UC launches trial to reduce radiation for HPV-positive throat cancer
Researchers hope to reduce side effects for cancer patients
A University of Cincinnati physician‑researcher has opened a new phase II clinical trial to test whether patients with HPV‑positive throat cancer can safely receive lower doses of radiation.
Sara Medek, MD, assistant professor of radiation oncology in the UC College of Medicine, UC Cancer Center member and UC Health physician, is leading a study that delivers 30 Gy of radiation to certain lymph nodes and tumor areas in HPV‑positive head and neck tumors to see if treatment side effects can be reduced without sacrificing cancer control.
Dr. Sara Medek is an assistant professor of radiation oncology in the UC College of Medicine.
“Head and neck cancers aren’t easily treated,” explains Medek. “They require a lot of different types of treatment, including surgery, sometimes chemotherapy and sometimes radiation. And so what we're trying to do in this patient population is that we know that these patients with these tumors tend to do better, and we want to try to minimize treatment side effects.”
Each year, about 58,000 Americans are diagnosed with oral cancer, resulting in around 12,000 deaths, according to the National Institute of Dental and Craniofacial Research.
A subset of head and neck cancers, called oropharyngeal cancers, affects the back of the throat, including the base of the tongue and the tonsils. Oropharyngeal cancer can be caused by certain subtypes of HPV, the same virus that causes cervical cancer.
“Patients with HPV-positive oropharyngeal cancer are living longer,” Medek adds.
How lower-dose radiation could reduce treatment side effects
“There was some preclinical data and some early clinical data at other sites that looked at reducing the dose of radiation to these patients in order to prevent some of the side effects that are associated with radiation, both short-term and long-term," says Medek.
The UC study is building upon that data, which included physicians using specialized scans to identify patients who could safely get less radiation. It will keep full-dose radiation on visible cancer, but lower the dose to nearby lymph nodes that don’t show an obvious tumor but could have microscopic cancer cells present. Researchers hope to enroll about 30 patients.
“Because microscopic disease often responds well to lower doses, they can safely drop radiation to those areas — almost cutting it in half — while still giving the standard, higher dose to the main tumor. So the thought is that by doing that, we'll still be just as effective at getting rid of the tumor, but hopefully we can reduce some of the side effects from radiation,” explains Medek.
Side effects from head and neck radiation can be debilitating, causing sores in the mouth and changes in a patient’s sense of taste, along with pain or difficulty swallowing, explains Medek.
“Going through a course of radiation is extremely difficult for this patient population, and so the ability to be able to kind of dial back on some of those is really important to us,” adds Medek. “This is a very tough regimen of treatment, unfortunately."
Frequently asked questions about UC’s HPV-positive throat cancer trial
What is this UC clinical trial studying?
The phase II trial, led by UC radiation oncologist Sara Medek, MD, is testing whether patients with HPV-positive throat cancer can safely receive lower doses of radiation (30 Gy) to certain lymph nodes and tumor areas while still effectively treating the cancer.
Why lower the radiation dose for HPV-positive head and neck cancers?
Patients with HPV-positive head and neck tumors often have better outcomes. The trial aims to see if radiation doses can be reduced to help minimize treatment side effects while maintaining good cancer control.
Who is leading the study and where is it taking place?
The study is led by Dr. Medek, an assistant professor of radiation oncology at the UC College of Medicine, a member of the University of Cincinnati Cancer Center and a UC Health physician, with patients treated in Cincinnati, Ohio.
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