Head and Neck Cancer
AMA PRA Category 1 Credits 1.25
CAMPEP Credits: 1.25
MDCB Credits: 1.25
John Lukens, MD
Hospital of the University of Pennsylvania
Philadelphia, PA
The use of HPV ctDNA in the clinical management of patients with HPV-associated oropharyngeal squamous cell carcinoma is rapidly increasing; however, questions remain regarding its utility and validity in various clinical settings. A recent review article highlighted some of the knowledge gaps that exist with regard to biomarker-based surveillance and raises several cautionary notes before the widespread adaptation of testing.[1]
There are several clinical contexts in which this biomarker is being studied and implemented, including:
(1) the adjuvant setting, where it remains to be determined if the sensitivity of existing assays is sufficient to safely guide de-intensification,
(2) the definitive setting, as a way to monitor response in real time to potentially personalize radiotherapy dosing, and to assess treatment response, and
(3) in surveillance after treatment, and to monitor response to systemic therapy in the recurrent/metastatic setting.
This session brings together experts in all three areas to clarify the existing data, and provide recommendations for how to integrate this biomarker into clinical practice at this time. In so doing, we hope to address common clinical conundrums such as: does a negative HPV ctDNA titer post-op obviate the need for adjuvant therapy; can a rising titer in conjunction with concerning imaging findings obviate the need for biopsy; and, with time, will it be possible to monitor treatment response "in real time" during definitive RT to personalize therapy?
[1] Kuhs KA et al., Circulating Tumor HPV DNA for Surveillance of HPV-Positive Oropharyngeal Squamous Cell Carcinoma: a Narrative Review. JAMA Oncol. 2023;9(12):1716-1724.
Speaker: John Lukens, MD – Hospital of the University of Pennsylvania
Speaker: David Routman, MD – Mayo Clinic
Speaker: Michelle Mierzwa, MD – University of Michigan
Speaker: Daniel Faden, MD, PhD – Massachusetts Eye and Ear
Speaker: John Lukens, MD – Hospital of the University of Pennsylvania