Oropharyngeal cancer, HPV-positive
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| 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
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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 | 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
- 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 | Dates 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