Oropharyngeal squamous cell carcinoma (OPSCC) caused by human papillomavirus (HPV) had a high cure rate. However, 15–25% of individuals will experience a recurrence despite this. Physical exams and imaging are currently used for posttreatment surveillance. However, they are inconsistently applied. The researchers analyzed circulating tumor tissue modified viral (TTMV)-HPV DNA from a large group of actual patients during normal posttreatment surveillance. This retrospective clinical case series included 1,076 patients from 108 sites in the United States who had 1 or more TTMV-HPV DNA tests (NavDx, Naveris Laboratories) obtained during surveillance between February 6, 2020, and June 29, 2021. All patients had been treated for HPV-driven OPSCC for more than or equal to 3 months. Clinical assessments were made when the testing was completed and compared to the results. Around 80 out of 1,076 (7.4%) patients had detectable levels of TTMV-HPV DNA in their blood, and follow-up was possible for all of them, and 21 out of 80 patients (26%) had a known recurrence at the time of the first positive surveillance test, while the remaining 59 out of 80 (74%) did not. Around 55 (93%) of these 59 patients subsequently experienced a confirmed recurrence, 2 patients had clinically suspicious lesions, and 2 patients had clinically “no evidence of disease” (NED) at the last follow-up. To date, TTMV-HPV DNA testing has a 95% overall positive predictive value (N = 76/80) for recurrent illness. The negative predictive value at a single point in time is 95% (N = 1,198/1,256). These results demonstrate the feasibility of testing for circulating TTMV-HPV DNA in clinical settings. In the majority of patients, recurrence was first indicated by TTMV-HPV DNA positive, which preceded identification by standard clinical and imaging examinations used in surveillance. These findings may benefit future clinical and guideline-endorsed solutions for HPV-driven malignancy surveillance.
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