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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.
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).
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
334 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Severe (grade 3-5) toxicity events per patient at 24 monthsprimary | Radiotherapy + cisplatin | 166 | 4.8 events per patient | - | 0.98 | link |
| Radiotherapy + cetuximab | 168 | 4.8 events per patient | ||||
| Overall survival at 2 years | Radiotherapy + cisplatin | - | 97.5% | 5 (1.7 to 14.7) | 0.001 | link |
| Radiotherapy + cetuximab | - | 89.4% | ||||
| Recurrence at 2 years | Radiotherapy + cisplatin | - | 6% | 3.4 (1.6 to 7.2) | 0.0007 | link |
| Radiotherapy + cetuximab | - | 16.1% |
Shares HPV-positive oropharyngeal cancer, Oropharyngeal cancer (tonsil and base of tongue), HPV DNA testing and self-sampling, Chemoradiation (chemoradiotherapy, CRT) and the tag radiation-wave4.
Shares Oropharyngeal cancer (tonsil and base of tongue), Cetuximab, Head and neck squamous cell carcinoma, IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares Chemoradiation (chemoradiotherapy, CRT), Cisplatin, Head and neck squamous cell carcinoma, IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares Chemoradiation (chemoradiotherapy, CRT), Cisplatin, IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares Chemoradiation (chemoradiotherapy, CRT), IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares Chemoradiation (chemoradiotherapy, CRT), IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares Chemoradiation (chemoradiotherapy, CRT), IMRT / IGRT (modern external beam) and the tag radiation-wave4.
Shares Chemoradiation (chemoradiotherapy, CRT), IMRT / IGRT (modern external beam) and the tag radiation-wave4.