TROPICCANA
Research type
Research Study
Full title
Treatment Response In Cervix Cancer Assessed by circulating HPV DNA
IRAS ID
310379
Contact name
Susan Lalondrelle
Contact email
Sponsor organisation
The Royal Marsden NHS Foundation Trust
Duration of Study in the UK
4 years, 11 months, 30 days
Research summary
Cervix cancer is largely caused by human papilloma virus (HPV) and is most common in women aged 25-55. LaCC, where the cancer has progressed beyond the cervix itself, is treated with curative intent with chemotherapy and radiotherapy in combination (CRT), followed by internal radiation, or brachytherapy. Most patients will be cured but around 30% will relapse after apparent complete tumour absence, either with localised or distant disease and mostly within 2 years of completing initial treatment. Currently, there is no test that can reliably predict which patients will suffer relapse or detect this early.
We have developed and tested a blood test, named panHPV-detect, which measures for the presence of HPV-DNA fragments in the blood. In an initial feasibility study (Lalondrelle et al., in preparation), we have demonstrated that cHPV-DNA can accurately be detected in the blood before chemoRT and if present at the end of treatment or detected during follow up, is indicative of tumour relapse. In our study of 22 laCC patients, at 3 months following treatment, we found c-HPVDNA in 3 patients all of whom subsequently relapsed. The test was also useful for clarifying the absence of residual disease at 3 months: sometimes when imaging is performed 3 months after CRT there remains some abnormality in the cervix which is difficult for the radiologist to distinguish cancer from scar tissue. This generates anxiety for the patient who has to wait a further 3 months for repeat scans to reassess. We found that if cHPV-DNA was not detected at 3 months, this correlated with a complete response on subsequent imaging and could be used to reassure patients of a good outcome sooner.
We now propose a larger study using cHPV-DNA to validate these findings and define a role for the test in the assessment and monitoring of laCC.REC name
South Central - Oxford A Research Ethics Committee
REC reference
26/SC/0016
Date of REC Opinion
6 Jan 2026
REC opinion
Favourable Opinion