What happens to ctHPVDNA immediately after surgery for an HPV-associated cancer? 

HPV+OPSCC is increasing at epidemic proportions and is commonly treated with transoral robotic surgery(TORS). A new manuscript published by the Faden Lab describes results from a prospective study examining the early clearance kinetics of ctHPVDNA following TORS. Using frequent blood draws immediately after surgery they found that ctHPVDNA levels drop rapidly and clear within hours in patients who lack risk factors for residual disease (RD), remain significantly elevated in patients with macroscopic RD and decrease to intermediate levels in patients with risk factors for microscopic RD. They then applied these findings to a larger cohort of patients using ctHPVDNA levels the morning after surgery finding that POD 1 ctHPVDNA levels are associated with the risk of residual disease. This work suggests POD 1 ctHPVDNA levels could be used as a personalized biomarker for selecting adjuvant treatment in the future. These findings are the first to demonstrate the potential utility of ctHPVDNA in patients with HPV+OPSCC undergoing surgery.

The manuscript can be found in the journal Cancer.