Professor Danny Rischin: Cisplatin or cetuximab in HPV-associated oropharyngeal cancer

Professor Danny Rischin

New data from the TransTasman Radiation Oncology Group, presented by Professor Danny Rischin, Head of the Department of Medical Oncology at Peter Mac has confirmed radiotherapy and cisplatin as standard of care for HPV-associated oropharyngeal cancer.

In a poster presentation held at the virtual 2021 ASCO meeting this week Professor Rischin discussed findings from a randomised trial of radiotherapy with weekly cisplatin or cetuximab in low-risk human papillomavirus associated oropharyngeal cancer.

Over 180 patients with  p16 positive, stage III or IV,  T1-2N2 or T3N0-2 oropharyngeal cancers were randomised to receive to receive either cisplatin 40mg/m2 weekly or cetuximab in standard doses weekly during radiotherapy, with an additional loading dose pre radiotherapy.

At a median 4.1 years follow up Professor Rischin said there was a ‘significant difference in efficacy’ between the two groups with patients on cetuximab experiencing inferior failure-free survival without improvement in symptoms burden or toxicity.

Patients in the cetuximab arm had a three-year failure-free survival of 80% compared to 93% in the cisplatin arm, which was attributed to an increase in both distant and local regional failures. However the finding did not translate to a difference that was significant for overall survival Professor Rischin added.

While there was no difference in the number of patient reported head and neck symptom interference symptoms between groups adverse events, which xx said were largely expected based on the already know toxicities of cisplatin and cetuximab were The adverse events observed were increased radiation dermatitis in acneiform rash in the cetuximarm and increased emesis, febrile neutropenia, fatigue, and dry mouth in the cisplatin arm.

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