Evidence map›Paper›PMID 41385605›Full record

Trial reportClinical cancer research : an official journal of the American Association for Cancer Research2026

FDG-PET-Based Selective Deescalation of Chemoradiation in Human Papillomavirus-Related Oropharyngeal Squamous Cell Carcinoma: A Multicenter Phase II Trial.

Michelle Mierzwa, Benjamin Rosen, Krithika Suresh, Arjun Dinesh, Sam Regan, Collin Brummel, Kakit Wong, Keith Casper, Mark Prince, Kelly Malloy and 18 more

Abstract readClinical Trial, Phase IIMulticenter Study
In one paragraph

Trial report in Clinical cancer research : an official journal of the American Association for Cancer Research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors.

Michelle Mierzwa *Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0002-3923-9970
Benjamin Rosen *Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0002-7827-4197
Krithika SureshDepartment of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0001-7785-3536
Arjun DineshDepartment of Otolaryngology - Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan.ORCID 0009-0003-2801-384X
Sam ReganDepartment of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0002-5449-8348
Collin BrummelDepartment of Otolaryngology - Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0001-7198-8560
Kakit WongDivision of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, Michigan.ORCID 0009-0006-0837-7816
Keith CasperDepartment of Otolaryngology - Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0003-2878-3863
Mark PrinceDepartment of Otolaryngology - Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0002-1120-9008
Kelly MalloyDepartment of Otolaryngology - Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0002-0337-9293
Andrew ShumanDepartment of Otolaryngology - Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0002-9305-7860
Steven ChinnDepartment of Otolaryngology - Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0003-4282-0640
Yue CaoDepartment of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0003-3910-3261
Madhava AryalDepartment of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0003-3938-1843
Molly Heft-NealDepartment of Otolaryngology - Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0002-8813-5537
Chaz StuckenDepartment of Otolaryngology - Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0003-1448-3376
Marisa BuchakjianDepartment of Otolaryngology - Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0001-8261-1566
David FornerDepartment of Otolaryngology - Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0002-1014-3545
Pratyusha YalamanchiDepartment of Otolaryngology - Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0003-0776-3759
Paul SwiecickiDivision of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0003-2286-3555
Theodore S LawrenceDepartment of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0002-4186-8821
Rawan AkhdarDepartment of Otolaryngology - Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan.ORCID 0009-0008-7045-8638
Muneesh TewariDivision of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0002-7781-3152
Chandan BhambhaniDivision of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0001-9572-9328
Heather WallineDepartment of Otolaryngology - Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0003-3790-5738
J Chad BrennerDepartment of Otolaryngology - Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0003-3238-1111
Jennifer ShahDepartment of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0002-3847-8865
Francis WordenDivision of Hematology Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0002-6632-4951

Funding

Quantitative MRI models of HN Cancers for Physiological Adaption of RTU01CA183848 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CAO, YUE · 2014 to 2019
$2.0M
National Cancer Institute (NCI) 1U01CA183848NCI NIH HHS U01 CA183848
6 · The paper itself

Abstract

purposeWe conducted a phase II multicenter clinical trial to test the hypothesis that 18F-fluorodeoxyglucose positron emission tomography (FDG-PET)-based chemoradiation (CRT) dose deescalation would provide noninferior locoregional control compared with historical controls among patients with early-stage p16+ oropharyngeal cancer. We also hypothesized that human papillomavirus (HPV) circulating tumor DNA (ctDNA) changes during treatment predict locoregional recurrence (LRR). PATIENTS AND

methodsPatients with stage I/II p16+ oropharyngeal squamous cell carcinoma were planned to receive radiation 70 Gy in 35 fractions with concurrent weekly carboplatin and paclitaxel. All patients underwent FDG-PET at baseline and at radiation therapy (RT) fraction 10. Patients with ≥50% decrease from baseline to mid-treatment metabolic tumor volume had treatment deescalated to 54 Gy in 27 fractions. The primary endpoint was LRR. Plasma HPV ctDNA was evaluated weekly and in surveillance.

resultsOf 84 evaluable patients, 43% met deescalation criteria. With a median follow-up of 37.8 months, 24-month LRR for the entire cohort was 7.8% [90% confidence interval (CI), 2.6%-12.6%], which was less than the 25% rate specified for assessing noninferiority, thereby meeting the primary endpoint. At 1 month after RT, the mean of multiple quality of life measures between the two groups was improved in the 54 Gy cohort, exceeding the minimal clinically important difference threshold. During CRT, week 1 percentage increase in ctDNA relative to baseline was significantly associated with worse loco-regional control (LRC; HR = 1.052 per 10 percentage point increase in ctDNA; 95% CI, 1.007-1.099; P = 0.023) and loco-regional progression-free survival (HR = 1.038; 95% CI, 1.002-1.076; P = 0.035).

conclusionsFDG-PET-based RT dose personalization resulted in promising LRR outcomes in early-stage oropharynx cancer with improved short-term patient-reported outcomes. Furthermore, HPV ctDNA changes early in treatment may predict LRC.

Indexed as

ChemoradiotherapyFluorodeoxyglucose F18Oropharyngeal NeoplasmsPapillomavirus InfectionsPositron-Emission TomographySquamous Cell Carcinoma of Head and NeckAdultAgedCarboplatinCirculating Tumor DNAFemaleHuman Papillomavirus VirusesHumansMaleMiddle AgedNeoplasm Recurrence, LocalCarboplatinCirculating Tumor DNAFluorodeoxyglucose F18Paclitaxel

Identifiers

PMID41385605
PMCPMC12832149

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.