Oropharyngeal cancer, HPV-positive
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Michael Gibson, MD, PhD 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
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All lines of therapy
Cisplatin & RT
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RT: Radiation Therapy
Variant #1, 100 mg/m2 q3wk x 2
| Study | Evidence | Comparator | Comparative Efficacy |
|---|---|---|---|
| Gillison et al. 2018 (RTOG 1016) | Phase III (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
Variant #2, 100 mg/m2 q3wk x 3
| Study | Evidence | Comparator | Comparative Efficacy |
|---|---|---|---|
| Mehanna et al. 2018 (De-ESCALaTE HPV) | Phase III (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. 2018 Nov 15. [Epub ahead of print] link to original article contains protocol PubMed
- 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. 2018 Nov 15. [Epub ahead of print] link to original article contains protocol PubMed