2817 - Impact of Smoking Status on Circulating Tumor HPV DNA in a Diverse Population with Oropharyngeal Cancer
Presenter(s)
M. Z. Ozair1, T. Lambert2, C. Velten3, P. Brodin4, B. Nolasco5, K. Sehrawat6, M. Gjini7, B. Schiff8, V. Mehta9, E. Castellucci2, M. K. Garg2, and R. Kabarriti2; 1Montefiore Medical Center, Bronx, NY, 2Montefiore Einstein Comprehensive Cancer Center, Bronx, NY, 3Department of Radiation Oncology, Montefiore Medical Center, Bronx, NY, 4Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, 5Albert Einstein College of Medicine, Bronx, NY, 6Albert Einstein College of Medicine`, Bronx, NY, 7Institute for Onco-Physics, Albert Einstein College of Medicine, Bronx, NY, 8Department of Otorhinolaryngology - Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, NY, 9Department of Otorhinolaryngology - Head and Neck Surgery, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
Purpose/Objective(s):
Circulating tumor-tissue modified viral (TTMV) HPV DNA is emerging as a biomarker for detecting residual and recurrent disease in HPV-associated oropharyngeal squamous cell carcinoma (OPSCC). In this retrospective study, we evaluate its clinical utility in predicting recurrence within a diverse patient cohort, while also exploring patient characteristics that may influence TTMV-HPV DNA levels and their potential prognostic significance.Materials/Methods:
This retrospective cohort study included patients with HPV+ OPSCC who underwent at least one TTMV-HPV DNA blood test between 2020 and 2024 at a single institution. Plasma TTMV-HPV DNA levels were measured using the liquid biopsy assay. Demographic and clinical data, including tumor stage, tumor volume, recurrence status, smoking status and liquid biopsy results pre and post treatment, were analyzed.Results:
Ninety-nine patients met the inclusion criteria and were included in the analyses, with 63 having pre-treatment (Pre-Tx) scores and 77 having post-treatment (Post-Tx) scores available. This patient population consisted of those who identified as Hispanic (n=47), non-Hispanic Black (n=17), non-Hispanic White (n=16) or Other/Declined (n=19). There was no significant association between Pre-Tx scores and race/ethnicity (p=0.49). In the overall cohort, the mean Pre-Tx score was 5060 (median 195). By smoking status, the median Pre-Tx scores were 2906 for never smokers (n=37), 3,666 for former smokers (n=45), and 21,840 for current smokers (n=17). The median Pre-Tx score for current smokers and former smokers was significantly higher than in never smokers (p=0.02 and p=0.01, respectively). A significant association was observed between Pre-Tx scores and stage (p=0.034), with mean scores of 1228, 4546, and 12,237 for stages I, II, and III/IV, respectively. Additionally, Pre-Tx scores correlated significantly with total tumor volume (r=0.57, p<0.001), with the strongest correlation seen in current smokers (r=0.86, p=0.003). Among 77 patients with available Post-Tx scores, 10 were positive, and there were 9 total recurrences and all of which had a positive score. The negative predictive value (NPV) was 97.0%, and the positive predictive value (PPV) was 100%, indicating strong predictive value for recurrence.Conclusion:
These findings highlight TTMV-HPV DNA as a tool for monitoring disease recurrence in patients of a diverse background. The observed associations between TTMV-HPV DNA scores and smoking status suggests that viral DNA detection may provide valuable insights into the tumor microenvironment and why patients who are current smokers respond differently to treatment than their non-smoking counterparts.