HPV in Blood Samples From Cervical Cancer Patients.

Study Overview
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Brief Summary
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By means of digital droplet PCR (ddPCR), this study examines blood samples from patients newly diagnosed with cervical cancer to investigate whether it is possible to measure the presence and amount of HPV DNA in these blood samples. The first blood sample is taken at time of diagnosis, and follow-up blood samples are collected during treatment- and follow-up visits. We expect to find a correlation between the disease stage and the viral load and also a decline in viral load after treatment. Furthermore, we hope that this method may serve as a way of detecting disease recurrence earlier than what is possible today.

Detailed Description
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This study hypothesises that in patients with HPV-related cervical cancer, HPV DNA may be released into the bloodstream from tumor cells. These fragments of HPV DNA shed by tumor may therefore be measured in blood samples from the patients. By using the same setting as for real-time PCR with PCR primers and probes for fluorescence detection, the study uses digital droplet PCR (ddPCR), a method based on dilution and partitioning of the blood sample in many reaction chambers or droplets, to measure absolute quantities of HPV DNA fragments in blood samples from women with different stages of cervical cancer. Patients are recruited at the time of diagnosis, where a baseline blood sample is collected. Follow-up blood samples are collected during treatment and at follow-up visits up to two years after the diagnosis. We expect the HPV DNA load to decrease after treatment, and if an increase in viral load is detected during follow-up, we expect this to be an early sign of a disease recurrence. The method may therefore become an effective monitoring tool in these patients in terms of detecting a ongoing disease recurrence, which gives us the chance to intervene and treat these patients before the disease becomes too disseminated.

Official Title
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Can Digital Droplet PCR (ddPCR) on Blood Samples From Patients With HPV Related Cancers Become a Reality in Cancer Treatment and Monitoring?

Conditions
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HPV-Related Carcinoma, HPV-Related Malignancy

Intervention / Treatment
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* Other: Blood sample


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria cases: Diagnosed with cervical cancer ≥ stage 1B between june 2018 and june 2020 > 18 years of age at the time of diagnosis There must be available cervical tissue material from the patient to analyse for HPV Inclusion Criteria healthy controls Women > 18 years with no prior history of any cervical dysplasia Inclusion Criteria CIN3 controls Women > 18 years Must have a histologically verified severe cervical dysplasia (CIN3) Is admitted for cervical conisation Exclusion Criteria cases: < 18 years of age at time of cervical cancer diagnosis Cervical cancer < stage 1B Exclusion Criteria healthy controls: < 18 years of age Prior cervical dysplasia Exclusion Criteria CIN3 controls: < 18 years of age Women with only low grades of cervical dysplasia (CIN1 or CIN2) Women with HPV-negative cervical biopsies

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Intervention Model: Single Group Assignment
Interventional Model Description: Case-control study with 141 case patients newly diagnosed cervical cancer and a control group of 10 healthy women with no prior cervical dysplasia and 25 women with cervical dysplasia (CIN3), respectively.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Cervical cancer patients<br>Baseline- and follow-up blood samples are collected from the cervical cancer patients at time of diagnosis and during treatment and clinical follow-up. HPV DNA is measured in these samples. | Other: Blood sample<br>* Blood sample taken from cervical cancer patients at time of diagnosis (baseline) and follow-up visits.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| HPV DNA | A qualitative and quantitative measure of HPV DNA in blood samples. | Two years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cervical Cancer, HPV, Pathology, ddPCR