Novel Strategies to Effectively De-escalate Curative-Intent Therapy for Patients With HPV-Associated Oropharyngeal Cancer: Current and Future Directions

• Published in: American Society of Clinical Oncology educational book Vol. 40; p. 1
• Main Authors: Price, Katharine A R, Nichols, Anthony C, Shen, Colette J, Rammal, Almoaidbellah, Lang, Pencilla, Palma, David A, Rosenberg, Ari J, Chera, Bhisham S, Agrawal, Nishant
• Format: Journal Article
• Language: English
• Published: United States 01.03.2020
• ISSN: 1548-8756
• DOI: 10.1200/EDBK_280687

The treatment of patients with HPV-associated oropharyngeal cancer (HPV-OPC) is rapidly evolving and challenging the standard of care of definitive radiotherapy with concurrent cisplatin. There are numerous promising de-escalation strategies under investigation, including deintensified definitive chemoradiotherapy, transoral surgery followed by de-escalated adjuvant therapy, and induction chemotherapy followed by de-escalated locoregional therapy. Definitive radiotherapy alone or with cetuximab is not recommended for curative-intent treatment of patients with locally advanced HPV-OPC. The results of ongoing phase III studies are awaited to help answer key questions and address ongoing controversies to transform the treatment of patients with HPV-OPC. Strategies for de-escalation under investigation include the incorporation of immunotherapy and the use of novel biomarkers for patient selection for de-escalation.