# De-ESCALaTE HPV

Source: https://onco.cc/trials/de-escalate/  
OnCo record `de-escalate` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

De-ESCALaTE, the European counterpart of RTOG 1016, found that cetuximab gave no less toxicity than cisplatin and worse tumour control in HPV-positive throat cancer.

## Summary

De-ESCALaTE randomised 334 patients with low-risk HPV-positive oropharyngeal cancer to 70 Gy radiotherapy with cisplatin or with cetuximab. Severe toxicity, the primary endpoint, did not differ, while two-year overall survival was 97.5 percent with cisplatin and 89.4 percent with cetuximab and recurrence was more frequent with cetuximab (Mehanna and colleagues, Lancet 2019).

## Fields

- Kind: Trial
- Status: negative
- Last checked: 2026-09-17
- Tags: radiation-wave4
- Registry id: NCT01874171
- Phase: 3
- Setting: Low-risk HPV-positive oropharyngeal cancer: radiotherapy with cetuximab versus radiotherapy with cisplatin
- Sponsor: University of Warwick
- Enrolled: 334
- Result: Severe toxicity similar; 2-year overall survival 97.5% (cisplatin) vs 89.4% (cetuximab).
- Outcomes: Severe (grade 3-5) toxicity events per patient at 24 months: Radiotherapy + cisplatin 4.8 events per patient vs Radiotherapy + cetuximab 4.8 events per patient; Overall survival at 2 years: Radiotherapy + cisplatin 97.5% vs Radiotherapy + cetuximab 89.4%, HR 5; Recurrence at 2 years: Radiotherapy + cisplatin 6% vs Radiotherapy + cetuximab 16.1%, HR 3.4

## Sources

- ClinicalTrials.gov NCT01874171: https://clinicaltrials.gov/study/NCT01874171
- Lancet 2019: https://doi.org/10.1016/S0140-6736(18)32752-1

## Connected records

- cancers: [Head and neck squamous cell carcinoma](https://onco.cc/cancers/head-and-neck/), [HPV-positive oropharyngeal cancer](https://onco.cc/cancers/hpv-positive-oropharyngeal-cancer/), [Oropharyngeal cancer (tonsil and base of tongue)](https://onco.cc/cancers/oropharyngeal-cancer/)
- technologies: [HPV DNA testing and self-sampling](https://onco.cc/technologies/hpv-testing/), [IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/)
- drugs: [Cetuximab](https://onco.cc/drugs/cetuximab/), [Cisplatin](https://onco.cc/drugs/cisplatin/)
- terms: [Chemoradiation (chemoradiotherapy, CRT)](https://onco.cc/terms/chemoradiation/)
- key papers: [De-ESCALaTE HPV: radiotherapy plus cisplatin or cetuximab in low-risk HPV-positive oropharyngeal cancer](https://onco.cc/key-papers/paper-de-escalate-lancet-2019/)

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