Top Line: At ASCO 2022, initial reporting of the phase 2 IChoice-01 trial indicated induction chemo can serve as an effective bioselector for those who can do well with radiation de-escalation for locally-advanced, p16+ oropharyngeal squamous cell carcinoma (SCC).
The Study: Here we have the final report. As a reminder, 48 enrollees received upfront cisplatin + docetaxel x 2 cycles. Those with at least a 50% reduction at both the primary site and nodes (n=26) proceeded to definitive radiation alone to 60 Gy while the rest (n=22) received standard chemoradiation to 70 Gy with concurrent cisplatin. At a median follow-up of 30 months, the primary endpoint of progression-free survival as well as overall survival both remained 100% for the 26 responders receiving de-esclataed radiation. For the remaining 22 nonresponders who proceeded to standard chemoradiation, progression free survival was 68% and overall survival 86%. There was no difference between arms in MD Anderson Dysphagia Inventory (MDADI) scores, and both arms recovered to baseline by 12 months out from treatment.
TBL: In this phase 2 study, patients with p16+ oropharyngeal SCC that responded to induction chemo had excellent outcomes with de-escalated radiation alone to 60 Gy. Those who didn’t respond may benefit from further treatment intensification. | Xu, Int J Radiat Oncol Biol Phys 2023
The Study: Here we have the final report. As a reminder, 48 enrollees received upfront cisplatin + docetaxel x 2 cycles. Those with at least a 50% reduction at both the primary site and nodes (n=26) proceeded to definitive radiation alone to 60 Gy while the rest (n=22) received standard chemoradiation to 70 Gy with concurrent cisplatin. At a median follow-up of 30 months, the primary endpoint of progression-free survival as well as overall survival both remained 100% for the 26 responders receiving de-esclataed radiation. For the remaining 22 nonresponders who proceeded to standard chemoradiation, progression free survival was 68% and overall survival 86%. There was no difference between arms in MD Anderson Dysphagia Inventory (MDADI) scores, and both arms recovered to baseline by 12 months out from treatment.
TBL: In this phase 2 study, patients with p16+ oropharyngeal SCC that responded to induction chemo had excellent outcomes with de-escalated radiation alone to 60 Gy. Those who didn’t respond may benefit from further treatment intensification. | Xu, Int J Radiat Oncol Biol Phys 2023