Tumor Hypoxia-Directed De-Escalation of Chemoradiotherapy for Locally Advanced HPV-Related Oropharyngeal Carcinoma

Patients without tumor hypoxia as assessed by ¹⁸F-fluoromisonidazole PET had promising survival outcomes after treatment with reduced-dose radiation and chemotherapy.

Human papillomavirus (HPV)–related oropharyngeal carcinomas have excellent prognosis when treated with standard chemoradiotherapy, which can cause significant toxicity. De-escalation of standard therapy has been attempted in many clinical trials with various strategies, yet none has demonstrated noninferiority in a phase 3 randomized clinical trial. Tumor hypoxia has been associated with radiation resistance. To assess whether measurement of tumor hypoxia could identify candidates for de-escalation of chemoradiotherapy, investigators enrolled 152 patients with HPV-related oropharyngeal cancer and stage T0-2/N1-2c/M0 disease in a single-arm, single-center, phase 2 study.

Patients underwent primary tumor resection followed by baseline ¹⁸F-fluo…

Reviewing Author

Hyunseok Kang, MD, MPH, FACP

Disclosures

Consultant/Advisory BoardPIN Therapeutics; Bayer; Remix Therapeutics; MitoImmune; LG Chem; Coherus; Hanmi Pharma

RoyaltiesBMJ Publishing

Grant/Research SupportNRG Oncology

Editorial BoardsHead and Neck; Cancer Medicine; Korean Journal of Head and Neck Oncology