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Integration of HPV ctDNA Testing into Clinical Practice for HPV+ OPSCC – Ready for Prime Time?
The use of HPV ctDNA in the clinical management of patients with HPV-associated oropharyngeal squamous cell carcinoma is rapidly increasing; however, questions remain regarding its utility and validity in various clinical settings. A recent review article highlighted some of the knowledge gaps that exist with regard to biomarker-based surveillance and raises several cautionary notes before the widespread adaptation of testing. [1] There are several clinical contexts in which this biomarker is being studied and implemented, including: (1) the adjuvant setting, where it remains to be determined if the sensitivity of existing assays is sufficient to safely guide de-intensification, (2) the definitive setting, as a way to monitor response in real time to potentially personalize radiotherapy dosing, and to assess treatment response, and (3) in surveillance after treatment, and to monitor response to systemic therapy in the recurrent/metastatic setting. This activity brings together experts in all three areas to clarify the existing data and provide recommendations for how to integrate this biomarker into clinical practice at this time. In so doing, we address common clinical conundrums such as: does a negative HPV ctDNA titer post-op obviate the need for adjuvant therapy; can a rising titer in conjunction with concerning imaging findings obviate the need for biopsy; and, with time, will it be possible to monitor treatment response “in real time” during definitive RT to personalize therapy?
Topics:
- Circulating Tumor HPV DNA for Diagnosis and Surveillance of HPV+ Head and Neck Cancer
Daniel Lawrence Faden, MD, PhD, FACS - The Use of HPV ctDNA Assays in the Adjuvant Setting
David Routman, MD - HPV ctDNA Kinetics in Definitive Chemoradiation
Michelle L. Mierzwa, MD - Case Studies/Discussion/Q and A
John Nicholas Lukens, MD - Moderator
Full Panel
This activity is available from April 15, 2025, through 11:59 p.m. Eastern time on April 14, 2027.
The content was originally presented and recorded at the 2024 ASTRO Annual Meeting.
Target Audience
The activity is designed to meet the interests of medical oncologists, radiation oncologists, surgeons and residents.
Learning Objectives
Upon completion of this activity, participants should be able to:
- Be familiar with the data supporting the use of HPV ctDNA as a biomarker for HPV-associated OPSCC.
- Have a better sense of how to integrate the assay into routine clinical practice, and consider enrolling patients on clinical trials to address gaps in knowledge.
- John Nicholas Lukens, MD, is employed by Perelman School of Medicine at the University of Pennsylvania. Dr. Lukens serves on the Non-Melanoma Skin Cancer Panel of the NCCN.
- David Mason Routman, MD, is employed by Mayo Clinic Rochester. Dr. Routman holds a patent and other intellectual property with Exact Sciences and serves on the Advisory board of Adela.
- Michelle L. Mierzwa, MD, is employed by University of Michigan. Dr. Mierzwa serves as Co-Lead of the Behavioral Health Committee with the Michigan Radiation Oncology Quality Consortium. Dr. Mierzwa serves on the Advisory board of Adaptimmune and receives honoraria from ASCO Conquer Cancer and Devita Cancer Clinical Updates.
- Daniel Lawrence Faden, MD, PhD, is employed by Massachusetts Eye and Ear, Harvard Medical School and Mass General Brigham. Dr. Faden receives grant/research funding from Bristol Myers Squibb, Calico, Predicine, NeoGenomics, BostonGene and Haystack. Dr. Faden receives consulting fees and honoraria from Merck, Noetic, Focus, Guide Point, Chrysalis Biomedical Advisors and Acadia.
The person(s) above served as the developer(s) of this activity. Additionally, the ASTRO Education Committee had control over the content of this activity. All relevant financial relationships have been mitigated.
The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Available Credit
- 1.25 AMA PRA Category 1 Credit™The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 1.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
- 1.25 Certificate of AttendanceThis activity was designated for 1.25 AMA PRA Category 1 Credit™.
Price
Course Fees:
ASTRO members must log in to the ASTRO website to view and receive the member rate.
- Nonmember: $149
- Member: $99
- Member-in-Training: $49
- Student/Graduate Student/PGY-1 Member: $49
- Postdoctoral Fellow Member: $49
If you are an ASTRO member from a low or lower-middle income country, as identified by the World Bank, you can receive a 50% discount off your corresponding registration for this activity. Please email [email protected] to inquire about the discount.
Policies:
No refunds, extensions, or substitutions will be made for those participants who, for any reason, have not completed the activity by the expiration date.
Participants using ASTRO Academy activities to satisfy the requirement of a Continuing Certification (MOC) program should verify the credit number and type and availability dates of any activity before making a purchase. No refunds, extensions, or substitutions will be made for participants who have purchased activities that do not align with their MOC requirement.
The activity and its materials will only be available on the ASTRO website until April 14, 2027, regardless of purchase date. At the expiration of the activity, participants will no longer have access to the activity or its materials. ASTRO reserves the right to remove an activity before its expiration date.
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