Mutation profiling of circulating tumour DNA to inform prognosis and treatment selection for head and neck cancers

Dr Jenny Taylor

Project type:
Project

Project Leader:
-

Researcher:
Dr Jenny Taylor

Commencement date:
December 2018

Length of project:
2 years

Funding provided:
£153,622

Funder:
Heads Up and Oracle Cancer Trust

Location:
University of Oxford

The problem The research The future

The problem

Currently, when patients with oropharyngeal cancer are treated with chemo-radiotherapy, 12 weeks after treatment they have a PET scan to check for the presence of any remaining cancer, called residual disease.

The scan shows how successful the patients response to treatment has been. If all clear, patients can enter surveillance. If there is still tumour remaining, further treatment such as neck dissection is required.

However, for a proportion of patients, there is some doubt around what the scan is showing. Is there cancer remaining or are they clear? In these cases, even though not all these patients will have residual disease, as a precaution all patients are offered further treatment which may or may not be necessary.

On the flip side, for a minority group, patients with scans that are thought to show no residual tumour, then return at 3 months with recurrence of the disease.

The research

Whilst PET scans post treatment are currently only being used for oropharyngeal cancers, they are soon going to be used across all head and neck cancers which means the number of ambiguous results will increase. Dr Jenny Taylor is working to produce a test that will compliment the PET scan and help determine which patients need further treatment and which patients could be spared further treatment.

She plans to investigate whether fragments of DNA that are shed by tumours into the bloodstream hold the key to developing such a test. Genetic analysis of the DNA, known as circulating tumour DNA (ctDNA) could be used to flag up residual disease before clinical signs show.

The study will involve 75 patients; circulating tumour DNA from their blood will be analysed and data compared with their PET scan imaging results to see if both tests measure residual disease in concordance.

The future

When the link between ctDNA and presence of residual disease is established, this could be further developed into a test that hopes to detect residual disease before it even shows on a PET scan, around 6 weeks post chemo-radiotherapy and help decide if further treatment is needed or can be avoided.

When used in conjunction with PET scan at 12 weeks, it could confirm whether a patient is cured or not.

Analysing ctDNA in induvial patients will also help in selecting potential targeted therapies based on the mutation profile of the tumour.

University of Oxford

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