Dr. Glenn Hanna presented phase 2 data suggesting that circulating HPV DNA could serve as a real-time biomarker to guide treatment intensity in HPV-positive oropharyngeal cancer.
React one was a really important study. It was, it is one of the first trials, particularly for non-surgical management of HPV positive head and neck cancer or oropharyngeal cancer, to use on treatment real-time HPV, uh, tumor DNA or circulating tumor DNA in the plasma or in the blood to help guide how to risk stratify and risk adapt therapy for patients. So we know by giving chemo standard chemo radiation patients have increased morbidity. Um, they do well with treatment, but unfortunately there are long term complications from chemotherapy like platinum and radiation and so the goal with React was actually to take those sort of intermediate risk clinical features like T4 tumors and those who had smoked for greater than 10 pack here and really see if we could use the HPV DNA tests in a way that allowed us to risk stratify patients to a little bit less intensity therapy or. And so the meat of the study was we took the T4 smoking population with HPV orphyngeal cancer and we gave them less radiation and less chemo if they were able to clear their HPV DNA by 95% or greater of their baseline value and if their baseline value was detectable at a certain level. So it's a really exciting study and in that group who we de-escalated, we saw pretty solid 2 year progression free survival outcomes around 90%, which is pretty good if you look back at a comparable population getting standard chemo radiation in the past. So that was really exciting to see that sort of shows for the first time that you can use HPV DNA. In complement with other clinical risk features to help guide decision making and it's a first step, but I think the hope is that in the future we'll see many more trials, including our own, that use HPV DNA testing as part of a clinical risk stratification to de-intensify but also to intensify treatment for these patients so as a way of sort of guiding personalized therapy.
