# Circulating tumour HPV DNA (ctHPV-DNA)

Source: https://onco.cc/technologies/cthpv-dna/  
OnCo record `cthpv-dna` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A blood test that detects fragments of the virus DNA shed by HPV-positive throat cancers, to confirm diagnosis, track response, and catch recurrence early.

## Summary

Digital droplet PCR or NGS assays (NavDx, others) detect HPV16 DNA in plasma with high specificity; clearance during chemoradiation predicts cure and post-treatment surveillance detects recurrence months before imaging. Being used to select patients for response-adapted de-escalation after the failure of HPV-status-alone selection (NRG-HN005).

## Fields

- Kind: Technology
- Status: established
- Last checked: 2026-09-07
- Principle: Tumour-tissue-modified viral DNA fragments quantified in cell-free plasma DNA.
- Strengths: Highly specific to the tumour; Cheap, repeatable, earlier than imaging
- Limitations: Only for HPV-driven disease; Interventional trials proving benefit of acting on it are ongoing

## Sources

- Chera et al., Plasma circulating tumour HPV DNA for the surveillance of cancer recurrence in HPV-associated oropharyngeal cancer (Journal of Clinical Oncology 2020): https://doi.org/10.1200/JCO.19.02444

## Connected records

- cancers: [Anal cancer (squamous cell carcinoma)](https://onco.cc/cancers/anal/), [Anal high-grade squamous intraepithelial lesions (precursor)](https://onco.cc/cancers/anal-hsil-precursor/), [Head and neck squamous cell carcinoma](https://onco.cc/cancers/head-and-neck/), [HPV-positive oropharyngeal cancer](https://onco.cc/cancers/hpv-positive-oropharyngeal-cancer/), [Localised anal squamous cell carcinoma (stage I to III)](https://onco.cc/cancers/localised-anal-cancer/), [Metastatic and recurrent anal squamous cell carcinoma](https://onco.cc/cancers/metastatic-anal-cancer/), [Thyroid cancer](https://onco.cc/cancers/thyroid/)
- fronts: [Diagnostics & Biomarkers](https://onco.cc/fronts/diagnostics/)
- technologies: [Liquid biopsy (ctDNA)](https://onco.cc/technologies/liquid-biopsy/), [MRD / molecular residual disease testing](https://onco.cc/technologies/mrd-testing/)
- terms: [Circulating tumour DNA (ctDNA)](https://onco.cc/terms/ctdna/), [HPV-positive (p16) head and neck cancer](https://onco.cc/terms/hpv-p16/), [Plasma EBV DNA](https://onco.cc/terms/plasma-ebv-dna/)
- key papers: [Plasma Circulating Tumor HPV DNA for the Surveillance of Cancer Recurrence in HPV-Associated Oropharyngeal Cancer](https://onco.cc/key-papers/paper-chera-j-clin-oncol/)
- pairings: [Caution: de-escalating radiation on HPV status alone](https://onco.cc/pairings/hpv-deescalation-caution/)
- ideas: [ctHPV-DNA-adapted de-escalation of chemoradiation](https://onco.cc/ideas/idea-cthpv-adapted-deescalation/)
- pathways: [Oncogenic viruses](https://onco.cc/pathways/oncogenic-viruses/)

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