Circulating Tumor DNA in Head and Neck Cancer: A Review From the American Head and Neck Society

Authors

• Sagar Kansara, LSU Health Sciences Center – New OrleansFollow
• Kevin Contrera, University of Pittsburgh School of Medicine, Pittsburgh, PA
• Scott Roof, Mount Sinai School of Medicine, New York, NY
• Anne C. Kane, University of Alabama, Birmingham, AL
• Rula Mualla, LSU Health Sciences Center – New OrleansFollow
• Eleni Rettig, Harvard Medical School, Boston, MA
• Nishant Agrawal, University of Chicago School of Medicine, Chicago, IL
• Barry Wenig, University of Illinois, Chicago, IL
• Joseph Curry, Thomas Jefferson University School of Medicine, Philadelphia, PA
• Daniel Faden, Harvard Medical School, Boston, MA
• Chris Holsinger, Stanford University School of Medicine, Palo Alto, CA

Document Type

Article

Publication Date

7-30-2026

Publication Title

JAMA Otolaryngology- Head & Neck Surgery

Abstract

IMPORTANCE: Despite gains in understanding head and neck cancer over the past several decades, the discovery of reliable biomarkers remains elusive. With the advent of human papillomavirus-associated oropharynx cancer and Epstein-Barr virus-associated nasopharynx cancer, circulating tumor DNA (ctDNA) and oncogenic viral DNA have emerged as potentially promising biomarkers. OBSERVATIONS: A review was conducted by the American Head and Neck Society to address the current utility of ctDNA. Ongoing clinical trials were reviewed, with discussion of its utility in monitoring treatment response and measuring minimal residual disease (MRD). Although ctDNA holds promise in the push for precision oncology, several questions remain regarding its routine clinical use, including test variability and implications of inaccurate test results. Optimized clinical trial designs and further research are necessary to bring ctDNA to the forefront of head and neck cancer management. CONCLUSIONS AND RELEVANCE: Liquid biopsy targeting viral ctDNA is a promising biomarker in the diagnostic and surveillance settings across head and neck cancer types. Ongoing clinical trials will help elucidate how ctDNA can be implemented to monitor treatment response, assess MRD, and frame treatment decisions to adapt treatment via a precision oncology approach.

First Page

905

Last Page

913

PubMed ID

42530947

Volume

152

Rights

© 2026, American Medical Association

Recommended Citation

Kansara, Sagar; Contrera, Kevin; Roof, Scott; Kane, Anne C.; Mualla, Rula; Rettig, Eleni; Agrawal, Nishant; Wenig, Barry; Curry, Joseph; Faden, Daniel; and Holsinger, Chris, "Circulating Tumor DNA in Head and Neck Cancer: A Review From the American Head and Neck Society" (2026). School of Medicine Faculty Publications. 5012.
https://digitalscholar.lsuhsc.edu/som_facpubs/5012
10.1001/jamaoto.2026.2045