ESTRO 2024 - Abstract Book

S1383

Clinical - Head & neck

ESTRO 2024

Material/Methods:

We used multiplex HPV serology, to analyze HPV16 serum antibodies of the first 5,000 participants of the Hamburg City Health Study (HCHS), a prospective cohort study that is recruiting 45,000 participants of the general population of Hamburg between 45-74 years. 4,424 sera (blood draw 2016-2017) were analysed and participants seropositive for HPV16 E6 and at least one additional early protein (E1, E2, E7) were considered at highest risk for the development of HPV-positive OPC and invited to six-monthly head and neck follow-up (FU) examinations. Participants with suspicious lesions were examined by magnetic resonance imaging and panendoscopy with biopsy.

Results:

Overall, 35 participants were HPV16 E6 seropositive. Twelve participants were considered at highest risk due to positivity for at least two early antigens and ten of these were successfully re-contacted and invited to the regular FU examinations starting in 2019. At present, five of these ten high-risk participants (three males and two females) were diagnosed with HPV-positive OPC, which responds to a 900-fold elevated risk compared to the general population ((3) plus unpublished data). One diagnosis occurred at first FU and four during regular visits. All five were diagnosed with stage I HPV-positive OPC, 1x pT1 pN0 M0 and 4x pT2 pN1 pM0 with involvement of a single lymph node. All confirmed cases were treated according to standard of care following international guidelines. The remaining participants showed no detectable signs of cancer and undergo regular examinations.

Conclusion:

HPV serology for early detection of HPV-positive OPC appears feasible as it allowed the identification of a small group with highest risk out of a large general population cohort. Due to tumor development at the bottom of tonsillar crypts, the detection of earliest tumor stages (T1N0) during FU with non-invasive methods remains challenging. The next 10,000 participants are currently planned to be recruited within the PHORECAST study, a clinical trial combining HPV serology with further biomarkers, such as plasma cell-free HPV DNA, HPV DNA from oral rinse and gargle samples or tumor-derived exosomes to optimise specificity and the short-term positive predictive value to establish a further improved concept for a general screening approach.

Keywords: HPV oropharynx screening

References:

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