Selective Treatment Deintensification by Reducing Radiation Dose and Omitting Concurrent Chemotherapy Based on Response to Induction Chemotherapy in Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma: A Single-Arm, Phase 2 Trial (IChoice-01) DOI Creative Commons
Tingting Xu, Chunying Shen, Xin Zhou

et al.

International Journal of Radiation Oncology*Biology*Physics, Journal Year: 2023, Volume and Issue: 118(1), P. 169 - 178

Published: Aug. 12, 2023

To demonstrate the feasibility of deintensification regimen in light response to induction chemotherapy (IC) human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC).Patients with p16+ OPSCC, T1-2/N1-3M0 (excluding T1N1M0 single and ≤3 cm lymph node) or T3-4N0-3M0 were enrolled between January 2019 July 2021. All patients received 2 cycles IC docetaxel 75 mg/m2 dL cisplatin every 3 weeks. Those major responses (≥50% decrease both primary nodes) entered cohort (cohort D), which intensity modulated radiation therapy alone was given a reduced dose 60 Gy/30 fractions. who failed meet responsesentered concurrent chemoradiotherapy C), where simultaneously integrated boosted standard 70 Gy/35 fractions nonmajor sites, concurrently 80 dL,22. Patient-reported swallow function documented using MD Anderson Dysphagia Inventory. The endpoint 2-year progression-free survival (PFS) Simon's stage design.A total 26 48 (54.2%) participants met criteria enter D 22 (45.8%) C. With median follow-up time 29.7 months (6.9-48.0 months), PFS OS rates 85.4% 93.6%, respectively for all patients. In D, 100%. Grade 4 IC-related toxicities included leukopenia/neutropenia occurring 41.7% hyponatremia 4.2% A higher incidence grade mucositis (61.9% vs 23.1% P = .022) observed Consistent decline longitudinal Inventory scores at month after cohorts found recover baseline 12.Selective reduction removal based on HPV + OPSCC feasible promising. Further study this strategy balance efficacy toxicity is warranted prospective controlled trial.

Language: Английский

Targeting BRD4: Potential therapeutic strategy for head and neck squamous cell carcinoma (Review) DOI Creative Commons

Voraporn Yongprayoon,

Napasporn Wattanakul,

Winnada Khomate

et al.

Oncology Reports, Journal Year: 2024, Volume and Issue: 51(6)

Published: April 12, 2024

As a member of BET (bromodomain and extra-terminal) protein family, BRD4 (bromodomain‑containing 4) is chromatin‑associated that interacts with acetylated histones actively recruits regulatory proteins, leading to the modulation gene expression chromatin remodeling. The cellular epigenetic functions implicate normal development, fibrosis inflammation. has been suggested as potential therapeutic target it often overexpressed plays critical role in regulating programs drive tumor cell proliferation, survival, migration drug resistance. To address roles cancer, several drugs specifically have developed. Inhibition shown promising results preclinical models, inhibitors undergoing clinical trials for treatment various cancers. Head neck squamous carcinoma (HNSCC), heterogeneous group cancers, remains health challenge high incidence rate poor prognosis. Conventional therapies HNSCC cause adverse effects patients. Targeting BRD4, therefore, represents strategy sensitize chemo‑ radiotherapy allowing de‑intensification current regime subsequent reduced side effects. However, further studies are required fully understand underlying mechanisms action order determine optimal dosing administration BRD4‑targeted patients HNSCC.

Language: Английский

Citations

3
Immunotherapy in Head and Neck Cancer When, How, and Why? DOI Creative Commons
D. Pereira, Diana Martins, Fernando Mendes

et al.

Biomedicines, Journal Year: 2022, Volume and Issue: 10(9), P. 2151 - 2151

Published: Sept. 1, 2022

Head and neck cancer (HNC) is one of the most common cancers worldwide. Alcohol tobacco consumption, besides viral infections, are main risk factors associated with this cancer. When diagnosed in advanced stages, HNC patients present a higher probability recurrence or metastasising. The complexity therapeutic options post-treatment surveillance poor prognosis reduced overall survival (OS). This review aims to explore immunotherapy (immune checkpoint inhibitors (ICI), vaccines, oncolytic viruses) patients’ treatment, when, how, why can benefit from it. monotherapy ICI combination chemotherapy (QT) shows promising results. Compared standard therapy, able increase OS quality life. QT demonstrates significant response rates considerable long-term clinical benefits. However, toxicity approach still hurdle overcome. In parallel, vaccines directed Human Papilloma Virus also efficient increasing antitumour response, inducing cellular humoral immunity. Although these results demonstrate benefits compared it important unravel resistance mechanisms order predict immunotherapy.

Language: Английский

Citations

14
What is the future of treatment de-escalation for HPV-positive oropharyngeal cancer? A review of ongoing clinical trials DOI Creative Commons
Emma Mensour,

Shintha Alam,

Seliya Mawani

et al.

Frontiers in Oncology, Journal Year: 2022, Volume and Issue: 12

Published: Dec. 23, 2022

Background Human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) has increased in incidence recent decades. With higher cure rates younger populations, long-term survivors may live with acute- and toxicity, leading to interest de-escalation treatment strategies for HPV-related OPSCC. Herein, we have examined the current landscape of clinical trials this context. Methods A review active related HPV-associated OPSCC was performed using clinicaltrials.gov database from inception January 2022. search key words “oropharyngeal cancer” “HPV” completed. Three investigators independently reviewed each trial, any discrepancies settled by a fourth. Data collected study included phase, design, primary, secondary endpoints, strategies. final 24 articles were selected full text review. Results Many (n=19, 79%) non-randomized, most studies employed phase II design (n=14, 58%). Only 13% (n=3) randomized trials, 8% (n=2) III component. The frequent primary endpoint progression-free survival (PFS) (n=9, 37.5%). regards identified strategies, all (n=24) had at least one component assessing changes RT dose/fractionation and/or reduction volumes. smaller percentage assessed surgical interventions 37.5%) systemic therapy (n=8, 33.3%). Conclusion small number are underway, transition more future will be important change practice.

Language: Английский

Citations

14
30-day morbidity and mortality after transoral robotic surgery for human papillomavirus (HPV) associated oropharyngeal squamous cell carcinoma: A retrospective analysis of two prospective adjuvant de-escalation trials (MC1273 & MC1675) DOI
Travis J. Haller, Xueqian Yin,

Thomas J. O’Byrne

et al.

Oral Oncology, Journal Year: 2023, Volume and Issue: 137, P. 106248 - 106248

Published: Jan. 3, 2023

Language: Английский

Citations

8
Selective Treatment Deintensification by Reducing Radiation Dose and Omitting Concurrent Chemotherapy Based on Response to Induction Chemotherapy in Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma: A Single-Arm, Phase 2 Trial (IChoice-01) DOI Creative Commons
Tingting Xu, Chunying Shen, Xin Zhou

et al.

International Journal of Radiation Oncology*Biology*Physics, Journal Year: 2023, Volume and Issue: 118(1), P. 169 - 178

Published: Aug. 12, 2023

To demonstrate the feasibility of deintensification regimen in light response to induction chemotherapy (IC) human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC).Patients with p16+ OPSCC, T1-2/N1-3M0 (excluding T1N1M0 single and ≤3 cm lymph node) or T3-4N0-3M0 were enrolled between January 2019 July 2021. All patients received 2 cycles IC docetaxel 75 mg/m2 dL cisplatin every 3 weeks. Those major responses (≥50% decrease both primary nodes) entered cohort (cohort D), which intensity modulated radiation therapy alone was given a reduced dose 60 Gy/30 fractions. who failed meet responsesentered concurrent chemoradiotherapy C), where simultaneously integrated boosted standard 70 Gy/35 fractions nonmajor sites, concurrently 80 dL,22. Patient-reported swallow function documented using MD Anderson Dysphagia Inventory. The endpoint 2-year progression-free survival (PFS) Simon's stage design.A total 26 48 (54.2%) participants met criteria enter D 22 (45.8%) C. With median follow-up time 29.7 months (6.9-48.0 months), PFS OS rates 85.4% 93.6%, respectively for all patients. In D, 100%. Grade 4 IC-related toxicities included leukopenia/neutropenia occurring 41.7% hyponatremia 4.2% A higher incidence grade mucositis (61.9% vs 23.1% P = .022) observed Consistent decline longitudinal Inventory scores at month after cohorts found recover baseline 12.Selective reduction removal based on HPV + OPSCC feasible promising. Further study this strategy balance efficacy toxicity is warranted prospective controlled trial.

Language: Английский

Citations

8