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Post-treatment Surveillance in HPV+ Oropharyngeal SCC

Active, not recruiting
Conditions
HPV
Oropharyngeal Squamous Cell Carcinoma
Interventions
Other: Screening
Registration Number
NCT04965792
Lead Sponsor
Dana-Farber Cancer Institute
Brief Summary

In this research study the investigators are examining a blood test to detect HPV DNA in the blood that can possibly detect cancer recurrence earlier than with standard surveillance measures.

Detailed Description

This research study involves blood tests to detect HPV DNA at regular time points after treatment for HPV-positive oropharyngeal squamous cell carcinoma (HPV-OPC). Participants may undergo scans based on the results of the blood tests. Study participants will also be asked to complete quality of life questionnaires periodically.

Participation in this study may last for up to 3 years. It is expected that about 150 people will take part in this research study.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
150
Inclusion Criteria
  • Participants must have histologically or cytologically confirmed incident or recurrent squamous cell carcinoma of the tonsil or base of tongue (oropharynx) - includes biopsy of any lymph node with clinical evidence of an oropharynx tumor (unknown primary carcinoma in an involved cervical neck lymph node is permitted if high-risk HPV testing is positive on the involved node)
  • HPV-associated tumor as defined by one or more : positive p16 immunohistochemistry (>70%) OR in situ hybridization OR PCR-based methods
  • Age 18 years or older
  • Will undergo oropharyngeal cancer treatment with curative intent
  • Ability to understand and the willingness to sign a written informed consent document.
  • Baseline positive or detectable ctHPV DNA result in plasma OR detectable corresponding HPV DNA in tumor tissue prior to treatment
Exclusion Criteria
  • Distant metastatic disease (M1, AJCC 8th edition)

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
HPV-positive oropharyngeal squamous cell carcinoma (HPV-OPC) PatientsScreeningNewly diagnosed HPV-positive oropharyngeal squamous cell carcinoma (HPV-OPC) patients will undergo blood testing for circulating tumor HPV DNA.
Primary Outcome Measures
NameTimeMethod
Recurrent disease RateUp to 5 years

The proportion of patients with recurrence first detected by ctHPV DNA will be calculated as a percentage and 95% confidence intervals (CI) established using binomial exact calculation.

Secondary Outcome Measures
NameTimeMethod
Cost ComparisonUp to 5 years

Projected cost of ctHPV DNA-based compared with standard surveillance

Recurrence Detection Predictive PropertiesTime from first positive ctHPV DNA test to diagnosis of recurrence, assessed up to 5 years

Estimate positive and negative predictive value, sensitivity and specificity of ctHPV DNA for subsequent diagnosis of recurrent HPV-OPC

Time to diagnosis of recurrenceTime from first positive ctHPV DNA test to confirmed diagnosis of recurrence, assessed up to 5 years

The median (IQR) number of months between the first positive ctHPV DNA test to definitive diagnosis of recurrence will be calculated.

Progression-free survival (PFS)Time from registration to the earlier of progression or death due to any cause, assessed up to 5 years

Calculated using Kaplan Meier method

Overall survival (OS)Time from registration to death due to any cause, or censored at date last known alive, assessed up to 5 years

Calculated using Kaplan Meier method

Quality of Life (QOL)Pre-study, at 3 and 6 months, then at every other visit for the duration of the study up to 5 years

QOL will be evaluated using the by Fear of Recurrence Questionnaire-Short Form (score range 6-40; lower score is lower fear of recurrence) and EQ-5D-5L questionnaire (5 questions with score range 1-5 where higher score is worse; and one question with score range 0-100 where higher is better).

Trial Locations

Locations (1)

Dana Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

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