Single-center study of HPV circulating cell-free DNA kinetic in patients with cervical cancer undergoing definitive chemoradiation

Human papillomavirus (HPV) is a significant cause of cervical cancer. A study at MD Anderson Cancer Center (Houston, TX) evaluated HPV cell-free DNA (cfDNA) kinetics in patient with cervical cancer undergoing definitive chemoradiation (CRT). HPV cfDNA were quantified with droplet PCR at baseline, at weeks 1, 3, and 5 of CRT, and 3 ot 4 months after CRT. The levels peaked in the first week of CRT, and decreased throughout treatment. Patients receiving a therapeutic HPV vaccine and CRT had a higher rate of undetectable HPV type 16 cfDNA compared with those who received CRT alone. HPV cfDNA clearance correlated with better 2-year recurrence-free survival (92.9% versus 30%; p=0.0067). The strongest predictor of RFS was HPV cfDNA clearance in follow-up achieving a concordance index score of 0.83, which improved when combined with MRI response (concordance index 0.88). The authors conclude that monitoring HPV cfDNA during and after CRT may guide tailoring of personalized treatment.