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Deintensification of Treatment for HPV-Associated Cancers of the Oropharynx

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Textbook of Oral Cancer

Part of the book series: Textbooks in Contemporary Dentistry ((TECD))

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Abstract

HPV+ non-smoking-associated oropharyngeal carcinoma is unusually responsive to conventional chemoradiation and less frequently results in distant metastasis. As these “low-risk” patients are often cured by standard treatments and experience lengthier survival than other head and neck cancer patients, the negative long-term late sequelae of conventional therapies are a concern. Hence deintensification of standard treatments has emerged as a common aim for the best-prognosis patients from this population in the design of ongoing clinical trials. As of yet, no deintensification approach has displaced the current standards of care, and notable recent attempts to substitute targeted therapy for platinum chemotherapy were resoundingly unsuccessful. A variety of approaches remain under consideration. Randomized phase III trials will be needed to ensure that the results of deintensification programs, regardless of the specific treatments employed, are verifiably non-inferior to the results currently achieved in this good-prognosis population with the application of standard therapies.

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Authors and Affiliations

  1. Department of Radiation Oncology, University of California - San Francisco, San Francisco, CA, USA

    Susan Y. Wu & Sue S. Yom

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  1. Susan Y. Wu
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  2. Sue S. Yom
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Correspondence to Sue S. Yom .

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Editors and Affiliations

  1. Faculty of Dentistry, Oral & Craniofacial Sciences,, King’s College London, London, UK

    Saman Warnakulasuriya

  2. Department of Orofacial Sciences, Schools of Dentistry and Medicine, University of California San Francisco, San Francisco, CA, USA

    John S. Greenspan

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Wu, S.Y., Yom, S.S. (2020). Deintensification of Treatment for HPV-Associated Cancers of the Oropharynx. In: Warnakulasuriya, S., Greenspan, J. (eds) Textbook of Oral Cancer. Textbooks in Contemporary Dentistry. Springer, Cham. https://doi.org/10.1007/978-3-030-32316-5_23

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