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Circulating HPV16 DNA in Blood Plasma as Prognosticator and Early Indicator of Cancer Recurrence in Radio-Chemotherapy for Anal Cancer

Authors :
Agnieszka M. Mazurek
Ewa Małusecka
Iwona Jabłońska
Natalia Vydra
Tomasz W. Rutkowski
Monika Giglok
Rafał Suwiński
Source :
Cancers, Volume 15, Issue 3, Pages: 867
Publication Year :
2023
Publisher :
Multidisciplinary Digital Publishing Institute, 2023.

Abstract

Background: Implementation of anal squamous cell carcinoma (ASCC) treatment modifications requires reliable patient risk stratification. The circulating tumor–related human papillomavirus type 16 (ctHPV16) may play a role in predicting survival or assessing treatment response. Methods: The study included 62 ASCC patients treated with chemoradiotherapy. A threshold of 2.5 was used to determine the maximum standardized uptake value (SUVmax). The ctHPV16 viral load (VL) was quantified by qPCR. Results: In the multivariate Cox analysis, lower SUVmax (p = 0.047) and ctHPV16–positive (p = 0.054) proved to be independent prognostic factors for favorable overall survival (OS). In the subgroup with the higher SUVmax, ctHPV16 and nodal (N) status were independent prognostic factors with p = 0.022 for ctHPV16 and p = 0.053 for N. The best survival rate (95%) presented ctHPV16–positive/N–negative patients. High ctHPV16 VL tended to be slightly specific for patients younger than 63 years (p = 0.152). The decrease in ctHPV16 VL to undetectable level after the end of treatment correlated with the overall clinical response. Conclusions: A prognostic stratification by SUVmax, ctHPV16 and N–positive status allows consideration of more aggressive treatment in high–risk patients (those with high SUVmax, ctHPV16–negative, and N–positive) or de–intensification of therapy in low–risk patients (those with low SUVmax, ctHPV16–positive and N–negative). However, prospective clinical trials on a large group are needed.

Details

Language :
English
ISSN :
20726694
Database :
OpenAIRE
Journal :
Cancers
Accession number :
edsair.doi.dedup.....4013f074e7233e23d7544cd8df969eae
Full Text :
https://doi.org/10.3390/cancers15030867