Klin Onkol 2025; 38(6): 422-426. DOI: 10.48095/ccko2025422.
Background: Head and neck squamous cell carcinoma (HNSCC) represents a significant global oncological challenge with a rising incidence, particularly due to HPV-associated oropharyngeal squamous cell carcinomas (OPSCC). These tumours differ from HPV-negative entities biologically, clinically, and prognostically. Conventional diagnostic approaches, based on tissue biopsy and imaging techniques, face several limitations – from invasiveness and the inability to monitor disease dynamics to low sensitivity in the early detection of recurrence. Aim: This paper provides a comprehensive overview of circulating tumour DNA (ctDNA), specifically HPV-associated ctDNA, as a novel non-invasive biomarker enabling more accurate diagnosis, monitoring of treatment response, and early detection of recurrence in patients with HNSCC. Conclusion: ctDNA exhibits specific biological and physical characteristics that allow its reliable detection and differentiation from normal circulating cell-free DNA. Owing to its short half-life, ctDNA provides real-time insights into disease dynamics, while its concentration and fragmentation patterns reflect tumour burden and biological activity. Monitoring ctDNA holds significant potential as a pivotal clinical tool in the era of precision oncology, facilitating earlier recurrence detection, improved patient stratification, and optimization of therapeutic strategies in HPV-associated HNSCC.