ctDNA’s promise in early detection of MRD and recurrence prediction for Head and Neck Squamous Cell Carcinoma

Two recent studies, led by the Institute Curie in collaboration with OncoDNA, have assessed the potential of circulating tumor DNA (ctDNA) as a biomarker for early detection of Molecular Residual Disease (MRD) and predicting recurrence in patients with Head and Neck Squamous Cell Carcinoma (HNSCC).

Decoding link between ctDNA detection and cancer recurrence

The first study (AACR 2023 Abstract #3363) delves into a comparison between the variants identified in ctDNA and those found in surgical tumor specimens. It aims to unravel the connection between ctDNA detection and the likelihood of recurrence in HNSCC patients. This first study also highlighted the identification of specific pathogenic variants in ctDNA, same variants not detected in solid tissue.

Observation of a high concordance between tissue and ctDNA in the most frequently mutated genes.

• Detection of pathogenic variants that were missing from paired tissue-based NGS results,
suggesting spatial heterogeneity.

• Suggestion of temporal heterogeneity through mutational HNSCC landscape dynamics,
and identified acquired pathogenic variants over time thanks to longitudinal monitoring of ctDNA.

Potential to detect molecular residual disease and molecular-level disease recurrence in HNSCC
thanks to longitudinal monitoring of ctDNA.

MRD detection to predict clinical recurrence

The second study (ESMO 2023; FPN 864P) unequivocally demonstrates the value of ctDNA-based MRD detection in predicting clinical recurrence following curative-intent surgery for HNSCC patients. These findings have significant implications for improving early relapse detection and patient management in the context of HNSCC.

ctDNA-based MRD detection anticipated clinical recurrence by 9.9 months in 63% of HNSCC patients.

ctDNA-based MRD detection within 14 weeks after surgery correlated with disease recurrence in multivariate analysis.

MRD to anticipate disease reccurrence

ctDNA-based MRD detection after curative-intent surgery proves crucial, foreseeing clinical recurrence and suggesting potential stratification for timely adjuvant therapy.

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