Cisplatin/70 Gy IMRT confirmed as standard of care (SOC) for nonsmoking HPV+ oropharyngeal cancer, which is the treatment used in the Phase 2/3 clinical trial, KEVLARx, that features the EpicentRx lead small molecule, RRx-001 (nibrozetone).
According to the results of a Phase 2/3 clinical trial, the standard schedule of 70 Gy intensity-modulated radiation therapy (IMRT) plus cisplatin was not inferior to a less intensive IMRT schedule of 60 Gy or to a regimen that compared nivolumab (Opdivo) to cisplatin in patients with HPV-positive oropharyngeal cancer.
The good news for patients with HPV-positive oropharyngeal cancer who make up 70% of new patients is that they are very treatment-responsive. The bad news is that life-altering toxicities like dry mouth, dental problems, and hearing loss are common.
Dr. Danielle Margalit, MD, MPH, a senior physician at Dana-Farber Cancer Institute, and associate professor of radiation oncology at Harvard Medical School, summed it up expertly as follows:
“This is a very important study; it’s important because it doesn’t change practice, but it informs practice tremendously. What that means for the patients is that 70 Gy radiation and concurrent cisplatin remain the standard of care and now this is the regimen that has the largest body of scientific evidence and highest cure rate…among all the regimens tested so far for HPV-associated oropharynx cancer in this very favorable patient population. This study also tells us that we can’t de-intensify therapy across the board, so if a patient wants to have the optimal cure rate, this study shows us in this large population setting, 70 Gy and cisplatin is the standard.”