Amanda Psyrri, MD, PhD
Formal discussant of this trial, Amanda Psyrri, MD, PhD, of the University of Athens Medical School, Attikon Hospital, Athens, Greece, commented on these results, suggesting they would affect clinical practice “tomorrow.”
“Cisplatin/radiotherapy remains the standard of care for low-risk human papillomavirus (HPV)-positive oropharyngeal cancer. Cetuximab (Erbitux)/radiotherapy was not found to be superior to cisplatin. Cisplatin/radiotherapy has a different spectrum of toxicity, with more serious adverse events than cetuximab/radiotherapy. Although cross-trial comparisons cannot be made with confidence, a recent Radiation Therapy Oncology Group (RTOG) trial in 800 patients confirms these results,” stated Dr. Psyrri.
However, she does not think this should be the end of investigating de-escalation strategies in HPV-positive oropharyngeal cancer. “We need to select better candidates. The present study had 16% of patients who were slightly at higher risk. We need to continue the search to identify a radiotherapy partner as effective as cisplatin but less toxic and study it in well-designed, randomized clinical trials in low-risk patients,” Dr. Psyrri proposed. ■
DISCLOSURE: Dr. Psyrri has received honoraria from Merck Serono; is a consultant/advisor to Merck Serono, Amgen, AstraZeneca, MSD Oncology, Pfizer, and Bristol-Myers Squibb; and has received research funding from Bristol-Myers Squibb.
In the United States and European countries, many oncologists are using cetuximab (Erbitux)/radiotherapy instead of cisplatin/radiotherapy in the treatment of human papillomavirus (HPV)-positive oropharyngeal cancer, based on the belief that cetuximab is equally effective with less toxicity than...