Session Item

Despite advances in MRI-guided brachytherapy, a significant portion of patients with locally advanced cervical cancer relapse after definitive chemoradiation. Known clinical prognostic factors, such as stage and nodal status, are poor predictors of relapse (concordance index approximately 0.62). Adjuvant therapies may benefit a subset of patients, but clinical trials have been hampered by the lack of accurate biomarkers to identify early those patients at highest risk of relapse.

Tumors continually shed DNA into the circulation, where they can be accessed noninvasively and can provide a means for measurement of disease burden. The majority of cervical cancer is caused by HPV. HPV DNA provides a unique marker that distinguishes tumor-derived DNA from normal, nonmalignant sources of cell-free DNA (cfDNA). Digital polymerase chain reaction (dPCR) is an ultrasensitive and affordable technique for absolute quantification of cfDNA. Next generation sequencing (NGS) has emerged in recent years as a promising alternative methodology for detection of tumour-derived cfDNA (ctDNA).

This session will review the evidence for HPV ctDNA in cervical cancer, new HPV ctDNA detection technologies, knowledge gaps and road to clinical implementation.