Predictive impact of human papillomavirus circulating tumorDNAin treatment response monitoring ofHPV‐associated cancers; a meta‐analysis on recurrent event endpoints

Abstract

BackgroundHPV infection can cause cancer, and standard treatments often result in recurrence. The extent to which liquid biopsy using HPV circulating tumor DNA (HPV ctDNA) can be used as a promising marker for predicting recurrence in HPV‐related cancers remains to be validated. Here we conducted a systematic review and meta‐analysis to assess its effectiveness in predicting treatment response.MethodsWe conducted a systematic literature search of online databases, including PubMed, Embase, Scopus, and the Cochrane Library, up to December 2022. The goal was to identify survival studies that evaluated the potential of plasma HPV ctDNA at baseline and end‐of‐treatment (EoT) in predicting recurrence of related cancers. Hazard ratios were estimated directly from models or extracted from Kaplan–Meier plots.ResultsThe pooled effect of HPV ctDNA presence on disease recurrence was estimated to be HR = 7.97 (95% CI: [3.74, 17.01]). Subgroup analysis showed that the risk of recurrence was HR = 2.17 (95% CI: [1.07, 4.41]) for baseline‐positive cases and HR = 13.21 (95% CI: [6.62, 26.36]) for EoT‐positive cases. Significant associations were also observed between recurrence of oropharyngeal squamous cell carcinoma (HR = 12.25 (95% CI: [2.62, 57.36])) and cervical cancer (HR = 4.60 (95% CI: [2.08, 10.17])) in plasma HPV ctDNA‐positive patients.ConclusionsThe study found that HPV ctDNA detection can predict the rate of relapse or recurrence after treatment, with post‐treatment measurement being more effective than baseline assessment. HPV ctDNA could be used as a surrogate or incorporated with other methods for detecting residual disease.

Why Is Surgery Still Done after Concurrent Chemoradiotherapy in Locally Advanced Cervical Cancer in Romania?

“…HPV infection has the potential to induce cancer, and conventional therapies often lead to relapse. The validation of liquid biopsy using HPV circulating tumor DNA (HPV ctDNA) as a potential indicator for predicting recurrence in HPV-related malignancies is still pending, according to the conclusion of a study by Karimi [33].…”

Human Papilloma Virus Circulating Cell-Free DNA Kinetics in Cervical Cancer Patients Undergoing Definitive Chemoradiation

“…[6][7][8] Among these, circulating free DNA (cfDNA), including circulating tumor DNA (ctDNA), shows promise in various oncologic settings, reflecting tumor burden and treatment response. [9][10][11][12] However, the detection capabilities and utility of cfDNA in cervical cancer are less well-documented, particularly as an evolving marker over the course of chemoRT, highlighting a gap in our current understanding of how cfDNA clearance can be employed to inform treatment response. The utility of cfDNA as an evolving marker of response to radiation in cervical cancer is unknown.…”