Circulating tumor HPV DNA complements PET‐CT in guiding management after radiotherapy in HPV‐related squamous cell carcinoma of the head and neck

Positron emission tomography and computed tomography (PET‐CT) is widely used to assess the response to radiotherapy. However, the ability of PET‐CT to predict treatment failure in human papillomavirus (HPV)‐related squamous cell carcinoma of the head and neck (HNSCC) is unsatisfactory. We quantified...

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Bibliographic Details
Published in:International journal of cancer 2021-02, Vol.148 (4), p.995-1005
Main Authors: Tanaka, Hidenori, Takemoto, Norihiko, Horie, Masafumi, Takai, Erina, Fukusumi, Takahito, Suzuki, Motoyuki, Eguchi, Hirotaka, Komukai, Sho, Tatsumi, Mitsuaki, Isohashi, Fumiaki, Ogawa, Kazuhiko, Yachida, Shinichi, Inohara, Hidenori
Format: Article
Language:English
Subjects:
Cancer
Chemotherapy
circulating tumor DNA
Computed tomography
Deoxyribonucleic acid
DNA
droplet digital PCR
Head & neck cancer
Human papillomavirus
Medical research
Metabolic response
Metabolism
Positron emission tomography
positron emission tomography and computed tomography
Radiation therapy
Squamous cell carcinoma
squamous cell carcinoma of the head and neck
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Summary:Positron emission tomography and computed tomography (PET‐CT) is widely used to assess the response to radiotherapy. However, the ability of PET‐CT to predict treatment failure in human papillomavirus (HPV)‐related squamous cell carcinoma of the head and neck (HNSCC) is unsatisfactory. We quantified circulating tumor HPV type16 DNA (ctHPV16DNA) using optimized droplet digital PCR in 35 patients with HPV16‐related HNSCC, who received radiotherapy with or without chemotherapy, and prospectively correlated ctHPV16DNA and metabolic response with treatment failure. After a median follow‐up of 21 months, ctHPV16DNA and PET‐CT had similar negative predictive values (89.7% vs 84.0%), whereas the positive predictive value was much higher in ctHPV16DNA than in PET‐CT (100% vs 50.0%). Notably, six patients who had detectable posttreatment ctHPV16DNA all had treatment failure irrespective of metabolic response, whereas none of five patients who had partial metabolic response without detectable posttreatment ctHPV16DNA had treatment failure. The risk of treatment failure was high in patients who had incomplete metabolic response with detectable posttreatment ctHPV16DNA (hazard ratio [HR], 138.8; 95% confidence interval [CI], 15.5‐3366.4; P 
ISSN:0020-7136
1097-0215
DOI:10.1002/ijc.33287