# Circulating HPV DNA as a Prediagnostic Marker of Oropharyngeal Cancer

> **NIH NIH R21** · UNIVERSITY OF KENTUCKY · 2022 · $283,774

## Abstract

PROJECT SUMMARY
The incidence of HPV-driven oropharyngeal cancer (HPV-OPC), a type of head and neck cancer, is rapidly increasing in
the United States (US). HPV-OPC recently surpassed cervical cancer as the most common HPV-associated malignancy.
Unlike cervical cancer, there are no methods of early detection for HPV-OPC. HPV16 E6 antibody positivity has been
identified as a promising early biomarker of HPV-OPC. Previous work from our group showed that HPV16 E6 antibodies
are present in up to 90% of HPV-OPC patients and appear more than 10 years prior to diagnosis. However, given the
long lag time between HPV16 E6 seroconversion and cancer diagnosis, HPV16 E6 seropositive individuals may need to be
followed for a decade or more before the cancer is clinically diagnosable. Thus, early detection biomarkers that indicate
the presence or absence of tumor are needed before considering HPV16 E6 antibody testing for clinical use. Circulating
tumor (ct)HPV DNA detection is a promising marker for detection of HPV-OPC. Work from our group has demonstrated
that ctHPVDNA is 98.4% sensitive and 98.6% specific for HPV-OPC at the time of diagnosis. Prior studies of ctHPVDNA
have focused on the utility of ctHPVDNA for diagnosing HPV-OPC and monitoring for recurrence post-treatment. To
date, the potential of ctHPVDNA for early detection of HPV-OPC has not been explored. A major barrier to evaluating
ctHPVDNA in a pre-diagnostic setting is that assays developed to date require a high volume of blood (>1ml), which has
precluded nested studies in prospective cohorts given that blood samples collected prior to HPV-OPC diagnosis are
limited and precious. Leveraging our experience in ctDNA, we have re-optimized our droplet digital PCR (ddPCR) based
assay for detecting ctHPVDNA in small volumes of archived specimen. The objective of this study is to conduct the first
large study to evaluate the kinetics of ctHPVDNA prior to diagnosis and to compare this biomarker to HPV16 E6
seropositivity. A nested case-control study will be conducted within the Prostate Lung Colorectal and Ovarian (PLCO)
Cancer Screening Trial, a prospective cohort study of 154,935 middle aged men and women from across the US. Pre-
diagnostic blood samples from 81 OPC cases and 162 matched controls (1:2 ratio) will be tested for ctHPVDNA. All serial
samples from ctHPVDNA positive cases will also be tested to evaluate kinetics of the marker leading up to diagnosis. We
hypothesize that ctHPVDNA will be detectable prior to cancer diagnosis and that ctHPVDNA will be more sensitive than
HPV16 E6 seropositivity. This proposal is innovative given the use of a novel ctHPVDNA assay specifically optimized for
small volumes of archived specimen, which will allow us to conduct the first study to evaluate ctHPVDNA in a pre-
diagnostic setting. This research may lead to better methods for early detection of HPV-OPC and directly responds to the
joint Notice of Special Interest issued by the National Cancer Institute ...

## Key facts

- **NIH application ID:** 10526797
- **Project number:** 1R21CA267152-01A1
- **Recipient organization:** UNIVERSITY OF KENTUCKY
- **Principal Investigator:** Daniel Faden
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $283,774
- **Award type:** 1
- **Project period:** 2022-07-29 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10526797

## Citation

> US National Institutes of Health, RePORTER application 10526797, Circulating HPV DNA as a Prediagnostic Marker of Oropharyngeal Cancer (1R21CA267152-01A1). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/10526797. Licensed CC0.

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