. TTMV-HPV DNA positivity after treatment was associated with worse 1-year and 2-year overall survival outcomes, at 63.5% (37.7-100, = 0.022) and 50.8% (25.7-100, = 0.017) compared to 100% and 96.4% (91.6-100, = 0.017) in patients with undetectable TTMV-HPV DNA. Inability to clear TTMV-HPV DNA after treatment was associated with worse progression-free survival, at 45.0% (95% CI 21.8-92.7, = 0.009) at 1 year and 11.3% (95% CI 1.8-71.2, = <0.001) at 2 years compared to 93% (95% CI 87.3-99.1) and 84.7% (95% CI, 76.3-94.0) in patients with cleared TTMV-HPV DNA after treatment. Tumor tissue-modified viral human papillomavirus DNA positivity after definitive treatment was associated with worse survival and disease recurrence outcomes compared to that in patients with undetectable post-treatment TTMV-HPV DNA. Prospective studies are warranted to further establish the clinical utility of TTMV-HPV DNA testing and its use in surveillance, treatment intensification, or de-intensification.
在人乳头瘤病毒（HPV）介导的口咽鳞状细胞癌患者中，确定性治疗后可检测到的循环肿瘤DNA水平与临床结局之间的关系尚未完全明确。在对2016年至2024年于某单一机构就诊的HPV阳性口咽鳞状细胞癌患者进行的这项回顾性分析中，88例患者符合纳入标准，进行了基线肿瘤组织修饰病毒HPV DNA（TTMV-HPV DNA）检测及治疗后检测。在纳入生存分析的88例患者中，77例在治疗后检测不到肿瘤组织修饰病毒人乳头瘤病毒DNA，而11例检测到肿瘤组织修饰病毒人乳头瘤病毒DNA呈阳性（可检测到）。治疗后TTMV-HPV DNA阳性与1年和2年总生存结局较差相关，分别为63.5%（37.7 - 100，P = 0.022）和50.8%（25.7 - 100，P = 0.017），而TTMV-HPV DNA检测不到的患者分别为100%和96.4%（91.6 - 100，P = 0.017）。治疗后无法清除TTMV-HPV DNA与无进展生存期较差相关，1年时为45.0%（95%可信区间21.8 - 92.7，P = 0.009），2年时为11.3%（95%可信区间1.8 - 71.2，P = <0.001），而治疗后清除TTMV-HPV DNA的患者分别为93%（95%可信区间87.3 - 99.1）和84.7%（95%可信区间76.3 - 94.0）。与治疗后TTMV-HPV DNA检测不到的患者相比，确定性治疗后肿瘤组织修饰病毒人乳头瘤病毒DNA阳性与生存和疾病复发结局较差相关。有必要开展前瞻性研究以进一步确立TTMV-HPV DNA检测的临床实用性及其在监测治疗强化或弱化中的应用。
