دورية أكاديمية
Hypoxia-Directed Treatment of Human Papillomavirus-Related Oropharyngeal Carcinoma.
| العنوان: | Hypoxia-Directed Treatment of Human Papillomavirus-Related Oropharyngeal Carcinoma. |
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| المؤلفون: | Lee NY; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Sherman EJ; Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Schöder H; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY., Wray R; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY., Boyle JO; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY., Singh B; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY., Grkovski M; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY., Paudyal R; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY., Cunningham L; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY., Zhang Z; Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY., Hatzoglou V; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY., Katabi N; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY., Diplas BH; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Han J; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Imber BS; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Pham K; Department of Finance, Memorial Sloan Kettering Cancer Center, New York, NY., Yu Y; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Zakeri K; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., McBride SM; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Kang JJ; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Tsai CJ; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Chen LC; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Gelblum DY; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Shah JP; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY., Ganly I; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY., Cohen MA; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY., Cracchiolo JR; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY., Morris LGT; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY., Dunn LA; Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Michel LS; Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Fetten JV; Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Kripani A; Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Pfister DG; Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Ho AL; Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Shukla-Dave A; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY., Humm JL; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY., Powell SN; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Li BT; Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Reis-Filho JS; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY., Diaz LA; Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY., Wong RJ; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY., Riaz N; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY. |
| المصدر: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2024 Mar 10; Vol. 42 (8), pp. 940-950. Date of Electronic Publication: 2024 Jan 19. |
| نوع المنشور: | Clinical Trial, Phase II; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Society of Clinical Oncology Country of Publication: United States NLM ID: 8309333 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-7755 (Electronic) Linking ISSN: 0732183X NLM ISO Abbreviation: J Clin Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2003- : Alexandria, VA : American Society of Clinical Oncology Original Publication: New York, N.Y. : Grune & Stratton, c1983- |
| مواضيع طبية MeSH: | Papillomavirus Infections*/complications , Papillomavirus Infections*/therapy , Oropharyngeal Neoplasms*/therapy , Oropharyngeal Neoplasms*/drug therapy , Carcinoma*/drug therapy, Humans ; Human Papillomavirus Viruses ; Chemoradiotherapy/adverse effects ; Chemoradiotherapy/methods ; Hypoxia/etiology ; Hypoxia/drug therapy |
| مستخلص: | Purpose: Standard curative-intent chemoradiotherapy for human papillomavirus (HPV)-related oropharyngeal carcinoma results in significant toxicity. Since hypoxic tumors are radioresistant, we posited that the aerobic state of a tumor could identify patients eligible for de-escalation of chemoradiotherapy while maintaining treatment efficacy. Methods: We enrolled patients with HPV-related oropharyngeal carcinoma to receive de-escalated definitive chemoradiotherapy in a phase II study (ClinicalTrials.gov identifier: NCT03323463). Patients first underwent surgical removal of disease at their primary site, but not of gross disease in the neck. A baseline 18 F-fluoromisonidazole positron emission tomography scan was used to measure tumor hypoxia and was repeated 1-2 weeks intratreatment. Patients with nonhypoxic tumors received 30 Gy (3 weeks) with chemotherapy, whereas those with hypoxic tumors received standard chemoradiotherapy to 70 Gy (7 weeks). The primary objective was achieving a 2-year locoregional control (LRC) of 95% with a 7% noninferiority margin. Results: One hundred fifty-eight patients with T0-2/N1-N2c were enrolled, of which 152 patients were eligible for analyses. Of these, 128 patients met criteria for 30 Gy and 24 patients received 70 Gy. The 2-year LRC was 94.7% (95% CI, 89.8 to 97.7), meeting our primary objective. With a median follow-up time of 38.3 (range, 22.1-58.4) months, the 2-year progression-free survival (PFS) and overall survival (OS) rates were 94% and 100%, respectively, for the 30-Gy cohort. The 70-Gy cohort had similar 2-year PFS and OS rates at 96% and 96%, respectively. Acute grade 3-4 adverse events were more common in 70 Gy versus 30 Gy (58.3% v 32%; P = .02). Late grade 3-4 adverse events only occurred in the 70-Gy cohort, in which 4.5% complained of late dysphagia. Conclusion: Tumor hypoxia is a promising approach to direct dosing of curative-intent chemoradiotherapy for HPV-related carcinomas with preserved efficacy and substantially reduced toxicity that requires further investigation. |
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| معلومات مُعتمدة: | P30 CA008748 United States CA NCI NIH HHS; R01 CA157770 United States CA NCI NIH HHS; R01 CA238392 United States CA NCI NIH HHS |
| سلسلة جزيئية: | ClinicalTrials.gov NCT03323463 |
| تواريخ الأحداث: | Date Created: 20240119 Date Completed: 20240308 Latest Revision: 20240516 |
| رمز التحديث: | 20240516 |
| مُعرف محوري في PubMed: | PMC10927322 |
| DOI: | 10.1200/JCO.23.01308 |
| PMID: | 38241600 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1527-7755 |
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| DOI: | 10.1200/JCO.23.01308 |