Researchers at The Ohio State University Comprehensive Cancer Center—Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC—James) are advancing research on a promising blood test that could improve treatment planning for patients with HPV-associated throat cancer.
The study, published in JAMA Otolaryngology—Head and Neck Surgery, examines how circulating tumor HPV DNA (ctDNA) levels change before and after surgery. The findings highlight how tumor biology and patient characteristics influence ctDNA levels and demonstrate how this biomarker could support better risk assessment and more personalized treatment strategies.
Understanding the Role of ctDNA in HPV-Associated Throat Cancer
Human papillomavirus (HPV) is responsible for more than 90% of throat cancer cases, according to researchers. Although HPV-related throat cancers generally respond well to treatment, therapies such as radiation and chemotherapy can significantly affect patients’ quality of life.
Catherine Haring, MD, an otolaryngologist specializing in head and neck cancers and assistant professor at The Ohio State University College of Medicine, emphasized the importance of improving treatment precision.
She explained that better biomarkers could help physicians tailor treatment plans, potentially reducing unnecessary therapy while ensuring patients still receive effective cancer care.
Study Examines ctDNA Levels Before and After Surgery
The research followed 104 adult patients diagnosed with HPV-associated throat cancer between September 2021 and April 2025. Among the participants, 20 were women and 84 were men, with most patients presenting early-stage tumors in the tonsils.
All patients underwent surgical removal of the tumor, while additional treatments such as radiation therapy or chemotherapy were recommended based on pathology findings.
Researchers measured circulating tumor HPV DNA levels before surgery in all patients. In addition, 74 patients underwent ctDNA testing after surgery but before starting radiation therapy.
Interpreting ctDNA Results in Clinical Context
As reported by medicalxpress, the study revealed that pretreatment ctDNA levels are influenced by tumor biology and kidney function. Meanwhile, postoperative ctDNA levels may reflect both residual cancer and baseline tumor DNA levels.
Therefore, clinicians must interpret the test results carefully. A positive ctDNA result after surgery may signal a higher risk of recurrence, while a negative result does not always guarantee that the patient is cancer-free.
When combined with traditional pathology reports, the ctDNA blood test can provide additional insights into a patient’s risk profile after surgery, helping physicians make more informed treatment decisions.
Future Research to Improve Precision Oncology
According to the Centers for Disease Control and Prevention (CDC), more than 22,000 people are diagnosed with HPV-associated throat cancer each year, with men affected more frequently than women.
Patients who undergo surgery and radiation often experience long-term side effects, including difficulty swallowing, dry mouth, taste changes, sleep apnea, and hypothyroidism.
Future studies will focus on enhancing the sensitivity of ctDNA testing and integrating the biomarker into multifactorial risk models that combine molecular data with clinical and pathological factors. Such advancements could further support precision medicine approaches in head and neck cancer care.