MUNICHâ€”A â€œsalutary lessonâ€ was reported by researchers investigating therapy for oropharyngeal cancer at the 2018 annual congress of the European Society for Medical Oncology (ESMO). It came from results of the De-ESCALaTE HPVstudy that found patients with low-risk head and neck cancer who tested positive for human papilloma virus (HPV+) did better if they had been treated with standard platinum-based chemotherapy (added their radiotherapy) rather than the epidermal growth factor receptor (EGFR) inhibitor cetuximab.
Phase three trials needed
â€œOne of the big lessons is that you really need phase three trialsâ€”even when treatments are already approvedâ€”as in [the] case [of] head and neck cancer,â€ said Hisham Mehanna PhD BMed Sci FRCS, Chair of Head and Neck Surgery at the Institute for Head and Neck Studies Education in the University of Birmingham, UK. â€œYou need phase three trials to compare new treatments to standards of care to really be able to take [them] into the clinic,â€ he told the Audio Journal of Oncology. â€œClinical practice should not be changed without these phase three trials.â€
Detriment from cetuximab
TheDe-ESCALaTE HPV studyâ€”reported at ESMO by Mehanna and his colleaguesâ€”found there had been â€œsignificant detriment from the use of cetuximab instead of cisplatin in terms of tumor control and no benefit in terms of reduced toxicity. They concluded that: â€œCisplatin and radiotherapy remained the standard of care in this setting.â€