![]() ![]() HR with ≥ 50% response or LR with ≥ 30% and < 50% response receive treatment on the intermediate de-escalation arm (chemoradiation to 50 Gy with cisplatin). LR with ≥ 50% response receive treatment on the single-modality arm (minimally-invasive surgery or radiation alone to 50 Gy). All patients receive induction chemotherapy with three cycles of carboplatin and paclitaxel. Patients with locoregional HPV + OPC are stratified into two cohorts: High risk (HR) (T4, N3, 20 pack-year smoking history (PYH), or non-HPV16 subtype) Low risk (LR) (all other patients). This prospective study evaluates dynamic changes in cfHPV-DNA during induction therapy, definitive (chemo)radiotherapy, and post-treatment surveillance in the context of risk and response-adaptive treatment for HPV + OPC. Quantitative cell-free HPV-DNA (cfHPV-DNA) in plasma represents an attractive non-invasive biomarker for grading treatment response and post-treatment surveillance. Response-adaptive de-escalated treatment is promising, however improved biomarkers are needed. ![]() ![]() Human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) has a favorable prognosis which has led to efforts to de-intensify treatment. ![]()
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