Radiotherapy Plus Chemotherapy in HPV-Positive Oropharyngeal Cancer
Posted: Thursday, January 3, 2019
Hisham Mehanna, PhD, of the University of Birmingham, United Kingdom, and colleagues found no benefit with cetuximab compared with standard cisplatin in terms of reduced in patients treated with radiotherapy plus chemotherapy for low-risk human papillomavirus (HPV)-positive oropharyngeal cancer, according to a phase III trial. However, the use of cetuximab compared with cisplatin resulted in a detriment in terms of tumor control. The study findings were published in The Lancet.
“Cisplatin and radiotherapy should be used as the standard of care for HPV-positive low-risk patients who are able to tolerate cisplatin,” the investigators concluded. “Our findings also suggest caution with de-escalation strategies and highlight the importance of phase III trial data before changing clinical practice.”
The open-label, randomized, controlled study analyzed 334 patients from 32 head and neck treatment centers. Patients were enrolled between November 2012 and October 2016 and were randomly designated to receive either intravenous cisplatin (166 patients) or intravenous cetuximab (168 patients), in addition to radiotherapy.
Overall severe toxicity among the two groups was similar; the mean number of events for patients treated with cisplatin was 4·8 and for those treated with cetuximab it was 4·8. Additionally, there appeared to be no difference in overall all-grade toxicity . Cisplatin and cetuximab treatments did, however, significantly vary in 2-year overall survival (97.5% vs. 89.4%) and 2-year recurrence (6.0% vs. 16.1%).
Disclosure: Study authors’ disclosure information may be found at The Lancet.