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Present and Future of De-intensification Strategies in the Treatment of Oropharyngeal Carcinoma

  • Head and Neck Cancers (EY Hanna, Section Editor)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The treatment of patients with squamous cell carcinoma of the oropharynx (OPSCC) remains controversial. HPV positivity is widely accepted as a favorable prognostic factor, and HPV+ OPSCC is considered a distinct pathological entity with dedicated NCCN guidelines and may deserve a more personalized therapeutic strategy. The possibility to reduce surgical invasiveness and acute and late toxicity of radiotherapy/chemotherapy has led to the new concept of de-escalation treatment strategies. In particular, several de-intensified approaches have been investigated with the aim to give patients less toxic treatments, while maintaining comparable results in terms of disease’s control and survival. The aim of the present review is to systematically illustrate the current status of research in de-intensification surgical and non-surgical strategies in the treatment of the OPSCC.

Recent Findings

We categorized all completed and on-going trials on the basis of the specific de-escalated treatment protocol. Several de-intensified approaches have been investigated with the aim to give patients less toxic treatments, while maintaining comparable results in terms of disease’s control and survival.

Summary

Considering the conflicting results reported so far by preliminary studies, it is necessary to wait for the final results of the on-going trials to better clarify which is the best de-intensified strategy and which patients would really benefit from it.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Humanitas Clinical and Research Center-IRCCS, Viale Manzoni 56, Rozzano, MI, Italy

    Armando De Virgilio, Andrea Costantino, Giuseppe Mercante, Luca Malvezzi & Giuseppe Spriano

  2. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy

    Armando De Virgilio, Andrea Costantino, Giuseppe Mercante, Daniela Sebastiani, Ciro Franzese, Marta Scorsetti, Luca Malvezzi & Giuseppe Spriano

  3. Department of Otolaryngology-Head & Neck Surgery, IRCCS Regina Elena National Cancer Institute, via Elio Chianesi 53, Rome, Italy

    Gerardo Petruzzi & Raul Pellini

  4. Department of Radiotherapy, Humanitas Clinical and Research Center-IRCCS, Viale Manzoni 56, Rozzano, MI, Italy

    Ciro Franzese & Marta Scorsetti

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  1. Armando De Virgilio
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  2. Andrea Costantino
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Correspondence to Armando De Virgilio.

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Armando De Virgilio, Andrea Costantino, Giuseppe Mercante, Gerardo Petruzzi, Daniela Sebastiani, Ciro Franzese, Marta Scorsetti, Raul Pellini, Luca Malvezzi, and Giuseppe Spriano declare that they have no conflict of interest.

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De Virgilio, A., Costantino, A., Mercante, G. et al. Present and Future of De-intensification Strategies in the Treatment of Oropharyngeal Carcinoma. Curr Oncol Rep 22, 91 (2020). https://doi.org/10.1007/s11912-020-00948-1

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