Studies on human papillomavirus-positive head and neck cancer – Tina Dalianis' team

Human papillomavirus positive oropharyngeal cancer is increasing in incidence and despite its good prognosis not all patients are cured. Likewise, for high risk neuroblastoma and medulloblastoma not all cancers are cured. We focus on finding biomarkers that are prognostic and predictive for treatment responses e.g. to immune check inhibitors and that are also useful for targeted therapy. We have promising data on synergistic effects with targeted therapies against the above cancers.

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About our research

Our research aims to improve survival and quality of life for patients with human papillomavirus (HPV)-positive head and neck cancer, particularly HPV-positive oropharyngeal cancer. Our goal is to develop more personalised approaches to treatment and follow-up, allowing therapy to be adapted to each patient's disease and response to treatment.

A major focus of our research is circulating cell-free HPV DNA (cfHPV-DNA) in blood. Using droplet digital PCR (ddPCR), we analyse cfHPV-DNA before and during treatment and at follow-up. Changes in cfHPV-DNA levels can provide information about how well a patient is responding to treatment and may help identify persistent or recurrent disease at an earlier stage.

Our previous studies have shown that cfHPV-DNA can be detected in the vast majority of patients at diagnosis and that levels generally decrease or disappear following successful treatment. We have also shown that changes in cfHPV-DNA can help distinguish between patients who respond rapidly to treatment and those who may need closer monitoring or additional treatment.

Towards more personalised treatment and follow-up

Our research has three main areas:

Earlier detection of treatment resistance and recurrence

We investigate how monitoring cfHPV-DNA during and after treatment can be used to identify patients who do not respond sufficiently to therapy or who develop recurrent disease. Clinical studies are evaluating how this approach could be incorporated into routine follow-up and help guide decisions about further examinations and treatment.

Prognostic markers for individualised treatment

We study molecular and immunological markers in tumour tissue to identify characteristics associated with treatment response and prognosis. By combining tumour markers with cfHPV-DNA measurements, we aim to better distinguish between patients who may benefit from less intensive treatment and those who need intensified therapy.

Development of targeted therapies

We also conduct experimental studies to identify new targeted treatment strategies for patients who do not respond to current therapies. This includes investigating molecular characteristics of the tumour that may predict sensitivity to specific treatments.

Improving treatment while reducing side effects

Current treatment for HPV-positive head and neck cancer is highly effective for many patients, but chemoradiotherapy can cause substantial short- and long-term side effects. At the same time, some patients do not respond adequately to treatment or experience recurrence.

Our long-term goal is therefore to tailor treatment more precisely to the individual patient. Patients who respond rapidly and have favourable prognostic markers could potentially receive less intensive treatment, reducing side effects. Patients with signs of treatment resistance or recurrence could instead be identified earlier and offered intensified or targeted treatment.

Ultimately, our research aims to improve both survival and quality of life for patients with HPV-positive head and neck cancer.

Publications

Selected publications

All publications from group members

Funding

Grants

  • Swedish Cancer Society
    1 January 2024
  • Swedish Cancer Society
    1 January 2024
    Human papillomavirus positive tonsil and tongue base cancer (HPV+TSCC/BOTSCC) is increasing epidemically and today constitutes 40% of all head and neck cancers. With combined chemoradiotherapy, approx. 80% of patients are cured, but in addition to serious side effects during the treatment, they also have persistent chronic side effects such as dry mouth, difficulty swallowing and speaking, which impairs quality of life and return to normal life and usual work. About 20% are not cured. Our previous studies have identified a series of prognostic markers in HPV+TSCC/BOTSCC that can now be tested as possible targets in targeted therapy and also for follow-up for earlier detection of recurrence. We want to study the markers we previously identified as possible targets for targeted therapy against HPV+ tonsil/tongue base cancer. We also want to evaluate how these together with quantification of HPV DNA in blood can be used to improve prognosis assessment at diagnosis and to detect and treat early recurrence during the follow-up. For the development of targeted therapies, cell cultures and in vivo models are used to identify the best combinations of these therapies depending on the tumor's specific molecular profile. For the in vivo tests, biopsy material from patient tumors is also used, with resp. molecular profiles such as the cell lines. Our goal is to increase survival and quality of life by improving diagnostics and follow-up with the prognostic markers we have found and also to be better prepared to treat successfully with targeted therapy in the event. relapse where today not all can be cured. Tumors' molecular profiles and response to therapy vary. Laboratory-wise, we therefore want to identify which combinations of new targeted therapies are best for each tumor cell line depending on its mutational profile and in in vivo models apply it to patient tumors with resp. mutation profiles. This will lead to more patients being cured and increase patient survival.
  • The Stockholm Cancer Society
    1 January 2023