Difference between revisions of "Oropharyngeal cancer, HPV-positive"
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{{TOC limit|limit=3}} | {{TOC limit|limit=3}} | ||
| + | =Guidelines= | ||
| + | ==EHNS/ESMO/ESTRO== | ||
| + | *'''2020:''' Machiels et al. [https://doi.org/10.1016/j.annonc.2020.07.011 Squamous cell carcinoma of the oral cavity, larynx, '''oropharynx''' and hypopharynx: EHNS–ESMO–ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up] | ||
| + | ==[https://www.nccn.org/ NCCN]== | ||
| + | *[https://www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf NCCN Guidelines - Head and Neck Cancers] | ||
=Definitive therapy= | =Definitive therapy= | ||
==Cisplatin & RT {{#subobject:c7061f|Regimen=1}}== | ==Cisplatin & RT {{#subobject:c7061f|Regimen=1}}== | ||
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Cisplatin & RT: Cisplatin & '''<u>R</u>'''adiation '''<u>T</u>'''herapy | Cisplatin & RT: Cisplatin & '''<u>R</u>'''adiation '''<u>T</u>'''herapy | ||
| + | <div class="toccolours" style="background-color:#eeeeee"> | ||
===Regimen variant #1, 100 mg/m<sup>2</sup> q3wk x 2 {{#subobject:b44282|Variant=1}}=== | ===Regimen variant #1, 100 mg/m<sup>2</sup> q3wk x 2 {{#subobject:b44282|Variant=1}}=== | ||
{| class="wikitable sortable" style="width: 100%; text-align:center;" | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
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| + | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
*[[Cisplatin (Platinol)]] 100 mg/m<sup>2</sup> IV once on day 1 | *[[Cisplatin (Platinol)]] 100 mg/m<sup>2</sup> IV once on day 1 | ||
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*Concurrent [[External_beam_radiotherapy|radiation therapy]] 2 Gy fractions x 35 fractions (total dose: 70 Gy), given 6 times per week | *Concurrent [[External_beam_radiotherapy|radiation therapy]] 2 Gy fractions x 35 fractions (total dose: 70 Gy), given 6 times per week | ||
'''6-week course''' | '''6-week course''' | ||
| − | + | </div></div><br> | |
| + | <div class="toccolours" style="background-color:#eeeeee"> | ||
===Regimen variant #2, 100 mg/m<sup>2</sup> q3wk x 3 {{#subobject:aca3c0|Variant=1}}=== | ===Regimen variant #2, 100 mg/m<sup>2</sup> q3wk x 3 {{#subobject:aca3c0|Variant=1}}=== | ||
{| class="wikitable sortable" style="width: 100%; text-align:center;" | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
| Line 58: | Line 65: | ||
|- | |- | ||
|} | |} | ||
| + | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
*[[Cisplatin (Platinol)]] 100 mg/m<sup>2</sup> IV once on day 1 | *[[Cisplatin (Platinol)]] 100 mg/m<sup>2</sup> IV once on day 1 | ||
| Line 64: | Line 72: | ||
*Concurrent [[External_beam_radiotherapy|radiation therapy]] 2 Gy fractions x 35 fractions (total dose: 70 Gy), given 6 times per week | *Concurrent [[External_beam_radiotherapy|radiation therapy]] 2 Gy fractions x 35 fractions (total dose: 70 Gy), given 6 times per week | ||
'''6-week course''' | '''6-week course''' | ||
| − | + | </div></div> | |
===References=== | ===References=== | ||
# '''RTOG 1016:''' Gillison ML, Trotti AM, Harris J, Eisbruch A, Harari PM, Adelstein DJ, Sturgis EM, Burtness B, Ridge JA, Ringash J, Galvin J, Yao M, Koyfman SA, Blakaj DM, Razaq MA, Colevas AD, Beitler JJ, Jones CU, Dunlap NE, Seaward SA, Spencer S, Galloway TJ, Phan J, Dignam JJ, Le QT. Radiotherapy plus cetuximab or cisplatin in human papillomavirus-positive oropharyngeal cancer (NRG Oncology RTOG 1016): a randomised, multicentre, non-inferiority trial. Lancet. 2019 Jan 5;393(10166):40-50. Epub 2018 Nov 15. Erratum in: Lancet. 2020 Mar 7;395(10226):784. [https://doi.org/10.1016/S0140-6736(18)32779-X link to original article] '''contains dosing details in abstract''' [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6541928/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/30449625 PubMed] NCT01302834 | # '''RTOG 1016:''' Gillison ML, Trotti AM, Harris J, Eisbruch A, Harari PM, Adelstein DJ, Sturgis EM, Burtness B, Ridge JA, Ringash J, Galvin J, Yao M, Koyfman SA, Blakaj DM, Razaq MA, Colevas AD, Beitler JJ, Jones CU, Dunlap NE, Seaward SA, Spencer S, Galloway TJ, Phan J, Dignam JJ, Le QT. Radiotherapy plus cetuximab or cisplatin in human papillomavirus-positive oropharyngeal cancer (NRG Oncology RTOG 1016): a randomised, multicentre, non-inferiority trial. Lancet. 2019 Jan 5;393(10166):40-50. Epub 2018 Nov 15. Erratum in: Lancet. 2020 Mar 7;395(10226):784. [https://doi.org/10.1016/S0140-6736(18)32779-X link to original article] '''contains dosing details in abstract''' [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6541928/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/30449625 PubMed] NCT01302834 | ||
# '''De-ESCALaTE HPV:''' Mehanna H, Robinson M, Hartley A, Kong A, Foran B, Fulton-Lieuw T, Dalby M, Mistry P, Sen M, O'Toole L, Al Booz H, Dyker K, Moleron R, Whitaker S, Brennan S, Cook A, Griffin M, Aynsley E, Rolles M, De Winton E, Chan A, Srinivasan D, Nixon I, Grumett J, Leemans CR, Buter J, Henderson J, Harrington K, McConkey C, Gray A, Dunn J; De-ESCALaTE HPV Trial Group. Radiotherapy plus cisplatin or cetuximab in low-risk human papillomavirus-positive oropharyngeal cancer (De-ESCALaTE HPV): an open-label randomised controlled phase 3 trial. Lancet. 2019 Jan 5;393(10166):51-60. Epub 2018 Nov 15. [https://doi.org/10.1016/S0140-6736(18)32752-1 link to original article] '''contains dosing details in abstract''' [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6319250/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/30449623 PubMed] ISRCTN33522080 | # '''De-ESCALaTE HPV:''' Mehanna H, Robinson M, Hartley A, Kong A, Foran B, Fulton-Lieuw T, Dalby M, Mistry P, Sen M, O'Toole L, Al Booz H, Dyker K, Moleron R, Whitaker S, Brennan S, Cook A, Griffin M, Aynsley E, Rolles M, De Winton E, Chan A, Srinivasan D, Nixon I, Grumett J, Leemans CR, Buter J, Henderson J, Harrington K, McConkey C, Gray A, Dunn J; De-ESCALaTE HPV Trial Group. Radiotherapy plus cisplatin or cetuximab in low-risk human papillomavirus-positive oropharyngeal cancer (De-ESCALaTE HPV): an open-label randomised controlled phase 3 trial. Lancet. 2019 Jan 5;393(10166):51-60. Epub 2018 Nov 15. [https://doi.org/10.1016/S0140-6736(18)32752-1 link to original article] '''contains dosing details in abstract''' [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6319250/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/30449623 PubMed] ISRCTN33522080 | ||
| − | |||
[[Category:Head and neck cancer regimens]] | [[Category:Head and neck cancer regimens]] | ||
[[Category:Biomarker-specific pages]] | [[Category:Biomarker-specific pages]] | ||
[[Category:Head and neck cancers]] | [[Category:Head and neck cancers]] | ||
Revision as of 17:24, 28 February 2023
| Section editor | |
|---|---|
 |
Michael K. Gibson, MD, PhD, FACP Vanderbilt University Nashville, TN  mgibson21212 |
Note: this page has regimens which are specific to oropharyngeal cancer that is human papilloma virus (HPV) positive. Please see the head and neck cancer page for other regimens.
1 regimens on this page
2 variants on this page
|
Guidelines
EHNS/ESMO/ESTRO
- 2020: Machiels et al. Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx: EHNS–ESMO–ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up
NCCN
Definitive therapy
Cisplatin & RT
Cisplatin & RT: Cisplatin & Radiation Therapy
Regimen variant #1, 100 mg/m2 q3wk x 2
| Study | Years of enrollment | Evidence | Comparator | Comparative Efficacy |
|---|---|---|---|---|
| Gillison et al. 2018 (RTOG 1016) | 2011-2014 | Phase 3 (C) | Cetuximab & RT | Seems to have superior OS |
Chemotherapy
- Cisplatin (Platinol) 100 mg/m2 IV once on day 1
21-day cycle for 2 cycles
Radiotherapy
- Concurrent radiation therapy 2 Gy fractions x 35 fractions (total dose: 70 Gy), given 6 times per week
6-week course
Regimen variant #2, 100 mg/m2 q3wk x 3
| Study | Years of enrollment | Evidence | Comparator | Comparative Efficacy |
|---|---|---|---|---|
| Mehanna et al. 2018 (De-ESCALaTE HPV) | 2012-2016 | Phase 3 (C) | Cetuximab & RT | Superior OS |
Chemotherapy
- Cisplatin (Platinol) 100 mg/m2 IV once on day 1
21-day cycle for 3 cycles
Radiotherapy
- Concurrent radiation therapy 2 Gy fractions x 35 fractions (total dose: 70 Gy), given 6 times per week
6-week course
References
- RTOG 1016: Gillison ML, Trotti AM, Harris J, Eisbruch A, Harari PM, Adelstein DJ, Sturgis EM, Burtness B, Ridge JA, Ringash J, Galvin J, Yao M, Koyfman SA, Blakaj DM, Razaq MA, Colevas AD, Beitler JJ, Jones CU, Dunlap NE, Seaward SA, Spencer S, Galloway TJ, Phan J, Dignam JJ, Le QT. Radiotherapy plus cetuximab or cisplatin in human papillomavirus-positive oropharyngeal cancer (NRG Oncology RTOG 1016): a randomised, multicentre, non-inferiority trial. Lancet. 2019 Jan 5;393(10166):40-50. Epub 2018 Nov 15. Erratum in: Lancet. 2020 Mar 7;395(10226):784. link to original article contains dosing details in abstract link to PMC article PubMed NCT01302834
- De-ESCALaTE HPV: Mehanna H, Robinson M, Hartley A, Kong A, Foran B, Fulton-Lieuw T, Dalby M, Mistry P, Sen M, O'Toole L, Al Booz H, Dyker K, Moleron R, Whitaker S, Brennan S, Cook A, Griffin M, Aynsley E, Rolles M, De Winton E, Chan A, Srinivasan D, Nixon I, Grumett J, Leemans CR, Buter J, Henderson J, Harrington K, McConkey C, Gray A, Dunn J; De-ESCALaTE HPV Trial Group. Radiotherapy plus cisplatin or cetuximab in low-risk human papillomavirus-positive oropharyngeal cancer (De-ESCALaTE HPV): an open-label randomised controlled phase 3 trial. Lancet. 2019 Jan 5;393(10166):51-60. Epub 2018 Nov 15. link to original article contains dosing details in abstract link to PMC article PubMed ISRCTN33522080