Researchers at The Ohio State University Comprehensive Cancer Center have advanced the understanding of a blood test designed for human papillomavirus (HPV)-associated throat cancer. The study, published in JAMA Otolaryngology – Head and Neck Surgery, investigated how circulating tumor HPV DNA (ctDNA) levels change before and after surgery, as well as the influence of tumor biology and patient factors on these levels.
The findings suggest that the ctDNA test, when combined with standard pathology reports, can enhance risk assessment and aid in personalizing treatment plans for patients.
Research Overview
The research focused on the application of the ctDNA blood test to better understand and manage HPV-associated throat cancer, which accounts for over 90% of throat cancer cases.
According to Dr. Catherine Haring, an otolaryngologist specializing in head and neck cancers at The Ohio State University College of Medicine, while this type of cancer generally responds well to treatment, therapies like radiation and chemotherapy can significantly impact a patient's quality of life. Improved biomarkers are sought to help tailor treatments, aiming to minimize side effects while ensuring effective therapy.
Study Methodology
The study involved 104 adult patients diagnosed with HPV-associated throat cancer who received treatment between September 2021 and April 2025.
- Demographics: The cohort included 20 female and 84 male patients. Most participants had early-stage tumors, predominantly located in the tonsils.
- Treatment: All patients underwent surgery. Additional therapy, such as radiation and/or chemotherapy, was recommended based on pathological risk factors.
- ctDNA Testing: ctDNA levels were measured in all patients before surgery. Postoperative ctDNA levels were tested in 74 patients after surgery but prior to the initiation of any radiation therapy.
Key Findings and Interpretation
The researchers observed several key factors influencing ctDNA levels and their interpretation:
- Pretreatment Levels: Pretreatment ctDNA levels were found to be influenced by both tumor biology and the patient's kidney function.
- Postoperative Levels: Postoperative ctDNA levels reflected both the presence of residual cancer and the patient's baseline tumor DNA levels.
- Contextual Interpretation: The study concluded that the ctDNA test results require contextual interpretation. A positive result after surgery may indicate a higher risk of residual disease, but a negative result does not definitively guarantee the absence of cancer.
- Role in Risk Assessment: When integrated with standard pathology reports, the blood test is intended to provide additional insight into a patient's risk profile.
Context and Future Directions
The Centers for Disease Control and Prevention (CDC) reports that over 22,000 individuals are diagnosed with HPV-associated throat cancer annually in the United States, with a higher incidence rate observed in men. Patients undergoing surgery and radiation for this cancer may experience long-term side effects, including difficulty swallowing, dry mouth, taste changes, sleep apnea, and hypothyroidism.
Future research efforts at Ohio State will concentrate on improving the sensitivity of ctDNA testing. Researchers also aim to integrate ctDNA data into multifactorial risk models, which will combine biomarker information with traditional clinical and pathological risk factors to further enhance personalized patient care.
Additional Ohio State researchers involved in the study include Jack Birkenbeuel, MD; Christopher Noel, MD, PhD; Lauren Miller, MD; Enver Ozer, MD; Amit Agrawal, MD; Kyle VanKoevering, MD; Stephen Kang, MD; Nolan Seim, MD; and James Rocco, MD, PhD.