Predictive value of circulating tumor tissue-modified HPV DNA kinetics in induction therapy for oropharyngeal squamous cell carcinoma. (2025)

[BACKGROUND] Tumor tissue-modified viral (TTMV) HPV DNA is a sensitive, highly specific biomarker for human papillomavirus-positive oropharyngeal squamous cell carcinoma (HPVOPC). We monitored the kinetics of TTMV responses to induction chemotherapy (IC) or induction chemoimmunotherapy (ICI) and analyzed the predictive implications for treatment outcomes.

[METHODS] Patients with locally advanced HPVOPC with high-risk features were treated with 3 cycles of IC (docetaxel-cisplatin-fluorouracil) or anti-PD1 ICI (docetaxel-cisplatin-Cemiplimab or docetaxel-cisplatin-Pembrolizumab). Depending on clinical trial enrollment, patients were followed by standard- or reduced-dose chemoradiation (CRT) alone or with adjuvant immunotherapy. TTMV testing was done pre-treatment, after each cycle and CRT,