Human
papillomavirus–related oropharyngeal carcinoma (HPV-OPC) is increasing in
incidence in the United States. Although HPV-OPC has favorable prognosis, 10%
to 25% of HPV-OPCs recur. Detection of human papillomavirus (HPV) DNA in oral
rinses is associated with HPV-OPC, but its potential as was unclear.
Rettig et al. determined whether HPV DNA detection in oral rinses after treatment for
HPV-OPC is a prognostic biomarker
that associated with recurrence and
survival.
The
investigators studied 124 patients with HPV-OPC. Oral rinse samples were collected at
diagnosis and after treatment (9, 12, 18, and 24 months after diagnosis), and
evaluated for HPV DNA.
Oral
HPV type 16 (HPV16) DNA was common at diagnosis (67 of 124 participants [54%]).
Oral HPV16 DNA persisted in only 6 participants after treatment (5%). Two-year disease-free survival (DFS) and
overall survival (OS) were 92% and 98%. Persistent oral HPV16 DNA was
associated with worse DFS and OS . All 5 participants with persistent oral
HPV16 DNA developed recurrent disease, 3 with local disease involvement. In
contrast, just 9 of 119 participants (8%) without persistent oral HPV16 DNA
developed recurrent disease, only 1 (11%) with local disease involvement.
Median (range) time from earliest posttreatment oral HPV16 DNA detection to
recurrence was 7.0 (3.7-10.9) months.
This
study illustrates that although HPV type 16 DNA in oral rinses is common at
diagnosis, it is rare after treatment for HPV-OPC. Detection of HPV16 DNA in
oral rinses after treatment for HPV-OPC may be a useful adjunct to current
post-treatment tumor surveillance strategies, potentially facilitating earlier
diagnosis of progressive or recurrent HPV-OPC. This may enable earlier
intervention and the administration of proper surgical and medical treatment.
