Researchers at Mass Eye and Ear and Mass General Hospital (MGH) have developed a blood test—or liquid biopsy—for head and neck cancer associated with the human papilloma virus (HPV) that was shown in a new study to be more accurate, faster and cheaper than conventional testing methods.
In the study, published in Clinical Cancer Research, liquid biopsy was more than 98 percent accurate and obtained a diagnosis 26 days quicker on average than conventional tissue biopsy.
The cost of the novel test was 38% lower than standard methods. When the researchers combined the liquid biopsy with findings from routine imaging and physical exam to create a fully non-invasive diagnostic approach, diagnostic accuracy remained greater than 95%.
With HPV-associated head and neck cancer rates on the rise, there is a great need for more accurate, less-invasive, faster and less expensive diagnostic tests, according to authors of the study.
“Current diagnostic approaches for HPV-associated head and neck cancers are imperfect and invasive, which means patients often need repeat biopsies to get to the diagnosis, thereby delaying care and increasing uncertainty, not to mention the discomfort of the procedures,” says lead study author Daniel L. Faden, MD, a head and neck surgical oncologist and investigator in the Mike Toth Head and Neck Cancer Research Center at Mass Eye and Ear, and assistant professor of otolaryngology–head and neck surgery at Harvard Medical School. “Our results show strong proof of principle and suggest that in the future, a fully integrated liquid biopsy approach to diagnose and monitor disease could be possible.”
Liquid biopsy provides a less-invasive method to detect cancers. The new study attempts to see a highly accurate blood test, when combined with routine imaging and physical exam findings, could eliminate the need for an invasive tissue biopsy all together.
In the study, researchers prospectively enrolled 70 individuals presenting with the new, assumed diagnosis of HPV-associated head and neck cancer and 70 control subjects from Mass Eye and Ear and MGH. All underwent routine physical exam and imaging.
The average time from first presentation to a healthcare provider to diagnosis was 15 days, 63 percent less than typical methods.
The custom liquid biopsy developed and applied in this study detects microscopic levels of HPV DNA floating in the blood.
Rates of one type of head and neck cancer affecting the area of the throat behind the mouth, the oropharynx, have dramatically risen in recent years, driven by HPV, which now accounts for roughly 75 percent of all cases of oropharyngeal cancers in the United States.
When caught early, these cancers can be removed by surgery or treated with radiation. Once the cancer grows, and spreads through the lymph nodes, treatment becomes more challenging and patients often suffer life-long from the side effects of treatment.
“Liquid biopsy is an extremely promising approach to improve diagnostics for patients and to provide more essential information to surgeons faster,” says study co-author Mark A. Varvares, MD, FACS, chief of otolaryngology–head and neck surgery at Mass Eye and Ear and the John W. Merriam/William W. Montgomery Professor and Chair of Otolaryngology–Head and Neck Surgery at Harvard Medical School. “The ability to shorten the time from presentation to diagnosis will have significant impact on expediting the initiation of treatment, which will improve outcomes and decease patient anxiety. Sending a tube of blood into the lab when a patient first arrives can considerably cut down on time to diagnosis and lead to faster care.”
Featured image: Daniel L. Faden, MD, a head and neck surgical oncologist and investigator in the Mike Toth Head and Neck Cancer Research Center at Mass Eye and Ear, and assistant professor of otolaryngology–head and neck surgery at Harvard Medical School. Photo: Mass Eye and Ear