Perspectives in managing minimal residual disease and functional outcomes in head and neck pathology

Minimal residual disease (MRD) detection has emerged as a transformative approach in head and neck oncology, offering unparalleled insights into tumor persistence and recurrence risk beyond conventional imaging. Despite growing evidence supporting the use of MRD to guide therapy decisions, there remains limited consensus on assay validation, prognostic thresholds, and integration into clinical workflows. Recent studies employing circulating tumor DNA (ctDNA) and circulating HPV DNA (ctHPV‑DNA) have demonstrated promise for early relapse detection and treatment modulation, yet variability in analytical methods and scarce longitudinal correlation with patient‑reported outcomes hinder their full clinical adoption. While parallel advances in imaging, radiomics, and multi‑omic profiling have improved disease characterization, these have not been uniformly coupled with validated functional endpoints such as swallowing, speech performance, and quality of life measures. Thus, a unified framework linking molecular and functional recovery metrics is urgently needed to personalize survivorship pathways in head and neck pathology.This Research Topic aims to consolidate evidence and foster innovation at the intersection of MRD detection, therapeutic response adaptation, and functional outcome prediction. By integrating molecular diagnostics with clinical and patient‑reported endpoints, it seeks to define best practices for MRD assay validation and harmonization, explore mechanistic explanations for disease persistence, and identify actionable biomarkers that inform risk‑adapted treatment strategies. The objective is to move beyond binary survival outcomes towards a comprehensive model capturing both oncologic control and post‑treatment function, thereby enriching the precision‑medicine paradigm in head and neck oncology.To gather further insights into MRD‑guided clinical management across diverse tumor subtypes and treatment modalities, we welcome articles addressing, but not limited to, the following themes:- Analytical validation and standardization of ctDNA/ctHPV‑DNA assays- Perioperative and postoperative MRD kinetics and their prognostic implications- MRD‑guided de‑escalation and intensification strategies in adjuvant therapy trials- Correlations between MRD dynamics, imaging biomarkers, and functional outcomes- Mechanistic and multi‑omic analyses of MRD persistence and treatment toxicity- Implementation science and global harmonization of MRD‑based workflows- Ethical, regulatory, and patient‑centred frameworks for MRD‑guided careAppendix – Ideal submission types:Original research (prospective cohorts, pilot randomized de‑escalation trials, assay validation studies); short methods reports (standardized MRD assay protocols, inter‑laboratory harmonization); systematic reviews and meta‑analyses (MRD prognostic performance and functional outcomes); and perspectives or reviews (ethical, regulatory, and patient‑centred considerations for MRD‑guided care). Topic editors: Mihai Dumitru, Angeles Mercedes Oviedo Santos, Daniela Vrinceanu Source: https://www.frontiersin.org/research-topics/84376/perspectives-in-managing-minimal-residual-disease-and-functional-outcomes-in-head-and-neck-pathology