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2022-RA-205-ESGO Circulating HPV DNA in cervical cancer: a marker for early detection of relapse
  1. Emmanuelle Jeannot1,
  2. Aurélien Latouche2,
  3. Claire Bonneau3,
  4. Guillaume Bataillon1,
  5. Linda Larbi Chérif1,
  6. Marina Popovic4,
  7. Anne de la Rochefordière1,
  8. Fabrice Lecuru1,
  9. Virginie Fourchotte1,
  10. Ekaterina Jordanova5,
  11. Heiko von der Leyen6,
  12. Carine Tran-Perennou1,
  13. Legrier Marie-Emmanuelle1,
  14. Christophe Le Tourneau1,
  15. Ivan Bièche1,
  16. Roman Rouzier3,
  17. Els Berns7,
  18. Maud Kamal1 and
  19. Suzy Scholl1
  1. 1Institut Curie, PARIS, France
  2. 2INSERM U900, Paris, France
  3. 3Institut Curie, Saint-Cloud, France
  4. 4Oncology Institute of Vojvodina, Sremska Kamenica, Serbia
  5. 5Amsterdam UMC and The Netherlands Cancer Institute, Amsterdam, Netherlands
  6. 6Hannover Clinical Trial Center, Hannover, Germany
  7. 7Erasmus MC, Rotterdam, Netherlands


Introduction/Background Almost all cervical cancers (CC) are caused by human papillomavirus (HPV) and patients with advanced stage are at high risk for relapse. Studies has shown that most patients with HPV-associated tumors have detectable circulating HPV DNA (HPV ctDNA) in the blood at time of diagnosis, before treatment. Development in sensitive technologies led to the use of cell-free DNA for monitoring patients. In the present study, we investigated if HPV ctDNA may serve as a residual tumor marker at the end of chemo-radiation or to predict relapse during the follow-up period.

Methodology We analyzed serum samples from 94 HPV16- or HPV18-related CCs from the BioRAIDs (NCT02428842) prospective cohort. Samples were collected before and after treatment and during an 18-month follow-up period. Using digital droplet PCR (ddPCR), we assessed the relevance of circulating HPV E7 gene as a marker for residual disease. Finally, the prognostic impact of circulating HPV E7 gene was assessed with its prediction value of relapse.

Results Circulating HPV DNA (HPV ctDNA) was detected in 63% (59/94) of patients, before treatment. HPV ctDNA detection in serum sample was associated with high FIGO stage (p=0.02) and para-aortic lymph node involvement (p=0.01). The level of HPV ctDNA was positively correlated with HPV copy number in the tumor (R=0.39, p<0.001). Complete clearance of HPV ctDNA by the end of treatment was significantly associated with a longer PFS (p<0.0001). Patients with persistent HPV ctDNA in serum relapsed with a median time of 10 months (range, 2–15) from HPV ctDNA detection.

Conclusion HPV ctDNA detection is a useful marker to predict relapse in cervical cancer.

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