Researchers at Mass Eye and Ear and Mass General Hospital have developed a blood test for head and neck cancer associated with human papillomavirus (HPV), or liquid biopsy. This has been shown in new research to be more accurate, faster and cheaper. Conventional inspection method.
The study was published on December 2nd Clinical cancer research, Journal of the American Cancer Society, Liquid biopsy With an accuracy of over 98%, the diagnosis was made 26 days earlier on average than traditional tissue. biopsy.. The cost of the new test was 38% lower than the standard method.When researchers combine liquid biopsy with findings from routine imaging Physical examination Diagnostic accuracy remained above 95% to create a completely non-invasive diagnostic approach.
HPV related Head As the incidence of cervical cancer increases, the authors of the study strongly demand more accurate, less invasive, faster, and cheaper diagnostic tests.
“Current diagnostic approaches to HPV-related head and neck cancer are incomplete and invasive, which means patients need to repeat biopsies to get a diagnosis, which delays treatment and makes the procedure uncomfortable, not to mention. Increased uncertainty. ”Principal Investigator Daniel L. Faden is a Head and Neck Surgical Oncologist and a researcher at the Mass Eye and Year Mike Toss Head and Neck Cancer Research Center. He said he was an assistant professor of head and neck surgery in the Department of Otolaryngology, Harvard University School of Medicine. “Our results provide strong evidence of the principle and suggest that in the future a fully integrated liquid biopsy approach for diagnosing and monitoring disease may be possible. I am. “
Accurate and rapid diagnosis of HPV-related head and neck cancer
There are limits to traditional methods for diagnosing patients with HPV-related head and neck cancer. Tests such as surgical biopsies are invasive, and other tests such as needle aspiration may require repeated biopsies. In addition, biopsies, CT and PET imaging, and physical examinations can detect cancer only when it has grown into millions of cells and is “visible.”
Liquid biopsy provides a less invasive method for detecting cancer. Recent studies have shown that liquid biopsy can be used to monitor the recurrence of HPV-related head and neck cancer.This new study takes the next step and asks if it is very accurate Blood testCombined with routine diagnostic imaging and physical examination findings, the need for invasive tissue biopsy can be eliminated together.
According to the author, this study is the first time that liquid biopsy has been tested as a reliable diagnostic tool when presenting HPV-related head and neck cancer. In this study, the researchers prospectively enrolled 70 individuals presenting a new hypothetical diagnosis of HPV-related head and neck cancer and 70 control subjects from Massachusetts eyes and ears and MGH. All underwent regular physical and imaging tests.
They found that liquid biopsy was significantly more accurate than standard treatment, with 98.4% sensitivity to identify positive results and 98.6% specificity to detect negative results. When liquid biopsy was combined with routine diagnostic imaging and physical examination findings, the diagnostic sensitivity was 95.1 percent and the diagnostic specificity was 98.6 percent. The average time from first visit to the care provider to diagnosis was 15 days, 63% shorter than the usual method (41 days). The cost of liquid biopsy was also significantly lower than traditional methods, with an average estimated savings of over $ 6,000 per patient. According to Dr. Fadden, reducing the time to diagnosis by one month is anxiety that patients experience between the time they first see a doctor with their symptoms of concern and the time they are finally diagnosed with cancer. Is important to mitigate.
Detection of DNA fragments of HPV in blood
The custom liquid biopsy developed and applied in this study detects microscopic HPV DNA floating in the blood. This test is based on the expanding field of cell-free DNA in cancer screening and diagnostic studies. Cell-free DNA is a fragment of DNA that destroys cancer cells and is released into the bloodstream. Acellular DNA can be difficult to detect in some cancers, but HPV-related cancers have great advantages because they release HPV DNA that is found only in the bloodstream where HPV-related cancers are present.
As a result of these findings, the Mass Eye and Ear team, led by Dr. Faden and Jeremy D. Richmon, MD, and director of head and neck robotic surgery, designed a clinical trial to validate the findings from this study. It also uses liquid biopsy to make real-time patient decisions during treatment and personalize the care of each patient. This clinical trial will begin in 2022 in patients.
HPV-related head and neck cancer epidemics
Head and neck cancer is a common cancer in the United States and around the world, especially in adults over the age of 50. With the price of one type of head Cervical cancer The oropharynx, which affects the area of the throat behind the mouth, has risen dramatically in recent years, driven by HPV, which now accounts for about 75% of all cases of oropharyngeal cancer in the United States.
If detected early, these cancers can be removed by surgery or treated with radiation.one time cancer As it grows and spreads through the lymph nodes, it becomes more difficult to treat and patients often suffer lifelong side effects of the treatment.
“Liquid biopsy is a very promising approach to improving patient diagnosis and providing surgeons with more important information more quickly,” said Mark A, head of ENT, co-author of the study. . Varvares, MD, FACS states. neck Surgery at Mass Eye and Year and John W. Meliam / William W. Montgomery Professor and Otorhinolaryngology Chair – Head and Neck Surgery, Harvard Medical School. “The ability to reduce the time from presentation to diagnosis has a significant impact on facilitating the start of treatment, improving results and relieving patient anxiety. A tube of blood when the patient first arrives. Sending it to the lab can save you a lot of time, diagnose it and lead to faster treatment. ”
Giulia Siravegna et al, Cell-Free HPV DNA, provides an accurate and rapid diagnosis of HPV-related head and neck cancer. Clinical cancer research (2021). DOI: 1078-0432.CCR-21-3151
Massachusetts Eye and Ear Clinic
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