Trial reportOral oncology2021
Risk and response adapted de-intensified treatment for HPV-associated oropharyngeal cancer: Optima paradigm expanded experience.
Trial report in Oral oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Advancements in immunotherapy for oropharyngeal cancer: Current landscape and future prospects.Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia · 2026Pooled it
- Global Incidence and Mortality of Myocardial Infarction in Multi-Modality Head and Neck Cancer Treatment: A Systematic Review and Meta-analysis.Advances in therapy · 2025Pooled it
- Oropharyngeal cancer and human papillomavirus: a visualization based on bibliometric analysis and topic modeling.Frontiers in microbiology · 2024Pooled it
- HPV-specific innovations and controversies in therapeutic strategies for HPV-associated oropharyngeal carcinoma.Frontiers in immunology · 2026Review
- Review
- Meta-analysis of the association between long non-coding RNA maternally expressed gene 3 polymorphisms and cancer susceptibility.Oncology letters · 2025Article
- Incidence and outcomes of radiation-associated second primary malignancies in HPV-positive oropharyngeal cancer: long-term follow-up of the quarterback de-escalation trials.Oral oncology · 2025Article
- Early Dynamics of Circulating Tumor HPV-DNA with Neoadjuvant Chemotherapy and Response-Adapted De-escalation in Human Papillomavirus-Associated Oropharyngeal Cancer.Clinical cancer research : an official journal of the American Association for Cancer Research · 2025Article
- De-escalation for Human Papillomavirus-Positive Oropharyngeal Cancer: A Look at the Prospective Evidence.Current oncology reports · 2025Review
- A Review of Immunotherapy for Head and Neck Cancer.Journal of dental research · 2024Review
- Review
- Consensuses, controversies, and future directions in treatment deintensification for human papillomavirus-associated oropharyngeal cancer.CA: a cancer journal for clinicians · 2023Review
- Review
- Review
- Safety and preliminary activity of pembrolizumab-carboplatin-paclitaxel in heavily pretreated and/or fragile patients with PDL1-positive recurrent/metastatic head and neck cancer.Oncology letters · 2023Article
- Review
- Article
- Correlation between human papillomavirus protein expression and clinicopathological features in oral squamous cell carcinoma.International journal of immunopathology and pharmacologyArticle
Corrections and comments
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Authors and funding
18 authors.
Funding
Abstract
backgroundFavorable prognosis for Human papillomavirus-associated (HPV+) oropharyngeal cancer (OPC) led to investigation of response-adaptive de-escalation, yet long-term outcomes are unknown. We present expanded experience and follow-up of risk/response adaptive treatment de-intensification in HPV+ OPC.
methodsA phase 2 trial (OPTIMA) and subsequent cohort of sequential off-protocol patients treated from September 2014 to November 2018 at the University of Chicago were reviewed. Eligible patients had T3-T4 or N2-3 (AJCC 7th edition) HPV+ OPC. Patients were stratified by risk: High-risk (HR) (T4, ≥N2c, or >10PYH), all others low-risk (LR). Induction chemotherapy (IC) included 3 cycles of carboplatin and nab-paclitaxel (OPTIMA) or paclitaxel (off-protocol). LR with ≥50% response received low-dose radiotherapy (RT) alone to 50 Gy (RT50). LR with 30-50% response and HR with ≥50% response received intermediate-dose chemoradiotherapy (CRT) to 45 Gy (CRT45). All others received full-dose CRT to 75 Gy (CRT75).
results91 patients consented and 90 patients were treated, of which 31% had >10PYH, 34% had T3/4 disease, and 94% had N2b/N2c/N3 disease. 49% were LR and 51% were HR. Overall response rate to induction was 88%. De-escalated treatment was administered to 83%. Median follow-up was 4.2 years. Five-year OS, PFS, LRC, and DC were 90% (95% CI 81,95), 90% (95% CI 80,95), 96% (95% CI 90,99), and 96% (88,99) respectively. G-tube placement rates in RT50, CRT45, and CRT75 were 3%, 33%, and 80% respectively (p < 0.05).
conclusionRisk/response adaptive de-escalated treatment for an inclusive cohort of HPV+ OPC demonstrates excellent survival with reduced toxicity with long-term follow-up.
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