Nader Sadeghi1,2, Sarah Khalife1, Marco A Mascarella1,3, Agnihotram V Ramanakumar2, Keith Richardson1, Arjun S Joshi4, Nathaniel Bouganim2,5, Reza Taheri6, Andrew Fuson4, Robert Siegel7. 1. Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, Quebec, Canada. 2. Research Institute of McGill University Health Center, McGill University, Montreal, Quebec, Canada. 3. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada. 4. Department of Otolaryngology - Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, District of Columbia. 5. Department of Oncology, McGill University Health Center, McGill University, Montreal, Quebec, Canada. 6. Department of Diagnostic Radiology, George Washington University School of Medicine & Health Sciences, Washington, District of Columbia. 7. Division of Hematology and Oncology, George Washington University, Washington, District of Columbia.
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.
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.
Authors: Dante J Merlino; Jennifer M Johnson; Madalina Tuluc; Stacey Gargano; Robert Stapp; Larry Harshyne; Benjamin E Leiby; Adam Flanders; Ralph Zinner; Rita Axelrod; Joseph Curry; David M Cognetti; Kyle Mannion; Young J Kim; Ulrich Rodeck; Athanassios Argiris; Adam J Luginbuhl Journal: Front Oncol Date: 2020-12-02 Impact factor: 6.244
Authors: Christian R Moya-Garcia; Hideaki Okuyama; Nader Sadeghi; Jianyu Li; Maryam Tabrizian; Nicole Y K Li-Jessen Journal: Front Oncol Date: 2022-08-03 Impact factor: 5.738