Authors
Mohammad Rehan Asad, Alejandra Flores Pusarico, Nidhi Reji, Tareq Nayef AlRamadneh, Atta Ullah Khan
Published in
Frontiers in oncology. Volume 16. Pages 1902328. Epub Oct 16, 2026.
Abstract
The prognostic utility of circulating tumor DNA (ctDNA) for minimal residual disease detection in human papillomavirus (HPV)-negative head and neck squamous cell carcinoma (HNSCC) remains incompletely characterized. This meta-analysis evaluates the association between post-operative ctDNA and recurrence-free survival (RFS) in this population.
A systematic search of major databases through May 2026 identified studies evaluating post-operative ctDNA and RFS in HPV-negative HNSCC. Pooled hazard ratios (HRs) were calculated using a random-effects model.
Eight studies (n=325) were included. Detectable post-operative ctDNA was associated with diminished RFS (HR = 10.07, 95% CI: 5.64-17.99) and overall survival (HR = 8.98, 95% CI: 2.93-27.58). However, sensitivity analyses substantially attenuated the pooled RFS estimate (HR range: 2.22-2.43), suggesting the primary effect magnitude may lack stability.
While preliminary evidence suggests an association between post-operative ctDNA and recurrence risk in HPV-negative HNSCC, these findings require cautious interpretation. The current literature is constrained by small sample sizes, heterogeneous detection methodologies, mixed-cohort inclusion, and potential confounding biases. Consequently, post-operative ctDNA remains an investigational biomarker in this setting. Clinical implementation necessitates further validation through large, prospective, multi-institutional studies employing standardized methodologies in strictly defined HPV-negative #146;populations.
PMID:
42964065
Bibliographic data and abstract were imported from PubMed on 31 Oct 2026.
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