The incidence of human papillomavirus (HPV) associated oropharyngeal squamous cell carcinoma (OPSCC) has tripled over the past three decades, surpassing cervical cancer as the most prevalent HPV-related malignancy in the US. Over 70% of new OPSCC cases are HPV-positive. Texas ranks 47th out of 50 U.S. states for HPV vaccinations and have a 10% lower HPV vaccine uptake than the national average. HPV(+) OPSCC will continue to be a serious clinical and public health issue in Texas and the nation for a long time. While HPV(+) OPSCC has better prognosis than HPV(-) OPSCC, about 20-30% of patients experience recurrence. No screening exists for the early detection of initial disease or its recurren...

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The incidence of human papillomavirus (HPV) associated oropharyngeal squamous cell carcinoma (OPSCC) has tripled over the past three decades, surpassing cervical cancer as the most prevalent HPV-related malignancy in the US. Over 70% of new OPSCC cases are HPV-positive. Texas ranks 47th out of 50 U.S. states for HPV vaccinations and have a 10% lower HPV vaccine uptake than the national average. HPV(+) OPSCC will continue to be a serious clinical and public health issue in Texas and the nation for a long time. While HPV(+) OPSCC has better prognosis than HPV(-) OPSCC, about 20-30% of patients experience recurrence. No screening exists for the early detection of initial disease or its recurrence after curative care. The overarching goal of this proposal is to build dynamic blood-radiomic tools for the early detection of recurrence after initial treatment. We will focus on two of the most promising biomarkers in cancer field: 1) serum cell-free DNA (cfDNA) methylation; and 2) radiomics - characterizing tumors from radiographical scans. Serum cfDNA methylation profiles reflect cancer and tissue origin specificity, thus are the most sensitive and specific biomarkers for the early detection of initial cancer and its recurrence. Imaging data is routinely acquired at multiple time points in oncological practice. The conversion of images to higher dimensional data and subsequent data mining by machine learning and artificial intelligence has become a novel powerful tool for biomarker discovery. We hypothesize that integrated blood-radiomic profiling can form a synergistic model for the early detection of recurrence in HPV(+) OPSCC. Non-invasive, blood- and radiomics-based biomarkers for the early detection of recurrence would allow the identification of OPSCC patients needing treatment intensification or those able to benefit from the reduction of treatment intensity for more effective and less morbid treatment, thus improving patients' survival and quality of life.

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