Circulating Tumor Tissue-Modified-Viral-HPV DNA and Correlation With Disease Burden in Oropharyngeal Cancer

Saturday, September 28, 2024

9:42 AM – 9:48 AM EDT

Location: MBCC, 208

Disclosure(s):

Jaclyn Lee, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Carly A. Fassler, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Ryan M. Whitaker, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Michael C. Topf, MD, MSCI:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Tumor-tissue modified viral (TTMV)-human papillomavirus (HPV) DNA is an increasingly used biomarker for patients with HPV-mediated oropharyngeal squamous cell carcinoma (OPSCC). However, not much is known regarding the quantitative importance of a positive result and its correlations to disease burden.

Methods: Retrospective cohort study at a single tertiary care center between January 2022 and December 2023. All patients with HPV-associated OPSCC and baseline, pre-treatment TTMV levels drawn were included. Outcomes evaluated included primary tumor and regional lymph node extent of disease on clinical imaging, PET/CT standard uptake values (SUVs), clinical staging, and pathological staging when applicable. Associations with pre-treatment TTMV-HPV DNA levels were evaluated via multivariable linear and logistic regression models. A commercially available TTMV-HPV DNA test was used.

Results: In total, 184 patients had TTMV-HPV levels drawn during the study period, of which 74 were pre-treatment levels and included as the final cohort. These patients were 97% male, median age 63 years (IQR 54 – 70), and 60% non-smokers. Most patients were clinical tumor stage cT1 (44%) or cT0 (12.5%). Most were clinical nodal stage cN1 (79%). No patients presented with distant metastatic disease in our cohort. Median pretreatment TTMV-HPV level was 456 (IQR 58 – 1760). There was an independent association between pretreatment TTMV-HPV levels and clinical tumor (cT) staging (p = .048) as well as clinical nodal (cN) staging (p = .012). This was also true for pretreatment TTMV-HPV levels and maximum SUV on PET/CT of either primary or nodal disease (p = .005). No associations were found between pre-treatment TTMV-HPV levels and pathologic findings in those that underwent surgical resection (n = 19; 26%).

Conclusions: Pre-treatment TTMV-HPV DNA levels were significantly associated with cT and cN staging, as well as maximum SUV levels on PET/CT. The clinical significance of baseline TTMV-HPV DNA levels as it relates to treatment requires further investigation through prospective clinical trials.

Presenting Author(s)

Jaclyn Lee, MD

Resident Physician
Vanderbilt University Medical Center
Nashville, Tennessee, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Carly A. Fassler, BS

Medical Student
East Carolina University - Brody School of Medicine
Nashville, TN, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
KM

Kyle Mannion, MD

Associate Professor
Vanderbilt University Medical Center
nashville, TN, United States

Disclosure information not submitted.
Natalie A. Lockney, MD

Associate Professor, Department of Radiation Oncology
Vanderbilt University Medical Center
Nashville, TN, United States

Disclosure information not submitted.
RW

Ryan M. Whitaker, MD, PhD

Assistant Professor, Radiation Oncology
Vanderbilt University Medical Center
Nashville, TN, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

MT

Michael C. Topf, MD, MSCI

Assistant Professor of Otolaryngology - Head and Neck Surgery
Vanderbilt University Medical Center
Nashville, TN, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.