Revolutionary Advances in HPV-Linked Head and Neck Cancer Monitoring

In a stride toward more effective monitoring of recurrent HPV-positive head and neck cancer, researchers at the University of Michigan Rogel Cancer Center have shown promising findings. The initial findings from two studies conducted by the University of Michigan Rogel Cancer Center have brought in innovative methods for predicting the recurrence of HPV-positive head and neck cancer at an earlier stage.

These research papers, published in Cancer and Oral Oncology, provide both clinical and technological perspectives on assessing recurrence earlier than current blood tests permit. They also propose a framework for a more sensitive blood test, enhancing monitoring capabilities.

Paul Swiecicki, M.D., who serves as the associate medical director for the Oncology Clinical Trials Support Unit at Rogel, emphasizes that when metastatic head and neck cancer reemerges, it significantly impacts the patient's quality of life, potentially leading to disfigurement and affecting crucial functions like speech, swallowing, and breathing. Currently, there is no test available for actively monitoring its recurrence, with the only options being symptom observation or potentially using a blood test, which may not detect cancer until shortly before it clinically manifests.

The paper on Cancer aims to identify various clinical approaches for providers to strategically track recurrence. To do this, Swiecicki and his team first needed to determine which patient population was at the highest risk, in order to establish an appropriate monitoring protocol.

The team examined 450 patients with metastatic head and neck cancer, including individuals with HPV-positive and HPV-negative cancer. They identified certain indicators of when recurrences were likely to occur and to which organs the recurrent cancer would most commonly spread. Patients with HPV-positive cancers were found to develop recurrent disease significantly later than those with HPV-negative cancers and were also more likely to experience lung metastases. These characteristics may contribute to the development of a future "surveillance" method that combines routine blood testing and imaging to hopefully detect recurrences and intervene before they become incurable.

Swiecicki is careful to note that, at this stage, the results of this study are largely theoretical and provide a valuable framework to guide further research. This is where the newly developed blood test, highlighted in Oral Oncology, becomes significant.

Blood Markers Shed by Tumors Can be Identified Using Highly Sensitive Blood Test

Blood biomarkers, which are fragments of DNA shed by tumors into the blood, are minuscule and difficult to detect. Currently, available commercial blood tests may not be sensitive enough to detect recurrence significantly earlier than clinical surveillance. However, numerous studies employing various types of tests are ongoing. A research team, led by Muneesh Tewari, M.D., Ph.D., Swiecicki, and Chad Brenner, Ph.D., sought to create a highly sensitive blood test capable of detecting cancer even when a smaller number of DNA fragments were present, with the aim of offering a better option for earlier cancer detection in patients (1^✔ ✔Trusted Source
Development of a high-performance multi-probe droplet digital PCR assay for high-sensitivity detection of human papillomavirus circulating tumor DNA from plasma

Go to source).

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This test not only boasts greater sensitivity in detecting a smaller number of DNA fragments in blood, but it also employs an innovative approach, as noted by Chandan Bhambhani, Ph.D., the first author of the study. "We achieved this level of sensitivity by simultaneously examining nine different segments of the HPV genome DNA," stated Bhambhani, a research lab specialist.

Tewari believes this is a step towards a more proactive approach in addressing the recurrence in head and neck cancer. "Currently, we only have the tools to react to symptoms when they recur. We want to find a way to be able to detect what's causing the symptoms much, much sooner, even before the symptoms appear."

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As a clinician, Swiecicki concurs, expressing excitement about the potential to detect cancer before it becomes incurable, providing a window for clinical trials to determine if intervention could lead to both a better quality of life and possibly an extended lifespan, potentially transforming an incurable disease into a curable one. While it remains uncertain whether this will be the case, this marks the initial tool required for such a development.

"Successful collaborative research projects like these are the direct result of how the Rogel Cancer Center enables our faculty to work together in ways that might not otherwise be possible. We have an outstanding network of faculty and researchers at our university, who are working together to develop innovative blood-based tests like the one highlighted in this story. It is our hope that these collaborative projects will lead directly to even more tools that improve the outcomes and quality of life of cancer patients," said Brenner, Director of the Head and Neck Oncology Program.

Reference:

1. Development of a high-performance multi-probe droplet digital PCR assay for high-sensitivity detection of human papillomavirus circulating tumor DNA from plasma - (https://pubmed.ncbi.nlm.nih.gov/37269557/)

Source-Eurekalert