CLIA Test Identifies Head and Neck Cancer Recurrence from Post-Surgical Lymphatic Fluid

While the lymphatic system’s critical role in metastasis has long been recognized, routine access to patient lymph has been elusive. Now, a non-invasive process can access lymph through the collection of surgical drain fluid after tumor resection. Rich in T-cells, proteins, and other biomarkers, this lymphatic fluid can offer insights into the body’s immune response to cancer earlier and with greater sensitivity than blood.

Droplet Biosciences (Cambridge, MA, USA) has developed LymphDetect Head & Neck, which measures circulating tumor DNA (ctDNA) in surgical drain fluid, the most proximal biofluid to a recently resected tumor, to assess cancer recurrence risk at the source of potential spread – before it can travel to other parts of the body. Post-surgical lymphatic fluid contains unique and vital markers to guide treatment decisions.

Image: Post-surgical lymph fluid is a powerful source of ctDNA for early recurrence detection in head & neck cancer (Photo courtesy of Adobe Stock)

A recent groundbreaking clinical study utilizing Droplet's LymphDetect liquid biopsy assay has shown that lymphatic fluid collected via surgical drains in patients after resection of HPV-independent head & neck squamous cell carcinoma (HNSCC) contains significantly higher levels of ctDNA compared to matched plasma. The study also demonstrated that detection of tumor-informed ctDNA in this lymphatic exudate correlates strongly with disease recurrence. Results from two cohorts of tumor-informed ctDNA in lymphatic fluid collected shortly after surgery were strongly associated with recurrence.

In contrast, ctDNA detection in matched plasma at the same time point was not. Moreover, lymph-derived ctDNA outperformed standard high-risk pathological features in identifying patients at risk of recurrence. In the subgroup of intermediate-risk patients, detection of ctDNA in post-operative lymph achieved 88% sensitivity and 67% specificity for recurrence. The findings, published in Clinical Cancer Research, suggest the potential utility of post-operative lymph sampling for early and sensitive detection of residual disease to inform adjuvant therapy decisions in HNSCC.

"Our results highlight the incredible potential of LymphDetect to improve survival through precision adjuvant therapy, especially in patients with intermediate risk cancer where oncologic outcomes are balanced with toxicity of treatment," said Jose Zevallos, MD, MPH, FACS, lead clinician of the study and Droplet co-founder.

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