Circulating tumor DNA in HPV-associated head and neck cancers - a novel clinical tool in the era of precision oncology.

BACKGROUND

Head and neck squamous cell carcinoma (HNSCC) represents a significant global oncological challenge with a rising incidence, particularly due to HPV-associated oropharyngeal squamous cell carcinomas (OPSCC). These tumours differ from HPV-negative entities biologically, clinically, and prognostically. Conventional diagnostic approaches, based on tissue biopsy and imaging techniques, face several limitations - from invasiveness and the inability to monitor disease dynamics to low sensitivity in the early detection of recurrence.

AIM: This paper provides a comprehensive overview of circulating tumour DNA (ctDNA), specifically HPV-associated ctDNA, as a novel non-invasive biomarker enabling more accurate diagnosis, monitoring of treatment response, and early detection of recurrence in patients with HNSCC.

CONCLUSION

ctDNA exhibits specific biological and physical characteristics that allow its reliable detection and differentiation from normal circulating cell-free DNA. Owing to its short half-life, ctDNA provides real-time insights into disease dynamics, while its concentration and fragmentation patterns reflect tumour burden and biological activity. Monitoring ctDNA holds significant potential as a pivotal clinical tool in the era of precision oncology, facilitating earlier recurrence detection, improved patient stratification, and optimization of therapeutic strategies in HPV-associated HNSCC.