Oncoral® : oral cancer screening supported by saliva analysis (HPV & VOC)

The cancer epidemy in developed countries, is due to the combined effect of the ageing of populations, and the high and increasing levels of prevalence of cancer risk factors.
Oncoral is a new strategy for oral cancer risk measurement using stabilized saliva for HPV identification and saliva volatonomics analysis.

Oral cancer risk factors

It has now been established that the path that brings people to oral cancer contains at least two distinct etiologies; one through tobacco and alcohol and another via the HPV virus infection, particularly version 16.

If detected at an early stage, survival from oral cancer is better than 90% at 5 years, whereas late stage disease survival is only 30%.

About 50 to 70% of patients are diagnosed at an advanced stage depending on the countries.

An increase of oral infected HPV patient has been observed in the past 20 years.

In general it appears that HPV positive tumors occur most frequently in a younger group of individuals than tobacco related malignancies. (Tobacco oral cancers occur most frequently in the 5th through the 7th decade of life). HPV positive tumor also occur more in white males, and in non smokers.

What are the signs and symptoms of oropharyngeal cancer ?

Persistent mouth sore
Pain : Persistent mouth pain is another common oral cancer sign
A lump or thickening in the cheek
A white or red patch on the gums, tongue, tonsil, or lining of the mouth
A sore throat or feeling that something is caught in the throat that does not go away
Difficulty swallowing or chewing
Difficulty moving the jaw or tongue
Numbness of the tongue or elsewhere in the mouth
Jaw swelling that makes dentures hurt or fit poorly
Loosening of the teeth
Pain in the teeth or jaw
Voice changes
A lump in the neck
Unexplained weight loss
Persistent bad breath
Some persons have no signs or symptoms.

Oral cancer screening method definition

  • Patient history (age, tobacco, alcohol, bad oral hygiene , sexual life,  HPV statut (cervical, other…)
  • Clinical examination  (oral and noze)
  • HPV and volatonomics analysis of saliva
  • Biopsy if identified oral lesion

What is HPV

Human PapillomaVirus (also called HPV) is the most common sexually transmitted infection in developed countries. Most types of HPV are not harmful to people. There are more than 40 types of HPV that can infect the genital areas as well as the mouth and throat. HPV-induced cancers arise when viral sequences are accidentally integrated into the DNA of host cells. HPV is detected in saliva with Real Time PCR method.

What is Volatonomics analysis

Volatile organic compounds (VOCs) are organic chemicals . VOCs are small  molecules  coming from human  cell metabolism. Most scents or odors are of VOCs. Analysis of specific VOCs  profiling from specific sample (saliva, liquid biopsies) is call Volatonomics. VOCs are detected by Mass Spectrometry analysis in saliva. Logistic regression showed a significant difference in VOC  patterns between patients diagnosed with oral cancer and healthy group.

Technical recommendations and Oncoral® TM objectives

It is advised to carry out an analysis in the following situations :

Patient with any symptoms or signs

Patient that smoke (more than 45 years old)

Patient that drink (more than 45 years old)

Patient with poor oral hygiene

Patient with genital HPV or other HPV infection

6 months after the first positive oral saliva test

Annually for all patients at risk