Journal Article

DKFZ-2026-02632

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png 'HPV16 circulating tumour DNA for prognostic stratification and post-treatment surveillance in HPV-positive oropharyngeal cancer: A multinational study'.

Torrens, L. ; Chopard, P. ; Gaborieau, V. ; Forey, N. ; Perdomo, S. ; Virani, S. ; Waterboer, T.DKFZ* ; Rodriguez-Urrego, P. A. ; Arantes, L. M. ; Vilensky, M. ; Figari, M. ; Curado, M. P. ; Kowalski, L. P. ; Holcatova, I. ; Pinto, L. F. R. ; Dias, F. L. ; Richiardi, L. ; Popovic, M. ; Ventorin von Zeidler, S. ; Vasconcelos de Podesta, J. R. ; Polesel, J. ; Roux, P.-E. ; Fervers, B. ; Perol, O. ; Dupuis, C. ; Alberti, L. ; de Oliveira, J. C. ; Ahrens, W. ; Canova, C. ; Guarnizo, A. ; Nieto, O. J. T. ; Mamere, A. E. ; Araujo, T. E. ; Carvalho, R. ; Carrera, J. M. ; Brennan, P. ; Saintigny, P. ; de Carvalho, A. C.

2026
Elsevier Amsterdam [u.a.]

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.

Keyword(s): Circulating tumour DNA ; Disease monitoring ; HPV16 ; Oropharyngeal cancer ; Prognostic biomarker ; Recurrence

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Contributing Institute(s):

1. Infektionen und Krebsepidemiologie (C230)

Research Program(s):

1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2026

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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