"HPV16 circulating tumour DNA for prognostic stratification and post-treatment surveillance in HPV-positive oropharyngeal cancer: A multinational study".

Authors

Laura Torrens, Priscilia Chopard, Valérie Gaborieau, Nathalie Forey, Sandra Perdomo, Shama Virani, Tim Waterboer, Paula A Rodriguez-Urrego, Lidia Mrb Arantes, Marta Vilensky, Marcelo Figari, Maria Paula Curado, Luiz Paulo Kowalski, Ivana Holcatova, Luis Felipe Ribeiro Pinto, Fernando Luiz Dias, Lorenzo Richiardi, Maja Popovic, Sandra Ventorin von Zeidler, Jose Roberto Vasconcelos de Podesta, Jerry Polesel, Pierre-Eric Roux, Beatrice Fervers, Olivia Perol, Carmen Dupuis, Laurent Alberti, José Carlos de Oliveira, Wolfgang Ahrens, Cristina Canova, Angela Guarnizo, Oscar Javier Torres Nieto, Augusto Elias Mamere, Thais Emanuele Araujo, Raiany Carvalho, Juan Manuel Carrera, Paul Brennan, Pierre Saintigny, Ana Carolina de Carvalho

Published in

European journal of cancer (Oxford, England : 1990). Volume 249. Pages 117768. Oct 05, 2026. Epub Oct 05, 2026.

Abstract

Improved biomarkers are needed to refine prognosis and enable earlier detection of recurrence in HPV-associated oropharyngeal cancer (OPC). We evaluated the diagnostic performance, clinical associations, prognostic value, and longitudinal surveillance utility of HPV16 circulating tumour DNA (ctDNA) in a multinational cohort including patients from South America and Europe.
Plasma samples from 173 patients with HPV-positive OPC from South America and Europe were analysed using droplet digital PCR targeting HPV16 E6. Twenty-seven HPV-negative OPC cases and 58 HPV-negative cancer-free controls were included to evaluate assay specificity. Associations with clinicopathological features, tumour burden, overall survival (OS), and disease-free survival (DFS) were assessed, including multivariable Cox models. Longitudinal post-treatment ctDNA surveillance was performed in 72 non-metastatic HPV-positive OPC cases.
Baseline plasma HPV16 ctDNA demonstrated 100% specificity and 73.4% sensitivity for identifying HPV-positive OPC. Pretreatment ctDNA levels correlated with clinical stage and tumour burden and were detectable in 73.1% of stage I tumours. HPV-positive ctDNA-negative patients had significantly better OS than ctDNA-positive patients, and higher ctDNA levels (≥1082 copies/mL) predicted poorer OS. In multivariable models, higher ctDNA levels remained independently associated with worse OS (HR = 1.68; p = 0.019). ctDNA positivity further stratified patients with adverse clinical risk factors, with intermediate-risk ctDNA-positive cases showing worse OS (HR = 7.01; p = 0.0074). Persistent HPV ctDNA detection during surveillance was associated with disease progression or recurrence 6.3-23.0 months after completing treatment.
HPV16 ctDNA is a highly specific biomarker that reflects tumour burden and provides clinically meaningful prognostic information in HPV-associated OPC. Persistent post-treatment ctDNA detection was associated with disease progression, supporting the potential role of HPV16 ctDNA in risk-adapted surveillance following curative-intent treatment.

PMID:
42933086
Bibliographic data and abstract were imported from PubMed on 27 Oct 2026.

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