Evidence map›Paper›PMID 42098120›Full record

Trial reportNature communications2026

Risk-adapted therapy guided by human papillomavirus (HPV) circulating tumor DNA in HPV-positive oropharyngeal cancer (ReACT 1.0): an exploratory phase II trial.

Glenn J Hanna, Tulika R Gupta, Lorenzo Trippa, Eleni M Rettig, Danielle N Margalit, Roy B Tishler, Itai Pashtan, Emily Kim, Alexander Droznin, Lauren Gunasti and 20 more

Registry-linked trialAbstract readClinical Trial, Phase II
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Nature communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04900623 (Risk-adapted Therapy in HPV+ Oropharyngeal Cancer Using Circulating Tumor), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04900623 phase2recruitingnot on this map

Risk-adapted Therapy in HPV+ Oropharyngeal Cancer Using Circulating Tumor (ct)HPV DNA Profile - The ReACT Study

TypeinterventionalSponsorJonathan Schoenfeld, MD, MPHRan2021 to 2032Enrolled145ConditionsHPV-Associated Oropharyngeal Squamous Cell Carcinoma, HPV Positive Oropharyngeal Squamous Cell Carcinoma, HPV-Mediated (P16-Positive) Oropharyngeal Carcinoma by AJCC V8 Stage, HPV-Related Squamous Cell CarcinomaArmsNavDx HPV ctDNA Testing, Radiotherapy, Chemotherapy drug
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Glenn J HannaCenter for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. glenn_hanna@dfci.harvard.edu.ORCID http://orcid.org/0000-0002-9969-2523
Tulika R GuptaDepartment of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA.ORCID http://orcid.org/0009-0005-7089-2643
Lorenzo TrippaDepartment of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA.
Eleni M RettigCenter for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Danielle N MargalitCenter for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Roy B TishlerCenter for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Itai PashtanDana-Farber Brigham Cancer Center at South Shore Health, Weymouth, MA, USA.
Emily KimDepartment of Radiation Oncology, Dana-Farber Brigham Cancer Center, Boston, MA, USA.
Alexander DrozninDepartment of Radiation Oncology, Dana-Farber Brigham Cancer Center, Boston, MA, USA.ORCID http://orcid.org/0009-0006-4677-461X
Lauren GunastiDepartment of Radiation Oncology, Dana-Farber Brigham Cancer Center, Boston, MA, USA.
Riley MaddoxDana-Farber Brigham Cancer Center at Milford Regional Medical Center, Milford, MA, USA.
Jacqueline MinkenDepartment of Radiation Oncology, Dana-Farber Brigham Cancer Center, Boston, MA, USA.
Dev MukundanDepartment of Radiation Oncology, Dana-Farber Brigham Cancer Center, Boston, MA, USA.
Kartik SehgalCenter for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.ORCID http://orcid.org/0000-0003-4391-6943
Michael J DennisCenter for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Thomas O'ConnorDana-Farber Brigham Cancer Center at South Shore Health, Weymouth, MA, USA.
Jack M QianDana-Farber Brigham Cancer Center at South Shore Health, Weymouth, MA, USA.
Graham H BoydDana-Farber Brigham Cancer Center at South Shore Health, Weymouth, MA, USA.
Anurag SarafDana-Farber Brigham Cancer Center at South Shore Health, Weymouth, MA, USA.
Daribelle Massiel GilDana-Farber Brigham Cancer Center at South Shore Health, Weymouth, MA, USA.
Rosh K SethiCenter for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Donald J AnninoCenter for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Lauren A GoguenCenter for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Jeffrey P GuenetteDivision of Neuroradiology, Brigham & Women's Hospital, Boston, MA, USA.
Mina BakhtiarHarvard Radiation Oncology Residency Program, Boston, MA, USA.
Vickie Y JoDepartment of Pathology, Brigham & Women's Hospital, Boston, MA, USA.
Kristine WongDepartment of Pathology, Brigham & Women's Hospital, Boston, MA, USA.
Ravindra UppaluriCenter for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Robert I HaddadCenter for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Jonathan D SchoenfeldCenter for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. jdschoenfeld@bwh.harvard.edu.ORCID http://orcid.org/0000-0002-5119-0401

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Circulating tumor DNA (ctDNA) has an expanding role in oncology. It is unknown whether on-treatment ctDNA can be used to personalize radiation dose. This phase 2 exploratory clinical trial enrolled 102 patients with human papillomavirus (HPV)-positive oropharyngeal carcinoma (OPC). Intermediate-risk patients (T4 disease or >10 pack-year smokers with pre-treatment HPV ctDNA scores >200) were reclassified as low-risk if HPV ctDNA cleared by >95% mid-treatment. All clinically low-risk and reclassified patients received de-intensified (chemo)radiation. The primary outcome was progression-free survival (PFS) among de-escalated patients; secondary outcomes included tolerability, distant metastatic-free, and overall survival. Eighty-nine patients received de-escalated treatment (60 low-risk, 29 reclassified). Two-year PFS among de-escalated patients was 93% (95%CI, 87-99). Post-hoc analyses suggested that intermediate-risk patients reclassified as low-risk and treated with de-escalation had distinct HPV ctDNA dynamics and favorable outcomes. HPV ctDNA is an emerging biomarker that might improve risk stratification for patients with intermediate-risk HPV-positive OPC. Registration number: NCT04900623.

Indexed as

Circulating Tumor DNAHuman Papillomavirus VirusesOropharyngeal NeoplasmsPapillomavirus InfectionsAdultAgedChemoradiotherapyDNA, ViralFemaleHumansMaleMiddle AgedProgression-Free SurvivalCirculating Tumor DNADNA, Viral

Identifiers

PMID42098120
PMCPMC13365393

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.