Can circulating tumor DNA Guide how doctors should use immunotherapy in head and neck cancer?

Dr. Rosenberg intends to develop a personalized, dynamic, biomarker-driven treatment roadmap for patients with recurrent and/or metastatic head and neck cancer, allowing doctors to strategically combine immunotherapy with chemotherapy to improve treatment efficacy while reducing treatment-related toxicity. Dr. Rosenberg hopes to use circulating tumor DNA (ct-DNA) obtained from blood samples to better guide doctors in choosing the correct therapeutic combination. Circulating tumor DNA is a novel, non-invasive method of quantifying the amount of DNA from a patient’s cancer in their blood and analyzing ct-DNA, looking for specific genetic mutations and dynamic changes, might allow a doctor to predict which patients will benefit from immunotherapy alone. Using ct-DNA to guide decisions about when to add chemotherapy to immunotherapy would both increase its effectiveness and reduce its toxicity.

Dr. Rosenberg intends to evaluate how well circulating tumor DNA in blood predicts response to combined therapy and then will use his data, coupled with innovative imaging analysis tools and computational modeling, to create a monitoring and decision tool to guide oncologists in deciding how to use immunotherapy for each individualized case. It’s possible that ct-DNA will also provide a method for non-invasively indicating how well a given treatment is working. His project will obtain samples and compare results with a clinical trial in recurrent and/or metastatic head and neck cancer already in process, which is comparing patients treated with immunotherapy either alone or in combination with chemotherapy. The data Dr. Rosenberg plans to collect will be a first step towards a novel, adaptive, and personalized treatment program of immunotherapy and chemotherapy that will lead to improved survival and lower side effects in patients with recurrent and metastatic head and neck cancer,  allowing doctors to implement personalized treatment strategies rather than a “one-size-fits-all” approach.