Awards for team behind study using Cell-free DNA to monitor Head and Neck Cancer

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The study sought to discover whether examining the levels of human papilloma virus (HPV) in cell-free DNA using digital droplet PCR could improve diagnosis and monitoring of head and neck cancer. It was found that detection of oncogenic HPV strains by this non-invasive method had comparable accuracy to existing biopsy based techniques. In addition, higher levels of HPV after treatment in HPV positive cancers correlated with either treatment failure or reoccurrence of the disease.

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Awards and prizes associated with this study include:

Dr Robert Wescott – British Association of Head and Neck Oncologists Best Oral Presentation (Laryngology Section) 2022   

Dr Robert Wescott – Royal Society of Medicine Storz Travelling Professor and Garnett Passe memorial lecture short paper prize 2022 

Lara Carey - Best poster - ENT Scotland winter meeting  

Shivank Keni - Best medical student presentation - ENT Scotland winter meeting

Perspective on the study from recent clinical fellow Dr Robert Wescott:

“In a prospective cohort of 104 patients with oropharyngeal squamous cell carcinoma (OPSCC), we assessed the utility of using digital droplet PCR (ddPCR) to detect oncogenic strains of the human papilloma virus (HPV) in cell-free DNA (cfDNA). The proposed advantage of HPV detection from cfDNA is the ease of obtaining this genetic material; through a blood test. There were two primary aims to our study. The first aim was to compare the detection of HPV at the point of diagnosis using current 'tissue-based' methods with ddPCR on cfDNA. The second was to see if ddPCR methods to detect HPV in cfDNA could be utilsed as a clinical tool to determine response to treatment in HPV associated OPSCC and detect disease recurrence earlier than current clinical methods. 

We found an overall 95% concordance between our ddPCR method for HPV detection and current tissue biopsy-based methods for HPV detection (p16 immunohistochemistry and tissue base HPV-PCR). We had a median follow-up of 20-months for a subset of 48 patients with HPV+ve disease. In these 48-patients, blood samples were obtained at ~12-weeks post treatment, and at every follow-up appointment thereafter. We demonstrated that persistently elevated cfDNA-HPV levels post-treatment were associated with treatment failure (2/2 patients). We also found that an increase in cfDNA-HPV copy number post-treatment, in patients who were initially undetectable, was associated with disease recurrence (5/6 patients). Additionally, no recurrence of disease was observed in patients in whom cfDNA-HPV remained undetectable throughout the whole follow-up period. 

Our study adds to a growing body of evidence that detection of HPV from cfDNA using ddPCR has potential utility in the management of patients with HPV associated OPSCC. The field of cfDNA within viral associated Head and Neck Cancer is rapidly expanding, and standardised clinical trials are required to assess the impact of such testing methodologies on patient outcomes.”