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Originally published October 27, 2025
Last updated October 27, 2025
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Oropharyngeal squamous cell carcinoma (OPSCC) caused by human papillomavirus (HPV) . More patients are undergoing treatment for this type of throat cancer, including surgery, radiation therapy and chemotherapy. After treatment, some patients inevitably see cancer remain or return. Finding biomarkers to accurately detect the presence of cancer, in a minimally invasive way, is an active area of research.
One biomarker researchers are investigating is circulating HPV DNA (HPV ctDNA). Daniel Kwon, MD, is a head and neck surgeon with the 喵咪社区 Head and Neck Center, part of 喵咪社区. Kwon and his colleagues at the 喵咪社区 Head and Neck Center, whose specialists come from the 喵咪社区 Caruso Department of Otolaryngology 鈥� Head and Neck Surgery and the 喵咪社区 Norris Comprehensive Cancer Center, both part of Keck Medicine, have been investigating better ways to detect throat cancer caused by HPV, including blood tests and liquid biopsies. They have also conducted research on public awareness of the association between HPV and throat cancer.
Ahead, Kwon discusses what research on HPV ctDNA has shown so far.
As Kwon explains, initial treatment for throat cancer varies, ranging from minimally invasive transoral robotic surgery to traditional open surgery if necessary, as well as chemoradiation. After treatment, patients are monitored for any remaining cancer.
鈥淗istorically, we鈥檝e had to just wait and see if the cancer came back with exams and imaging. There wasn鈥檛 a very good way to tell if the treatment had worked,鈥� Kwon says. 鈥淭hese days, blood tests are being developed to help assess the treatment response more in real time. Initial studies show that circulating HPV DNA in the blood correlates with the disease burden in the body.鈥�
Testing for HPV ctDNA would be a more proactive way of detecting cancer. Researchers hope that this liquid biomarker could one day serve as a fast, minimally invasive way to assess for cancer before, during and after a patient鈥檚 cancer treatment, thereby providing patients and their physicians with additional information on which to base future treatment plans.
鈥淔or example,鈥� Kwon says, 鈥渆ven a few days after surgery, you can see the level of circulating HPV DNA decline, telling you whether the surgery was successful or not.鈥�
Researchers are studying how early results of these blood tests can help chart next steps for treatment. 鈥淜nowing early helps us pivot more quickly,鈥� Kwon says. Early testing may be able to guide the use of additional treatment including additional surgery, radiation, immunotherapy or chemotherapy, he says.
Testing for HPV ctDNA could also give doctors more insight to allow them to better customize treatment to each individual, not subjecting patients who don鈥檛 need it to unnecessary treatments and subsequent toxicities.
More research needs to be done to validate HPV ctDNA as a biomarker. Assays for quantifying HPV DNA also need to be scientifically validated and fit for this purpose. This work is ongoing.
鈥淏ecause this is all very new, there aren鈥檛 completely agreed-upon ways to utilize this information,鈥� Kwon says. He adds that other types of blood tests similar to HPV ctDNA tests are also being investigated for other types of head and neck cancers.
These blood tests, he says, would significantly strengthen the toolbox for head and neck cancer treatment beyond what currently exists. 鈥淥bviously, we still have imaging and clinical exams, but blood tests may become the most important tool of all because they鈥檙e the most sensitive and can be specific to each type of cancer,鈥� Kwon says.
More choices for treatment as also means more nuance and shared decision-making. 鈥淏ack in the day, treatment was basically, 鈥楬ey, you have this tumor. We鈥檙e either going to cut it out or shoot it with radiation,鈥欌�� Kwon says. 鈥淚t was pretty straightforward.鈥�
He continues: 鈥淗aving more sophisticated tools such as circulating tumor DNA tests, will require a lot more counseling and patient involvement in making subsequent treatment decisions.鈥�
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