From planned neck dissection to PET response to circulating tumour DNA: changes in post‐treatment assessment of HPV‐driven oropharyngeal cancer†
Abstract Introduction Circulating tumour human papillomavirus DNA (ctHPVDNA) is an emerging tool to assess post‐treatment response in patients with HPV+ oropharyngeal squamous cell carcinoma (OPSCC). Its use is not a standard practice, however, with interval F‐18 FDG PET/CT and fiberoptic examinatio...
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| Format: | Article |
| Language: | English |
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Wiley
2024-03-01
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| Series: | Journal of Medical Radiation Sciences |
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| Online Access: | https://doi.org/10.1002/jmrs.720 |
| _version_ | 1827323194047987712 |
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| author | Carl M. Post Kim C. Ohaegbulam Timur Mitin |
| author_facet | Carl M. Post Kim C. Ohaegbulam Timur Mitin |
| author_sort | Carl M. Post |
| collection | DOAJ |
| description | Abstract Introduction Circulating tumour human papillomavirus DNA (ctHPVDNA) is an emerging tool to assess post‐treatment response in patients with HPV+ oropharyngeal squamous cell carcinoma (OPSCC). Its use is not a standard practice, however, with interval F‐18 FDG PET/CT and fiberoptic examination preferred. Post‐treatment PET/CT at 3 months has a low positive predictive value (PPV), especially in patients with HPV+ OPSCC treated with (chemo)radiation therapy (CRT). We aimed to compare 3–6 month post‐treatment PET/CT and ctHPVDNA test results to determine the most effective option for post‐treatment response assessment. Methods Patients with HPV+ OPSCC that underwent commercially available ctHPVDNA blood testing after curative intent treatment were identified. Demographic, clinical, treatment, surveillance and oncologic outcome information were collected for each patient. Specificity and false positive rate were calculated for post‐treatment PET/CT and ctHPVDNA. Results 80% of patients had Stage I disease. 52% of the population was treated with definitive chemoradiation (43%) or accelerated radiation (9%), with the remaining patients treated with transoral robotic surgery (TORS) +/− risk‐adapted adjuvant therapy. In total, 25 patients underwent ctHPVDNA testing and PET/CT at 3–6 months after finishing treatment. At 3–6 months post‐treatment, specificity of ctHPVDNA and PET/CT was 96% and 56%, correlating to false positive rates of 4% and 44%, respectively. Conclusions ctHPVDNA is more reliable than PET/CT following treatment in patients with HPV+ OPSCC, and its incorporation in post‐treatment response assessment will decrease the rate of anxiety over persistent disease and lead to a decrease in unnecessary medical procedures, including completion of neck dissection. |
| first_indexed | 2024-04-25T01:40:28Z |
| format | Article |
| id | doaj.art-d694e89c9ee945d2993ee995a9e42349 |
| institution | Directory Open Access Journal |
| issn | 2051-3895 2051-3909 |
| language | English |
| last_indexed | 2024-04-25T01:40:28Z |
| publishDate | 2024-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Medical Radiation Sciences |
| spelling | doaj.art-d694e89c9ee945d2993ee995a9e423492024-03-08T05:32:43ZengWileyJournal of Medical Radiation Sciences2051-38952051-39092024-03-01711212510.1002/jmrs.720From planned neck dissection to PET response to circulating tumour DNA: changes in post‐treatment assessment of HPV‐driven oropharyngeal cancer†Carl M. Post0Kim C. Ohaegbulam1Timur Mitin2Department of Radiation Medicine Oregon Health and Science University Portland Oregon USADepartment of Radiation Medicine Oregon Health and Science University Portland Oregon USADepartment of Radiation Medicine Oregon Health and Science University Portland Oregon USAAbstract Introduction Circulating tumour human papillomavirus DNA (ctHPVDNA) is an emerging tool to assess post‐treatment response in patients with HPV+ oropharyngeal squamous cell carcinoma (OPSCC). Its use is not a standard practice, however, with interval F‐18 FDG PET/CT and fiberoptic examination preferred. Post‐treatment PET/CT at 3 months has a low positive predictive value (PPV), especially in patients with HPV+ OPSCC treated with (chemo)radiation therapy (CRT). We aimed to compare 3–6 month post‐treatment PET/CT and ctHPVDNA test results to determine the most effective option for post‐treatment response assessment. Methods Patients with HPV+ OPSCC that underwent commercially available ctHPVDNA blood testing after curative intent treatment were identified. Demographic, clinical, treatment, surveillance and oncologic outcome information were collected for each patient. Specificity and false positive rate were calculated for post‐treatment PET/CT and ctHPVDNA. Results 80% of patients had Stage I disease. 52% of the population was treated with definitive chemoradiation (43%) or accelerated radiation (9%), with the remaining patients treated with transoral robotic surgery (TORS) +/− risk‐adapted adjuvant therapy. In total, 25 patients underwent ctHPVDNA testing and PET/CT at 3–6 months after finishing treatment. At 3–6 months post‐treatment, specificity of ctHPVDNA and PET/CT was 96% and 56%, correlating to false positive rates of 4% and 44%, respectively. Conclusions ctHPVDNA is more reliable than PET/CT following treatment in patients with HPV+ OPSCC, and its incorporation in post‐treatment response assessment will decrease the rate of anxiety over persistent disease and lead to a decrease in unnecessary medical procedures, including completion of neck dissection.https://doi.org/10.1002/jmrs.720Circulating tumour DNAHPVoropharyngeal cancerPET/CTsurveillance |
| spellingShingle | Carl M. Post Kim C. Ohaegbulam Timur Mitin From planned neck dissection to PET response to circulating tumour DNA: changes in post‐treatment assessment of HPV‐driven oropharyngeal cancer† Journal of Medical Radiation Sciences Circulating tumour DNA HPV oropharyngeal cancer PET/CT surveillance |
| title | From planned neck dissection to PET response to circulating tumour DNA: changes in post‐treatment assessment of HPV‐driven oropharyngeal cancer† |
| title_full | From planned neck dissection to PET response to circulating tumour DNA: changes in post‐treatment assessment of HPV‐driven oropharyngeal cancer† |
| title_fullStr | From planned neck dissection to PET response to circulating tumour DNA: changes in post‐treatment assessment of HPV‐driven oropharyngeal cancer† |
| title_full_unstemmed | From planned neck dissection to PET response to circulating tumour DNA: changes in post‐treatment assessment of HPV‐driven oropharyngeal cancer† |
| title_short | From planned neck dissection to PET response to circulating tumour DNA: changes in post‐treatment assessment of HPV‐driven oropharyngeal cancer† |
| title_sort | from planned neck dissection to pet response to circulating tumour dna changes in post treatment assessment of hpv driven oropharyngeal cancer† |
| topic | Circulating tumour DNA HPV oropharyngeal cancer PET/CT surveillance |
| url | https://doi.org/10.1002/jmrs.720 |
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