For patients diagnosed with human papillomavirus (HPV)-related oropharyngeal cancer, detection of HPV DNA in oral rinse samples after diagnosis may provide a useful biomarker to identify patients at increased risk of recurrence after treatment, according to a recent study published in JAMA Oncology.
While survival of HPV-related oropharyngeal cancer is good, recurrence still poses a problem for these patients, said Gypsyamber D’Souza, PhD, associate professor in the viral oncology program at Johns Hopkins Bloomberg School of Public Health in Baltimore and co-author of the study. Research is ongoing to identify markers that can help clinicians better understand predictors of recurrence in this population, she added.
One potential biomarker under investigation is the detection of HPV DNA in oral rinses in patients treated for HPV-related oropharyngeal cancers. Evidence from two small cohort studies, published in 2008 and in 2014, has shown an association between HPV type 16 (HPV16) DNA in post-treatment oral rinses and survival and recurrence.
In the current study, investigators corroborate this evidence in a larger, multicenter, prospective cohort study of 124 patients with oral HPV16 DNA. At diagnosis, HPV16 DNA was detected in the oral rinses of 67 (54%) of the patients. After treatment, only 6 (5%) patients had persistent oral HPV16 DNA.
The study found significantly worse disease-free survival and overall survival in the patients with persistent oral HPV16 DNA detected in oral rinses, with hazard ratios of 29.7 (95% CI, 9.0-98.2) and 23.5 (95% CI, 4.7-116.9), respectively.
Local recurrence occurred in all patients with persistent oral HPV16 DNA but only in 9 of 119 (8%) of patients without persistent oral HPV16 DNA.
The authors say that their data suggest that, although infrequent, persistent HPV16 DNA in post-treatment oral rinses is associated with poor prognosis and is a potential tool for long-term tumor surveillance, and perhaps more so for local recurrence.