Circulating tumor tissue modified viral (TTMV)-HPV DNA in Recurrent, metastatic HPV-driven oropharyngeal cancer

• Published in: Oral oncology Vol. 158; p. 107002
• Main Authors: Hanna, Glenn J., Jabalee, Jamie, Lukens, John N., Sun, Lova, Rettig, Eleni M., Ferrandino, Rocco, Posner, Marshall R., Misiukiewicz, Krzysztof J., Routman, David M., Van Abel, Kathryn M., Del Vecchio Fitz, Catherine, Roof, Scott A.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.2024
• ISSN: 1368-8375; 1879-0593; 1879-0593
• DOI: 10.1016/j.oraloncology.2024.107002

•TTMV-HPV DNA may be a useful tool for monitoring response in advanced HPV+OPC.•Scores were higher with an increasing per-patient number of metastatic sites.•Scores were influenced by treatment modality.•Scores became undetectable in 67% of complete responders.•Patients with detectable scores at last follow-up had worse survival. Human papillomavirus (HPV) is causally linked to oropharyngeal squamous cell carcinoma (OPSCC). Testing for plasma tumor tissue modified viral (TTMV)-HPV DNA has emerged as a biomarker strategy for post-treatment surveillance to identify recurrent disease. We aimed to understand the prognostic and predictive potential of TTMV-HPV DNA when monitoring patients who had developed recurrent or metastatic (R/M) HPV+OPSCC. This retrospective observational cohort study included 80 patients from 4 academic centers with R/M HPV+OPSCC if they had ≥ 1 plasma TTMV-HPV DNA test obtained at any point during their R/M disease course. Physician-reported clinical data and treatment history were captured in a centralized database, along with investigator-assessed response to therapy and survival. Descriptive statistics and non-parametric tests of association were employed along with survival analyses (Kaplan-Meier method). Sixteen (20 %) patients had ≥ 5 test results over time. Consecutive TTMV-HPV DNA tests were performed a median of 73 days apart. Median TTMV-HPV DNA scores were higher with an increasing per-patient number of metastatic sites (<2 vs. 2+; p < 0.01). Score changes over time were influenced by R/M treatment modality and became undetectable in 67 % (12/18) of patients who achieved a complete response to R/M therapy. Patients with detectable scores at last follow-up had significantly worse survival compared with those who were undetectable (log-rank test, p < 0.01). TTMV-HPV DNA appears useful as a prognostic tool for monitoring response to therapy in the R/M setting. In the future, TTMV-HPV DNA could be explored as an exploratory clinical trial endpoint in the metastatic setting.