The Use of Liquid Biopsy for High-Risk Stratification of HPV16-Positive Oral Cancer Patients

Start year: 2025

Summary: Human papillomavirus 16 (HPV16) is a major contributor to squamous cell carcinomas (SCCs) in the oral cavity and oropharynx, accounting for up to 90% of oropharyngeal SCCs. Patients with HPV-positive OPSCC generally experience better treatment outcomes and survival rates. However, a subset of HPV16-positive patients carries specific single nucleotide polymorphisms (SNPs) in the HPV16 genes E1, L1, L2, and the upstream regulatory region (URR), which are associated with more aggressive disease and significantly reduced survival. Patients with these SNPs have a median survival of 3.96 years, compared to 18.67 years for those without them. Detecting HPV SNPs currently requires invasive DNA sequencing of biopsy tissues, as there are no rapid clinical methods available. To address this, our lab developed a multiplex quantitative real-time PCR platform that detects transcriptionally active HPV16 and its associated SNPs using saliva. Our assay successfully detected E6 and E7 DNA and RNA, indicating active viral presence, and identified specific SNPs in patient saliva samples. This approach has significant diagnostic potential, enabling accurate risk stratification, closer monitoring, and tailored interventions for high-risk individuals, ultimately improving clinical outcomes.

Acknowledgement of Country

UTS acknowledges the Gadigal people of the Eora Nation, the Boorooberongal people of the Dharug Nation, the Bidiagal people and the Gamaygal people, upon whose ancestral lands our university stands. We would also like to pay respect to the Elders both past and present, acknowledging them as the traditional custodians of knowledge for these lands.