ORIGINAL ARTICLE

Pathologic response to neoadjuvant chemotherapy in HPV-associated oropharynx cancer

Corresponding Author

Nader Sadeghi MD

[email protected]

orcid.org/0000-0002-3218-2668

Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, Quebec, Canada

Research Institute of McGill University Health Center, McGill University, Montreal, Quebec, Canada

Correspondence

Nader Sadeghi, Department of Otolaryngology-Head and Neck Surgery, Royal Victoria Hospital, MUHC Glen Site, 1001 boul Decarie, Rm D05.5704, Montreal, QC H4A3J1, Canada.

Email: [email protected]

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Sarah Khalife MD,

Sarah Khalife MD

orcid.org/0000-0001-5585-2962

Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, Quebec, Canada

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Marco A. Mascarella MD,

Marco A. Mascarella MD

orcid.org/0000-0002-8880-805X

Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, Quebec, Canada

Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada

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Agnihotram V. Ramanakumar PhD,

Agnihotram V. Ramanakumar PhD

Research Institute of McGill University Health Center, McGill University, Montreal, Quebec, Canada

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Keith Richardson MD,

Keith Richardson MD

Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, Quebec, Canada

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Arjun S. Joshi MD,

Arjun S. Joshi MD

Department of Otolaryngology – Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, District of Columbia

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Nathaniel Bouganim MD,

Nathaniel Bouganim MD

Research Institute of McGill University Health Center, McGill University, Montreal, Quebec, Canada

Department of Oncology, McGill University Health Center, McGill University, Montreal, Quebec, Canada

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Reza Taheri MD, PhD,

Reza Taheri MD, PhD

Department of Diagnostic Radiology, George Washington University School of Medicine & Health Sciences, Washington, District of Columbia

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Andrew Fuson MD,

Andrew Fuson MD

Department of Otolaryngology – Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, District of Columbia

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Robert Siegel MD,

Robert Siegel MD

Division of Hematology and Oncology, George Washington University, Washington, District of Columbia

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Nader Sadeghi MD,

Corresponding Author

Nader Sadeghi MD

[email protected]

orcid.org/0000-0002-3218-2668

Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, Quebec, Canada

Research Institute of McGill University Health Center, McGill University, Montreal, Quebec, Canada

Correspondence

Nader Sadeghi, Department of Otolaryngology-Head and Neck Surgery, Royal Victoria Hospital, MUHC Glen Site, 1001 boul Decarie, Rm D05.5704, Montreal, QC H4A3J1, Canada.

Email: [email protected]

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Sarah Khalife MD,

Sarah Khalife MD

orcid.org/0000-0001-5585-2962

Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, Quebec, Canada

Search for more papers by this author

Marco A. Mascarella MD,

Marco A. Mascarella MD

orcid.org/0000-0002-8880-805X

Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, Quebec, Canada

Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada

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Agnihotram V. Ramanakumar PhD,

Agnihotram V. Ramanakumar PhD

Research Institute of McGill University Health Center, McGill University, Montreal, Quebec, Canada

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Keith Richardson MD,

Keith Richardson MD

Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, Quebec, Canada

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Arjun S. Joshi MD,

Arjun S. Joshi MD

Department of Otolaryngology – Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, District of Columbia

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Nathaniel Bouganim MD,

Nathaniel Bouganim MD

Research Institute of McGill University Health Center, McGill University, Montreal, Quebec, Canada

Department of Oncology, McGill University Health Center, McGill University, Montreal, Quebec, Canada

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Reza Taheri MD, PhD,

Reza Taheri MD, PhD

Department of Diagnostic Radiology, George Washington University School of Medicine & Health Sciences, Washington, District of Columbia

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Andrew Fuson MD,

Andrew Fuson MD

Department of Otolaryngology – Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, District of Columbia

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Robert Siegel MD,

Robert Siegel MD

Division of Hematology and Oncology, George Washington University, Washington, District of Columbia

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First published: 27 November 2019

https://doi.org/10.1002/hed.26022

Citations: 37

Preliminary results of this project were presented at the American Head and Neck Society meeting of the Combined Otolaryngology Spring Meetings in Austin, Texas, on May 1, 2019 and at the Canadian Society of Otolaryngology-Head & Neck Surgery 73^rd Annual Meeting in Edmonton, Alberta on June 3, 2019.

Section Editor: Athanassios Argiris

Funding information: George Washington University Institutional Review Board, Grant/Award Number: IRB 061431; Research Ethics Board of McGill University Health Centre, Grant/Award Number: MP-37-2018-3568; American Head and Neck Society

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Abstract

Background

A paradigm shift has led to de-escalation trials for the treatment of HPV-positive oropharynx cancer (OPC). The objective of this study was to assess the ability of tumor volume reduction on imaging to predict pathological response to neoadjuvant chemotherapy in patients with HPV-positive OPC.

Methods

A prospective observational study of 54 patients with HPV-positive OPC enrolled in a clinical trial of neoadjuvant chemotherapy followed by surgery was performed. Patients underwent three cycles of induction chemotherapy (cisplatin/docetaxel); prechemotherapy and postchemotherapy imaging were obtained. Receiver operating characteristic curves and logistic regression analyses were used.

Results

The complete pathologic response (pCR) rate at primary and nodal sites were 72% and 57%, respectively. Tumor volume reduction of ≥90% following induction chemotherapy predicted pCR of the primary tumor.

Conclusions

Neoadjuvant chemotherapy followed by definitive transoral surgery is a new paradigm worthy of further investigation and MRI is a reliable modality to assess preoperative response.

CONFLICT OF INTEREST

The authors declare no potential conflict of interest.

REFERENCES

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Volume42, Issue3

March 2020

Pages 417-425

Pathologic response to neoadjuvant chemotherapy in HPV-associated oropharynx cancer

Abstract

Background

Methods

Results

Conclusions

CONFLICT OF INTEREST

REFERENCES

Citing Literature

References

Information

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Pathologic response to neoadjuvant chemotherapy in HPV-associated oropharynx cancer

Abstract

Background

Methods

Results

Conclusions

CONFLICT OF INTEREST

REFERENCES

Citing Literature

References

Related

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