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Plasma Circulating Tumor HPV DNA for the Surveillance of Cancer Recurrence in HPV-Associated Oropharyngeal Cancer.
Chera, Bhishamjit S; Kumar, Sunil; Shen, Colette; Amdur, Robert; Dagan, Roi; Green, Rebecca; Goldman, Emily; Weiss, Jared; Grilley-Olson, Juneko; Patel, Shetal; Zanation, Adam; Hackman, Trevor; Blumberg, Jeff; Patel, Samip; Thorp, Brian; Weissler, Mark; Yarbrough, Wendell; Sheets, Nathan; Mendenhall, William; Tan, Xianming M; Gupta, Gaorav P.
Afiliación
  • Chera BS; Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC.
  • Kumar S; Lineberger Comprehensive Cancer Center, University of North Carolina Hospitals, Chapel Hill, NC.
  • Shen C; Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC.
  • Amdur R; Lineberger Comprehensive Cancer Center, University of North Carolina Hospitals, Chapel Hill, NC.
  • Dagan R; Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC.
  • Green R; Lineberger Comprehensive Cancer Center, University of North Carolina Hospitals, Chapel Hill, NC.
  • Goldman E; Department of Radiation Oncology, University of Florida Hospitals, Gainesville, FL.
  • Weiss J; Department of Radiation Oncology, University of Florida Hospitals, Gainesville, FL.
  • Grilley-Olson J; University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Patel S; University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Zanation A; Lineberger Comprehensive Cancer Center, University of North Carolina Hospitals, Chapel Hill, NC.
  • Hackman T; Department of Medicine, Division of Hematology Oncology, University of North Carolina School of Medicine, Chapel Hill, NC.
  • Blumberg J; Lineberger Comprehensive Cancer Center, University of North Carolina Hospitals, Chapel Hill, NC.
  • Patel S; Department of Medicine, Division of Hematology Oncology, University of North Carolina School of Medicine, Chapel Hill, NC.
  • Thorp B; Lineberger Comprehensive Cancer Center, University of North Carolina Hospitals, Chapel Hill, NC.
  • Weissler M; Department of Medicine, Division of Hematology Oncology, University of North Carolina School of Medicine, Chapel Hill, NC.
  • Yarbrough W; Department of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, NC.
  • Sheets N; Department of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, NC.
  • Mendenhall W; Department of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, NC.
  • Tan XM; Department of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, NC.
  • Gupta GP; Department of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, NC.
J Clin Oncol ; 38(10): 1050-1058, 2020 04 01.
Article en En | MEDLINE | ID: mdl-32017652
PURPOSE: Plasma circulating tumor human papillomavirus DNA (ctHPVDNA) is a sensitive and specific biomarker of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC). We investigated whether longitudinal monitoring of ctHPVDNA during post-treatment surveillance could accurately detect clinical disease recurrence. METHODS AND MATERIALS: A prospective biomarker clinical trial was conducted among patients with nonmetastatic HPV-associated (p16-positive) OPSCC. All patients were treated with curative-intent chemoradiotherapy (CRT). Patients underwent a 3-month post-CRT positron emission tomography/computed tomography scan and were thereafter clinically evaluated every 2-4 months (years 1-2), then every 6 months (years 3-5). Chest imaging was performed every 6 months. Blood specimens were collected every 6-9 months for analysis of plasma ctHPVDNA using a multianalyte digital polymerase chain reaction assay. The primary endpoint was to estimate the negative predictive value (NPV) and positive predictive value (PPV) of ctHPVDNA surveillance. RESULTS: One hundred fifteen patients were enrolled, and 1,006 blood samples were analyzed. After a median follow-up time of 23 months (range, 6.1-54.7 months), 15 patients (13%) developed disease recurrence. Eighty-seven patients had undetectable ctHPVDNA at all post-treatment time points, and none developed recurrence (NPV, 100%; 95% CI, 96% to 100%). Twenty-eight patients developed a positive ctHPVDNA during post-treatment surveillance, 15 of whom were diagnosed with biopsy-proven recurrence. Sixteen patients had 2 consecutively positive ctHPVDNA blood tests, 15 of whom developed biopsy-proven recurrence. Two consecutively positive ctHPVDNA blood tests had a PPV of 94% (95% CI, 70% to 99%). Median lead time between ctHPVDNA positivity and biopsy-proven recurrence was 3.9 months (range, 0.37-12.9 months). CONCLUSION: Detection of ctHPVDNA in two consecutive plasma samples during post-treatment surveillance has high PPV and NPV for identifying disease recurrence in patients with HPV-associated oropharyngeal cancer and may facilitate earlier initiation of salvage therapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: ADN Viral / Neoplasias Orofaríngeas / Alphapapillomavirus / ADN Tumoral Circulante / Carcinoma de Células Escamosas de Cabeza y Cuello / Recurrencia Local de Neoplasia Tipo de estudio: Observational_studies / Risk_factors_studies / Screening_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Clin Oncol Año: 2020 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: ADN Viral / Neoplasias Orofaríngeas / Alphapapillomavirus / ADN Tumoral Circulante / Carcinoma de Células Escamosas de Cabeza y Cuello / Recurrencia Local de Neoplasia Tipo de estudio: Observational_studies / Risk_factors_studies / Screening_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Clin Oncol Año: 2020 Tipo del documento: Article
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