Predictive factors for cancer recurrence：the importance of establishing early detection methods for advanced and recurrent malignant tumors using liquid biopsy in Japan

In recent clinical trials, it has been shown that measuring Circulating Tumor DNA spilled into the blood from each malignant tumor is better than the increase in the value of each tumor marker in order to determine the recurrence of various types of cancer at an early stage.
 

The study conducted by our clinical research team, investigated the treatment of 2,991 patients (OncoGuideTM NCC oncopanel test: 679 patients, Foundation One CDx test: 2312 patients) with cancer genomic medicine at national universities in Japan from December 2019 to April 2023. The treatment of 106 patients with advanced nasopharyngeal cancer was examined by cancer genomic medicine. The gender breakdown of the 106 patients with advanced oropharyngeal squamous cell carcinoma was 88 males and 18 females. From the results of a cancer genome test conducted on 106 cases of advanced oropharyngeal squamous cell carcinoma, HPV infection was found in 37 males (42.0%; 37/88) and 6 females (33.3%; 6/18).
 

The results of these clinical studies do not provide medical evidence that recurrence is more common in patients with advanced oropharyngeal squamous cell carcinoma infected with HPV than in patients without HPV infection. However, there are many cases of recurrence in patients with advanced oropharyngeal squamous cell carcinoma infected with HPV.
 

In Japan, several types of tests that use surgically removed tissue to detect HPV infection are covered by insurance. However, the only test that uses liquid biopsy to detect HPV infection is FoundationOne CDx liquid (Foundation Medicine Inc. Cambridge, MA, USA). Unfortunately, in Japan, FoundationOne CDx liquid cannot be used to detect recurrence of various malignant tumors. In the future, based on the result of clinical research being conducted in other countries, if it is established that measuring Circulating Tumor HPV DNA spilled into the blood from each malignant tumor is better than the increase in the value of each tumor marker in order to early determine the recurrence of various cancer types, in Japan as well, tests for detecting HPV infection using liquid biopsy are likely to be covered by insurance. It is hoped that further clinical trials will be conducted for the early detection of advanced and recurrent malignant tumors.
 

We do not have potential conflicts of interest.

Published in JAMA Oncology on October 14, 2023 by Kyoto@takumah

Doctor specializing in emerging infectious diseases
Doctor specializing in cancer mdeicine