Blood and saliva tests help predict return of HPV-linked oral cancers

Aug. 4, 2014

Physicians at Johns Hopkins have developed blood and saliva tests that help to accurately predict recurrences of HPV-linked oral cancers in a substantial number of patients. The tests screen for DNA fragments of the human papillomavirus (HPV) shed from cancer cells lingering in the mouth or other parts of the body. A description of the development is published in the July 31 issue ofJAMA Otolaryngology—Head & Neck Surgery.

“There is a window of opportunity in the year after initial therapy to take an aggressive approach to spotting recurrences and intensively addressing them while they are still highly treatable,” says lead author Joseph Califano, MD. “Until now, there has been no reliable biological way to identify which patients are at higher risk for recurrence, so these tests should greatly help do so.”

The Johns Hopkins team analyzed blood and saliva samples from 93 oropharyngeal cancer patients who were treated with surgery, radiation alone, or combined chemotherapy and radiation at The Johns Hopkins Hospital or Greater Baltimore Medical Center. Samples were collected before and after treatment. Eighty-one patients had HPV-positive tumors. The researchers selected patients with a variety of early-to-advanced stage cancers; none of the patients had distant metastasis.

The blood and saliva tests were performed using polymerase chain reaction. The scientists found that HPV DNA detected in patients’ saliva after treatment was predictive for recurrence nearly 20% of the time in a subset of the patients. When the scientists looked for HPV DNA in the blood of another subset of patients, the accuracy of a recurrence prediction rose to more than 55%. In a third subset, finding HPV DNA in both blood and saliva samples after treatment accurately predicted recurrence 70% of the time. Read the study abstract.

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