Research identifies how circulating tumor DNA can inform personalized treatment and surveillance strategies.
Researchers are evaluating a blood test that could personalize treatment and surveillance for patients with human papillomavirus (HPV)-associated throat cancer.
The research, published in JAMA Otolaryngology – Head and Neck Surgery, explores how a blood-based test, circulating tumor HPV DNA (ctDNA), changes before and after surgery. The study provides insight into how ctDNA testing can be used alongside pathology reports to improve risk assessment and personalize treatment plans.
“We know that more than 90% of throat cancer cases are caused by HPV,” says Catherine Haring, MD, an otolaryngologist specializing in head and neck cancers and an assistant professor in the department of otolaryngology – head and neck surgery at The Ohio State University College of Medicine, in a release. “While this type of cancer responds well to treatment, patient quality of life is impacted by radiation and chemotherapy. Improved biomarkers could help us better tailor treatment to reduce unnecessary side effects while ensuring patients receive the therapy they need.”
Analyzing ctDNA Levels
The study followed 104 adult patients treated for HPV-associated throat cancer between September 2021 and April 2025. Most patients had early-stage tumors located in the tonsils. All participants underwent surgery to remove the cancer, with additional therapy, such as radiation or chemotherapy, recommended based on pathologic risk factors.
Circulating tumor HPV DNA was tested before surgery in all patients and after surgery in 74 patients. The findings indicate that pretreatment ctDNA levels are influenced by tumor biology and kidney function. Postoperative ctDNA reflects both residual cancer and baseline tumor DNA levels.
“This means the test needs to be interpreted in context. A positive result after surgery may indicate higher risk, but a negative result does not always mean a patient is in the clear,” says Haring in a release. In practical terms, the blood test provides an additional layer of insight after surgery, helping clinicians better understand patient risk when combined with standard pathology.
Future Clinical Integration
More than 22,000 people are diagnosed with HPV-associated throat cancer each year, according to the Centers for Disease Control and Prevention (CDC). Rates of the disease are higher in men than in women. Following surgery and radiation, patients may experience long-term side effects such as difficulty swallowing, dry mouth, and taste changes.
Future research will focus on improving the sensitivity of ctDNA testing and integrating it into multifactorial risk models. These models aim to combine biomarker data with traditional clinical and pathologic risk factors to better personalize care.
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