Oropharyngeal cancer, HPV-positive

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Jennifer H. Choe, MD, PhD
Vanderbilt University
Nashville, TN, USA

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C. Beau Hilton, MD
Vanderbilt University
Nashville, TN, USA

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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


Guidelines

Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any article published 5+ years ago to be for historical purposes, only.

EHNS/ESMO/ESTRO

NCCN

Definitive therapy

Cisplatin & RT

Cisplatin & RT: Cisplatin & Radiation Therapy

Regimen variant #1, 100 mg/m2 q3wk x 2

Study Dates 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

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 Dates of enrollment Evidence Comparator Comparative Efficacy
Mehanna et al. 2018 (De-ESCALaTE HPV) 2012-2016 Phase 3 (C) Cetuximab & RT Superior OS

Chemotherapy

Radiotherapy

  • Concurrent radiation therapy 2 Gy fractions x 35 fractions (total dose: 70 Gy), given 6 times per week

9-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. 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
  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. 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