Oropharyngeal cancer, HPV-positive

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Michael Gibson, MD, PhD
Vanderbilt University
Nashville, TN

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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


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

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

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

  1. 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
  2. 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