Circulating tumor DNA in HPV-associated head and neck cancers – a novel clinical tool in the era of precision oncology
Authors:
M. Lacek; R. Lohynská
Authors‘ workplace:
Onkologická klinika 1. LF UK a FTN Praha
Published in:
Klin Onkol 2025; 38(6): 422-426
Category:
Reviews
doi:
https://doi.org/10.48095/ccko2025422
Overview
Background: Head and neck squamous cell carcinoma (HNSCC) represents a significant global oncological challenge with a rising incidence, particularly due to HPV-associated oropharyngeal squamous cell carcinomas (OPSCC). These tumours differ from HPV-negative entities biologically, clinically, and prognostically. Conventional diagnostic approaches, based on tissue biopsy and imaging techniques, face several limitations – from invasiveness and the inability to monitor disease dynamics to low sensitivity in the early detection of recurrence. Aim: This paper provides a comprehensive overview of circulating tumour DNA (ctDNA), specifically HPV-associated ctDNA, as a novel non-invasive biomarker enabling more accurate diagnosis, monitoring of treatment response, and early detection of recurrence in patients with HNSCC. Conclusion: ctDNA exhibits specific biological and physical characteristics that allow its reliable detection and differentiation from normal circulating cell-free DNA. Owing to its short half-life, ctDNA provides real-time insights into disease dynamics, while its concentration and fragmentation patterns reflect tumour burden and biological activity. Monitoring ctDNA holds significant potential as a pivotal clinical tool in the era of precision oncology, facilitating earlier recurrence detection, improved patient stratification, and optimization of therapeutic strategies in HPV-associated HNSCC.
Keywords:
human papillomavirus – head and neck squamous cell carcinoma – precision oncology – circulating tumour DNA (ctDNA)
Sources
1. Sung H, Ferlay J, Siegel RL et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71 (3): 209–249. doi: 10.3322/caac.21660.
2. WHO: International Agency for Research on Cancer. Data visualization tools for exploring the global cancer burden in 2022. [online]. Dostupné z: https: //gco.iarc.fr/today/en.
3. Lechner M, Liu J, Masterson L et al. HPV-associated oropharyngeal cancer: epidemiology, molecular biology and clinical management. Nat Rev Clin Oncol 2022; 19 (6): 306–327. doi: 10.1038/s41571-022-00603-7.
4. Tabatabaeian H, Bai Y, Huang R et al. Navigating therapeutic strategies: HPV classification in head and neck cancer. Br J Cancer 2024; 131 (2): 220–230. doi: 10.1038/s41416-024-02655-1.
5. Tran VH, Nguyen TH, Pham VH et al. Advances in human papillomavirus detection and molecular understanding in head and neck cancers: implications for clinical management. J Med Virol 2024; 96 (7): e29746. doi: 10.1002/jmv.29746.
6. Araujo M, Bouassaly J, Farshadi F et al. Current status of circulating tumor DNA and circulating cell alterations in HPV-associated head and neck cancer. Oral Oncol 2025; 167 : 107417. doi: 10.1016/j.oraloncology.2025.107417.
7. Huang X, Duijf PHG, Sriram S et al. Circulating tumour DNA alterations: emerging biomarker in head and neck squamous cell carcinoma. J Biomed Sci 2023; 30 (1): 65. doi: 10.1186/s12929-023-00953-z.
8. Cao H, Banh A, Kwok S et al. Quantitation of human papillomavirus DNA in plasma of oropharyngeal carcinoma patients. Int J Radiat Oncol Biol Phys 2012; 82 (3): e351–e358. doi: 10.1016/j.ijrobp.2011.05.061.
9. Damerla RR, Lee NY, You D et al. Detection of early human papillomavirus-associated cancers by liquid biopsy. JCO Precis Oncol 2019; 3: PO.18.00276. doi: 10.1200/PO.18.00276.
10. Mattox AK, D’Souza G, Khan Z et al. Comparison of next generation sequencing, droplet digital PCR, and quantitative real-time PCR for the earlier detection and quantification of HPV in HPV-positive oropharyngeal cancer. Oral Oncol 2022; 128 (12): 105805. doi: 10.1016/j.oraloncology.2022.105805.
11. Chera BS, Kumar S, Shen C et al. Plasma circulating tumor HPV DNA for the surveillance of cancer recurrence in HPV-associated oropharyngeal cancer. J Clin Oncol 2020; 38 (10): 1050–1058. doi: 10.1200/JCO.19.02444.
12. Ferris RL, Flamand Y, Weinstein GS et al. Phase II randomized trial of transoral surgery and low-dose intensity modulated radiation therapy in resectable P16+ locally advanced oropharynx cancer: an ECOG-ACRIN cancer research group trial (E3311). J Clin Oncol 2022; 40 (2): 138–149. doi: 10.1200/JCO.21.01752.
13. Gale D, Lawson ARJ, Howarth K et al. Development of a highly sensitive liquid biopsy platform to detect clinically-relevant cancer mutations at low allele fractions in cell-free DNA. PLoS One 2018; 13 (3): e0194630. doi: 10.1371/journal.pone.0194630.
14. Haderlein M, von der Grün J, Balermpas P et al. De-intensification of postoperative radiotherapy in head and neck cancer irrespective of human papillomavirus status-results of a prospective multicenter phase II trial (DIREKHT trial). Front Oncol 2024; 14 : 1447123. doi: 10.3389/fonc.2024.1447123.
15. Misawa K, Imai A, Matsui H et al. Identification of novel methylation markers in HPV-associated oropharyngeal cancer: genome-wide discovery, tissue verification and validation testing in ctDNA. Oncogene 2020; 39 (22): 4741–4755. doi: 10.1038/s41388-020-1327-z.
Labels
Paediatric clinical oncology Surgery Clinical oncologyArticle was published in
Clinical Oncology
2025 Issue 6
- Metamizole vs. Tramadol in Postoperative Analgesia
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Current Insights into the Antispasmodic and Analgesic Effects of Metamizole on the Gastrointestinal Tract
- Spasmolytic Effect of Metamizole
- Possibilities of Using Metamizole in the Treatment of Acute Primary Headaches
-
All articles in this issue
- EANO 2025 v Praze – milník pro českou neuroonkologii
- Příběh regulačních T lymfocytů
- Circulating tumor DNA in HPV-associated head and neck cancers – a novel clinical tool in the era of precision oncology
- Registration of childhood cancer – current status and perspectives
- Why sex and gender matter in cancer research and care
- Polyclonal hypergammaglobulinemia, infiltration of the salivary glands, lymphadenopathy, and kidney damage – Mikulicz’s disease, Sjögren’s syndrome, or Castleman’s disease? Case report and overview of differential diagnosis and treatment
- Integrated clinical-bio logical infrastructure for precision oncology in pancreatic adenocarcinoma – experience with REDCap implementation in an academic setting
- Histopathological predictive factors of sentinel node positivity in melanoma in the Blumenau-SC Brazilian region
- Cardiac metastasis of urothelial carcinoma mimicking ST-elevation myocardial infarction
- MET exon 14 skipping gene-positive lung adenocarcinoma associated with atypical adenomatous hyperplasia in lungs and metachronous lung adenocarcinoma
- Aktuality z Národního ústavu pro výzkum rakoviny
- Clinical Oncology
- Journal archive
- Current issue
- About the journal
Most read in this issue
- Polyclonal hypergammaglobulinemia, infiltration of the salivary glands, lymphadenopathy, and kidney damage – Mikulicz’s disease, Sjögren’s syndrome, or Castleman’s disease? Case report and overview of differential diagnosis and treatment
- Histopathological predictive factors of sentinel node positivity in melanoma in the Blumenau-SC Brazilian region
- Cardiac metastasis of urothelial carcinoma mimicking ST-elevation myocardial infarction
- MET exon 14 skipping gene-positive lung adenocarcinoma associated with atypical adenomatous hyperplasia in lungs and metachronous lung adenocarcinoma