Biomarker blood test could diagnose HPV-related cancers
A potential breakthrough in the early detection of neck, head and anal cancers linked to human papilloma viruses (HPV) has emerged — and it’s based on a highly specific diagnostic test that appears to indicate cancer, and predict its course, from just a pinprick of blood.
Even with the success of the Pap smear and the vaccine against cervical cancer, HPV-induced cancers remain a global health burden, with an estimated seven billion unprotected people at risk and about 400,000 deaths annually. There are more than 200 types of HPV viruses, with the most aggressive one, HPV16, responsible for over 90% of all HPV-related head and neck tumours and over 70% of all cases of cervical cancer. The new point-of-care biomarker test detects levels of a specific antibody (named DRH1) to HPV16, which is only produced when an infection had led to increased cell growth.
“While HPV infection does not indicate cancer, scientists have suspected for some time that if antibodies were to develop, there may be a link to cancer,” said Dr Ralf Hilfrich, founder of biotech company Abviris and creator of the DRH1 HPV tumour marker. “Being able to detect that early enough could have a major impact on patient outcomes.”
The new marker was evaluated in a pan-European study that was conducted across six clinical centres, comparing 1500 patient samples — including carcinomas of the head and neck, oral cavity carcinomas and anal carcinomas — with those of the healthy control group. A retrospective study of patients with anal cancer was able to show that high antibody levels indicating anal cancer would have been detected more than six months (293 days) before the tumour had actually been picked up. A prospective study of neck and head cancer patients meanwhile monitored patients for two years after treatment, confirming the test’s ability to predict cancer.
The results of the study, published in the journal EBioMedicine, revealed a sensitivity of 90−95% for anal and oropharyngeal cancers and a specificity of 99.3% — performance characteristics that are diagnostically significant compared to existing methods for the early detection of HPV-induced cancers. Scientists say the biomarker test is therefore promising not only for the early diagnosis of HPV-related cancers, but also for monitoring a patient’s response to therapy and as an early warning that the disease has returned.
“The test’s specificity has enabled scientists to show that rising levels of HPV antibodies in blood do reflect malignancy,” Dr Hilfrich said. “The study also indicates that it may prove diagnostically significant, compared to current detection methods, when a biopsy is hard to access, or where the site of the primary cancer is unknown or unidentifiable, such as very early metastasis.”
“This is the first time that we have been able to show a link between raised levels of this specific antibody and HPV cancers, indicating the course of disease,” added study leader Dr Thomas Weiland, from the Medical University of Graz. “This might raise the potential of being able to detect disease recurrence much earlier than current clinical practice.”
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