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

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 ch...

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Published inAmerican 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
LanguageEnglish
Published United States 01.03.2020
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Abstract 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.
AbstractList 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.
Author Nichols, Anthony C
Palma, David A
Chera, Bhisham S
Lang, Pencilla
Rosenberg, Ari J
Agrawal, Nishant
Shen, Colette J
Price, Katharine A R
Rammal, Almoaidbellah
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  organization: Division of Medical Oncology, Mayo Clinic, Rochester, MN
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  organization: Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada
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  organization: Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC
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  givenname: Nishant
  surname: Agrawal
  fullname: Agrawal, Nishant
  organization: Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Chicago, Chicago, IL
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Title Novel Strategies to Effectively De-escalate Curative-Intent Therapy for Patients With HPV-Associated Oropharyngeal Cancer: Current and Future Directions
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