Early findings suggest clinical and lab-based approach critical to tracking head and neck cancer recurrence

Quicker detection of HPV-positive head and neck cancer recurrence could lie in new monitoring guidelines and a more sensitive blood test

5:00 AM

Author | Anna Megdell

blood sample
Getty Images

Early findings of two studies from the University of Michigan Health Rogel Cancer Center shed light on new ways to anticipate recurrence in HPV-positive head and neck cancer sooner.

The papers, published in Cancer and Oral Oncology, offer clinical and technological perspectives on how to measure if recurrence is happening earlier than current blood tests allow, and provide a framework for a new, more sensitive blood test that could help in this monitoring.

“When metastatic head and neck cancer returns, it impacts their quality of life and can be disfiguring, interfering with the ability to talk, swallow, and even breathe,” said Paul Swiecicki, M.D., associate medical director for the Oncology Clinical Trials Support Unit at Rogel.

“As of now, there’s no test to monitor for its recurrence except watching for symptoms or potentially using a blood test which may not detect cancer until shortly before it clinically recurs.”

The paper in Cancer aims to identify different clinical ways that providers can more strategically track for recurrence.

To do this, Swiecicki and his team needed to first understand what patient population was at the highest risk to then figure out an appropriate monitoring pattern.

The team examined 450 patients with metastatic head and neck cancer, including people with HPV-positive and HPV-negative cancer.

HPV-positive cancer is caused by the human papillomavirus and is increasingly more common in head and neck cancer patients. The team identified some predictors of when recurrences would happen, and to what organs the recurrent cancer would most commonly spread.

Patients with HPV-positive cancers were found to develop recurrent disease significantly later than those that were HPV-negative, and also were more likely to spread to the lungs.

Taken together, these characteristics may help create a “surveillance” method in the future that combines routine blood testing and imaging to hopefully catch these recurrences and intervene before it’s incurable.

Swiecicki is quick to mention that, at this point, the results of this study are largely theoretical and provide a helpful framework to direct further research.

That’s where the newly developed blood test, highlighted in Oral Oncology, comes into play.

Blood biomarkers – pieces of DNA that tumors shed into the blood – are tiny and hard to detect. Commercially available blood tests currently being used may not be sensitive enough to detect a recurrence significantly earlier than clinical surveillance, though several studies with multiple types of tests are ongoing.

A research team, led by Muneesh Tewari, M.D., Ph.D., Swiecicki and Chad Brenner, Ph.D., aimed to create a highly sensitive blood test to detect cancer even when a smaller number of DNA fragments were present, with the intention of providing a better option for detecting cancer earlier in patients.

Not only is this test more sensitive and able to detect a smaller number of DNA fragments in blood, but it’s innovative in other ways too, says Chandan Bhambhani, Ph.D., the first author of the study.

“We achieved this level of sensitivity by looking for nine different pieces of the HPV genome DNA all at once,” said Bhambhani, research lab specialist.

Tewari says this is a step towards a more proactive approach to tackling recurrence in head and neck cancer.

“As of now, we only have the tools to react to symptoms when they recur. We want to find a way to be able to detect what’s causing the symptoms much, much sooner, even before the symptoms appear.”

As a clinician, Swiecicki agrees.

“It’s exciting to have the ability to potentially detect cancer before it's incurable and offer us a window for clinical trials to see if we could intervene on cancer to help give people both a better quality of life and perhaps longer quality of life, and even convert their disease from incurable to curable. We don't know if that's the case yet, but this is the first tool needed for that to develop.”

“Successful collaborative research projects like these are the direct result of how the Rogel Cancer Center enables our faculty to work together in ways that might not otherwise be possible. We have an outstanding network of faculty and researchers at our university, who are working together to develop innovative blood-based tests like the one highlighted in this story. It is our hope that these collaborative projects will lead directly to even more tools that improve the outcomes and quality of life of cancer patients.” said Brenner, Director of the Head and Neck Oncology Program. 

Additional authors: Catherine T Haring Lulia A KanaSarah M DermodyCollin BrummelJonathan B McHughKeith A Casper Steven B Chinn Kelly M Malloy Michelle Mierzwa Mark E P Prince Andrew J Rosko Jennifer Shah Chaz L Stucken Andrew G Shuman ,  Matthew E Spector Francis P Worden ,  Erin Sandford ,  Kirsten L Tuck Mary Olesnavich Apurva D Bhangale Heather M Walline Sarah M Dermody

Funding: These projects were supported by an American Cancer Society Grant,

Disclosures: Some of the authors hold a patent, US 63/208736, titled “MATERIALS AND METHODS FOR MEASURING HPV CTDNA”, and also have a pending patent for materials and high-performance methods for measuring HPV circulating tumor DNA.

DOIs: 10.1002/cncr.34823 and 10.1016/j.oraloncology.2023.106436


More Articles About: Cancer Research Head and Neck Cancer All Research Topics
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of healthcare news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]

734-764-2220

Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Subscribe
Featured News & Stories blue xray throat tumor lump with lab note written in blue with yellow overlay on bottom right
Health Lab
Two markers help predict head and neck cancer prognosis
HPV circulating tumor DNA and MRI/PET imaging markers predicted which tumors would respond to chemoradiation as early as two weeks into treatment.
blue glove holding blood vial
Health Lab
Blood test shows promise for predicting treatment response in metastatic HPV-positive throat cancer
A new blood test could give doctors more time to try alternative treatments for HPV-positive throat cancer by signaling whether initial treatment is effective much earlier than current diagnostic tests.
pills floating blue pink dark background physician in middle looking at chart white coat scrubs
Health Lab
Better medical record-keeping needed to fight antibiotic overuse, studies suggest
Efforts to reduce overuse of antibiotics may be hampered by incomplete medical records that don’t show the full reasons for prescriptions.
zoom screens with 7 different backgrounds and doctor silhouettes outlined in each
Health Lab
The doctor is in…. but what’s behind them?
A study reveals that what a doctor has behind them during a telehealth visit can make a difference in how the patient feels about them and their care.
surgery gloves passing tool blue and yellow
Health Lab
A universal heparin reversal drug is shown effective in mice
The newest version of the heparin reversal drug, described in a recent issue of Advanced Healthcare Materials, adjusted the number of protons bound to it, making the molecule less positive so it would preferentially bind to the highly negative heparin, resulting in a much safer drug.
blue gloves in hospital hanging IV bag
Health Lab
Commonly used antibiotic brings more complications, death in the sickest patients
In emergency rooms and intensive care units across the country, clinicians make split-second decisions about which antibiotics to give a patient when a life threatening infection is suspected. Now, a study reveals that these decisions may have unintended consequences for patient outcomes.