Circulating tumor HPV DNA as an alternative method to determine HPV status in oropharyngeal squamous cell carcinoma

Human Papilloma Virus (HPV) testing is mandatory for all newly diagnosed oropharyngeal squamous cell carcinoma (OPSCC) due to its importance for prognostication and aiding in treatment decision making. Fine needle aspiration (FNA) is a widely used and accepted diagnostic tool for OPSCC. Although FNA can accurately determine histological diagnosis, results are often indeterminate or lack insufficient samples for HPV testing. For samples with an indeterminant FNA, we propose an alternate method for determining HPV status using circulating tumor tissue modified HPV DNA (ctHPVDNA). We report three cases that confirmed HPV status using ctHPVDNA following an indeterminate FNA. If validated, this non-invasive assay could prevent the need for repeat FNAs or operative biopsies for the sole purpose of determining HPV status.

Automated summary

HPV testing is mandatory for newly diagnosed OPSCC in order to assist in treatment decisions and prognosis. FNA is commonly used for OPSCC but can yield indeterminate results for HPV testing. In this study, we propose the use of ctHPVDNA to determine HPV status in cases with indeterminate FNA results. We report three cases where ctHPVDNA successfully confirmed HPV status. If validated, this non-invasive assay could eliminate the need for repeat FNAs or biopsies solely for determining HPV status.