Detectable Circulating Tumor Tissue Modified Viral (TTMV)-HPV DNA in Non-Oropharyngeal Head and Neck Cancers

• Published in: International journal of radiation oncology, biology, physics Vol. 118; no. 5; pp. e28 - e29
• Main Authors: Duffy, E.W., Kaczmar, J., Albergotti, W., Kejner, A., Newman, J.G., Graboyes, E.M., Tamblyn, A., Chera, B.S.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-04-2024
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/j.ijrobp.2024.01.067

Plasma ctHPVDNA is detectable prior to treatment in ∼90% of patients with HPV-OPSCC and has shown utility in the dynamic monitoring of treatment response and detecting recurrences (4, 5, 6). Recent data has demonstrated ctHPVDNA to be detectable in patients with sinonasal and nasopharyngeal primary tumors (7). Herein, we present our early experience of ctHPVDNA detection in non-oropharyngeal HPV-associated head and neck cancers using an ultrasensitive multianalyte droplet polymerase chain reaction assay that tests for cell free tumor tissue modified viral (TTMV)-HPV DNA (liquid biopsies).
The medical record of all head and neck cancer patients at our institution seen from April 2022-September 1, 2023 were reviewed. HPV status was determined by immunohistochemical staining of tumor tissue for p16 and in-situ hybridization for high risk subtypes of HPV, per our institutional standard procedures. TTMV-HPV DNA results, patient demographic information, clinical data, and were obtained from chart review.
We identified 20 patients with non-oropharyngeal HPV-associated head and neck cancers in whom TTMV-HPV DNA was assessed. All cancers were p16 positive and HPV was tested in 8/20 and was positive in 7/8. Of these 20 patients, 15 patients had assessment TTMV-HPV DNA prior to treatment. This included 3 patients with SCC of the nasopharynx, 3 patients with sinonasal SCC, 1 patient with SCC of the posterior pharyngeal wall, 3 patients with SCC of unknown primary, 1 patient with SCC of the oral tongue, 2 patients with SCC of the larynx, 1 patient with cutaneous SCC, and one patient with sinonasal neuroendocrine carcinoma of the ethmoid sinus. Pre-treatment TTMV-HPV DNA was detectable in 13/16 with a median value of 7,808 (range 0-98,950). 11 had TTMV-HPV16 DNA positivity, 1 -HPV18, 0-HPV 33, 1 -HPV 35. TTMV-HPV DNA was undetectable in patients with the following primary sites: T4N0 subglottic SCCA (HPV positive), and pT2N0 SCC of the nasal cavity (HPV positive).
Circulating TTMV-HPV DNA is detectable in non-oropharyngal HPV-associated head and neck cancers. More research is needed to validate the sensitivity, specificity, and clinical utility of TTMV-HPV DNA in non-oropharyngeal HPV-associated head and neck cancers.