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Valor predictivo de la cinética del ADN del VPH modificado por el tejido tumoral circulante en la terapia de

Megan Tang¹, Max Dougherty², Leslie Worona²

¹Department of Hematology/Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.

|August 20, 2025

Resumen

El retraso en el aclaramiento del ADN viral modificado por el tejido tumoral (TTMV) del VPH durante el tratamiento de inducción para el carcinoma de células escamosas orofaríngeas positivo para el virus del papiloma humano (HPVOPC) predice el fracaso del tratamiento. El aclaramiento temprano de TTMV se asocia con mejores resultados, lo que sugiere su utilidad en la terapia de orientación.

Área de la Ciencia:

En el campo de la oncología
Virología
Descubrimiento de biomarcadores

Sus antecedentes:

El ADN viral modificado por el tejido tumoral (TTMV) del VPH es un biomarcador sensible y específico para el carcinoma de células escamosas orofaríngeas positivo para el virus del papiloma humano (HPVOPC).
El monitoreo de la cinética TTMV puede proporcionar información sobre la respuesta al tratamiento y los resultados del paciente.

Objetivo del estudio:

Investigar la cinética de los niveles de ADN TTMV en pacientes con HPVOPC sometidos a quimioterapia de inducción (CI) o quimioinmunoterapia de inducción (CI).
Analizar el valor predictivo de los patrones de aclaramiento de TTMV para los resultados del tratamiento, incluida la recurrencia y la supervivencia.

Principales métodos:

Los pacientes con HPVOPC localmente avanzado recibieron IC o ICI, seguido de quimiorradiación (CRT) con o sin inmunoterapia adyuvante.
Los niveles de ADN TTMV se midieron retrospectivamente antes del tratamiento, después de cada ciclo de quimioterapia, después de la TCR y durante la vigilancia.

Principales resultados:

El aclaramiento rápido de TTMV después del primer ciclo de IC se asoció significativamente con un menor riesgo de recurrencia (p=0,046) y niveles de TTMV basales más bajos (p=0,049).
El retraso en el aclaramiento de TTMV durante la terapia de inducción predijo fuertemente la insuficiencia sistémica.
Todos los pacientes obtuvieron negatividad TTMV después de la CRT, pero 6/ 28 pacientes experimentaron recurrencia durante la vigilancia.

Conclusiones:

El retraso en el aclaramiento de TTMV durante la terapia de inducción para HPVOPC es un fuerte predictor de la insuficiencia sistémica.
La cinética del TTMV puede ayudar a identificar a los pacientes que podrían beneficiarse de un tratamiento sistémico más intensivo.
Se requiere una validación adicional en cohortes más grandes para confirmar estos hallazgos generadores de hipótesis.

Palabras clave:

Cáncer de cabeza y cuello Quimioterapia por inducción Valor predictivo Cinética de la respuesta ADN del tumor circulante

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