Treatment De-Intensification for Patients With HPV-Positive Head and Neck Cancers

被引:1
作者
Gillison, Maura L. [1 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Dept Thorac Head & Neck Med Oncol, 1515 Holcombe Blvd,Unit 432, Houston, TX 77030 USA
来源
JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK | 2022年 / 20卷 / 5.5期
关键词
SQUAMOUS-CELL CARCINOMA; HUMAN-PAPILLOMAVIRUS; SURVIVAL; CISPLATIN; CETUXIMAB;
D O I
10.6004/jnccn.2022.5010
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Cisplatin and 70 Gy of intensity-modulated radiotherapy remain the standard of care (SoC) in HPV-positive head and neck cancer, with no data to support de-escalation as a new SoC. Cetuximab compromises locoregional tumor control and overall survival without reduced toxicity, although with different toxicity. Eliminating cisplatin and reducing radiation by 10 Gy compromise progression-free survival but not overall survival, and replacement of SoC adjuvant chemoradiotherapy with low-dose radiotherapy plus docetaxel compromises progression-free survival for patients with extracapsular extension and/or multiple cervical metastases, without significantly reducing grade 3 toxicities. The current trend toward numerous, single-institution phase II trials should be minimized, because they can be difficult to interpret. Instead, to move the field forward with more definitive outcomes, focus should be placed on taking promising concepts to multicenter, randomized phase II/III studies with clear statistical endpoints.
引用
收藏
页码:596 / 599
页数:4
相关论文
共 12 条
[1]   Human Papillomavirus and Survival of Patients with Oropharyngeal Cancer [J].
Ang, K. Kian ;
Harris, Jonathan ;
Wheeler, Richard ;
Weber, Randal ;
Rosenthal, David I. ;
Nguyen-Tan, Phuc Felix ;
Westra, William H. ;
Chung, Christine H. ;
Jordan, Richard C. ;
Lu, Charles ;
Kim, Harold ;
Axelrod, Rita ;
Silverman, C. Craig ;
Redmond, Kevin P. ;
Gillison, Maura L. .
NEW ENGLAND JOURNAL OF MEDICINE, 2010, 363 (01) :24-35
[2]   Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial [J].
Fakhry, Carole ;
Westra, William H. ;
Cmelak, Sigui Li Anthony ;
Ridge, John A. ;
Pinto, Harlan ;
Forastiere, Arlene ;
Gillison, Maura L. .
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2008, 100 (04) :261-269
[3]   Phase II Randomized Trial of Transoral Surgery and Low-Dose Intensity Modulated Radiation Therapy in Resectable p16+Locally Advanced Oropharynx Cancer: An ECOG-ACRIN Cancer Research Group Trial (E3311) [J].
Ferris, Robert L. ;
Flamand, Yael ;
Weinstein, Gregory S. ;
Li, Shuli ;
Quon, Harry ;
Mehra, Ranee ;
Garcia, Joaquin J. ;
Chung, Christine H. ;
Gillison, Maura L. ;
Duvvuri, Umamaheswar ;
O'Malley, Bert W., Jr. ;
Ozer, Enver ;
Thomas, Giovana R. ;
Koch, Wayne M. ;
Gross, Neil D. ;
Bell, R. Bryan ;
Saba, Nabil F. ;
Lango, Miriam ;
Mendez, Eduardo ;
Burtness, Barbara .
JOURNAL OF CLINICAL ONCOLOGY, 2022, 40 (02) :138-+
[4]   ARTSCAN III: A Randomized Phase III Study Comparing Chemoradiotherapy With Cisplatin Versus Cetuximab in Patients With Locoregionally Advanced Head and Neck Squamous Cell Cancer [J].
Gebre-Medhin, Maria ;
Brun, Eva ;
Engstrom, Per ;
Haugen Cange, Hedda ;
Hammarstedt-Nordenvall, Lalle ;
Reizenstein, Johan ;
Nyman, Jan ;
Abel, Edvard ;
Friesland, Signe ;
Sjodin, Helena ;
Carlsson, Henrik ;
Soderkvist, Karin ;
Thomasson, Marcus ;
Zackrisson, Bjorn ;
Nilsson, Per .
JOURNAL OF CLINICAL ONCOLOGY, 2021, 39 (01) :38-+
[5]   Radiotherapy plus cetuximab or cisplatin in human papillomavirus-positive oropharyngeal cancer (NRG Oncology RTOG 1016): a randomised, multicentre, non-inferiority trial [J].
Gillison, Maura L. ;
Trotti, Andy M. ;
Harris, Jonathan ;
Eisbruch, Avraham ;
Harari, Paul M. ;
Adelstein, David J. ;
Sturgis, Erich M. ;
Burtness, Barbara ;
Ridge, John A. ;
Ringash, Jolie ;
Galvin, James ;
Yao, Min ;
Koyfman, Shlomo A. ;
Blakaj, Dukagjin M. ;
Razaq, Mohammed A. ;
Colevas, A. Dimitrios ;
Beitler, Jonathan J. ;
Jones, Christopher U. ;
Dunlap, Neal E. ;
Seaward, Samantha A. ;
Spencer, Sharon ;
Galloway, Thomas J. ;
Phan, Jack ;
Dignam, James J. ;
Quynh Thu Le .
LANCET, 2019, 393 (10166) :40-50
[6]   Effect of HPV-Associated p16INK4A Expression on Response to Radiotherapy and Survival in Squamous Cell Carcinoma of the Head and Neck [J].
Lassen, Pernille ;
Eriksen, Jesper G. ;
Hamilton-Dutoit, Stephen ;
Tramm, Trine ;
Alsner, Jan ;
Overgaard, Jens .
JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (12) :1992-1998
[7]  
Ma DM, 2021, 2021 ASTROANNUAL M
[8]   Factors associated with severe late toxicity after concurrent chemoradiation for locally advanced head and neck cancer: An RTOG analysis [J].
Machtay, Mitchell ;
Moughan, Jennifer ;
Trotti, Andrew ;
Garden, Adam S. ;
Weber, Randal S. ;
Cooper, Jay S. ;
Forastiere, Arlene ;
Ang, K. Kian .
JOURNAL OF CLINICAL ONCOLOGY, 2008, 26 (21) :3582-3589
[9]   De-Escalation After DE-ESCALATE and RTOG 1016: A Head and Neck Cancer InterGroup Framework for Future De-Escalation Studies [J].
Mehanna, Hisham ;
Rischin, Danny ;
Wong, Stuart J. ;
Gregoire, Vincent ;
Ferris, Robert ;
Waldron, John ;
Quynh-Thu Le ;
Forster, Martin ;
Gillison, Maura ;
Laskar, Sarbani ;
Tahara, Makoto ;
Psyrri, Amanda ;
Vermorken, Jan ;
Porceddu, Sandro .
JOURNAL OF CLINICAL ONCOLOGY, 2020, 38 (22) :2552-+
[10]   Randomized Trial of Radiation Therapy With Weekly Cisplatin or Cetuximab in Low-Risk HPV-Associated Oropharyngeal Cancer (TROG 12.01)-A Trans-Tasman Radiation Oncology Group Study [J].
Rischin, Danny ;
King, Madeleine ;
Kenny, Lizbeth ;
Porceddu, Sandro ;
Wratten, Christopher ;
Macann, Andrew ;
Jackson, James E. ;
Bressel, Mathias ;
Herschtal, Alan ;
Fisher, Richard ;
Fua, Tsien ;
Lin, Charles ;
Liu, Chen ;
Hughes, Brett G. M. ;
McGrath, Margaret ;
McDowell, Lachlan ;
Corry, June .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2021, 111 (04) :876-886