Researchers at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Institute (OSUCCC – James) are advancing the understanding of a promising blood test that could personalize treatment and monitoring for patients with human papillomavirus (HPV)-related throat cancer.
This study JAMA Otorhinolaryngology – Head and Neck Surgeryinvestigates how circulating tumor HPV DNA (ctDNA), a blood-based test, changes before and after surgery. This study investigates how tumor biology and patient factors influence ctDNA levels. This discovery provides important new insights into how this ctDNA test can be used in conjunction with pathology reports to improve risk assessment and personalize treatment plans.
It is known that over 90% of pharyngeal cancers are caused by HPV. Although this type of cancer responds well to treatment, a patient’s quality of life is affected by radiation and chemotherapy. Improving biomarkers could help better tailor treatments to reduce unnecessary side effects while ensuring patients receive the treatment they need. ”
Katherine Herring, M.D., otolaryngologist specializing in head and neck cancer and assistant professor in the Department of Otolaryngology-Head and Neck Surgery at The Ohio State University School of Medicine
The study followed 104 adult patients treated for HPV-related pharyngeal cancer from September 2021 to April 2025. Twenty patients were women and 84 were men, most of whom had early-stage tumors in their tonsils. All patients underwent surgery to remove the cancer, and additional therapy (radiation and/or chemotherapy) was recommended based on pathological risk factors.
Circulating tumor HPV DNA was tested preoperatively in all patients and postoperatively (before radiation) in 74 patients.
“We found that pre-treatment ctDNA levels were influenced by tumor biology and kidney function,” Herring said. “Postoperative ctDNA reflects both residual cancer and baseline tumor DNA levels. This means that the test must be interpreted in context. A positive result after surgery can indicate high risk, but a negative result is necessary. It doesn’t necessarily mean that the patient is OK.”Practically speaking, this means that blood tests can provide further insight after surgery and give doctors a better understanding of the patient’s risks when combined with standard pathology.
According to the U.S. Centers for Disease Control and Prevention, more than 22,000 people are diagnosed with HPV-related throat cancer each year. The prevalence of the disease is higher in men than in women.
After surgery or radiation therapy, patients may experience long-term side effects such as difficulty swallowing, dry mouth, changes in taste, sleep apnea, and hypothyroidism.
Future research will focus on improving the sensitivity of ctDNA testing and integrating biomarker data into multifactorial risk models that combine traditional clinical and pathological risk factors to better personalize care.
Other co-authors from the Ohio State researchers include Jack Birkenbuell, MD, and Christopher Noel, MD. Lauren Miller, MD. Ember Ozer, Maryland. Amit Agrawal, MD. Kyle Vancoe-Eberling, MD. Stephen Kang, MD. Nolan Seim, MD. and James Rocco, MD.
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The Ohio State University Wexner Medical Center
Reference magazines:
Birkenbeuer, JL, others. (2026). Determinants of circulating tumor HPV DNA in surgically treated oropharyngeal cancer. JAMA Otorhinolaryngology/Head and Neck Surgery. DOI: 10.1001/jamaoto.2026.0015. https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/2847179
