Trial Outcomes & Findings for Evaluation of De-escalated Adjuvant Radiation Therapy for Human Papillomavirus (HPV)-Associated Oropharynx Cancer (NCT NCT02908477)

NCT ID: NCT02908477

Last Updated: 2025-02-11

Results Overview

To compare rate of late grade 3-5 toxicities between de-escalated adjuvant radiation therapy (DART) and standard adjuvant therapy.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

228 participants

Primary outcome timeframe

2 years

Results posted on

2025-02-11

Participant Flow

Participant milestones

Participant milestones
Measure
De-escalated Adjuvant Radiation Therapy (DART)
Docetaxel 15 mg/m2 days 1, 8 and Radiation Therapy (RT) 30 Gy/1.5 Gy fractions twice daily (b.i.d.) days 1-12 only (intermediate risk) or 36 Gy/1.8 Gy b.i.d. fractions (high risk)\> \> Adjuvant Radiation Therapy: 60 Gy / 2 Gy fractions (standard arm)\> 30 - 36 Gy / 1.5 - 1.8 Gy b.i.d. fractions (experimental arm)\> \> Docetaxel: 15 mg/m2. Experimental arm only.
Standard of Care Treatment (SOC)
RT 60 Gy/2 Gy fractions daily (qday) days 1-40. \> For high risk, add weekly Cisplatin 40 mg/m2 (Around days 1, 8, 15, 22, 29, 36)\> \> Adjuvant Radiation Therapy: 60 Gy / 2 Gy fractions (standard arm)\> 30 - 36 Gy / 1.5 - 1.8 Gy b.i.d. fractions (experimental arm)\> \> Cisplatin: 40 mg/m2. Standard arm only.
Overall Study
STARTED
136
92
Overall Study
COMPLETED
128
64
Overall Study
NOT COMPLETED
8
28

Reasons for withdrawal

Reasons for withdrawal
Measure
De-escalated Adjuvant Radiation Therapy (DART)
Docetaxel 15 mg/m2 days 1, 8 and Radiation Therapy (RT) 30 Gy/1.5 Gy fractions twice daily (b.i.d.) days 1-12 only (intermediate risk) or 36 Gy/1.8 Gy b.i.d. fractions (high risk)\> \> Adjuvant Radiation Therapy: 60 Gy / 2 Gy fractions (standard arm)\> 30 - 36 Gy / 1.5 - 1.8 Gy b.i.d. fractions (experimental arm)\> \> Docetaxel: 15 mg/m2. Experimental arm only.
Standard of Care Treatment (SOC)
RT 60 Gy/2 Gy fractions daily (qday) days 1-40. \> For high risk, add weekly Cisplatin 40 mg/m2 (Around days 1, 8, 15, 22, 29, 36)\> \> Adjuvant Radiation Therapy: 60 Gy / 2 Gy fractions (standard arm)\> 30 - 36 Gy / 1.5 - 1.8 Gy b.i.d. fractions (experimental arm)\> \> Cisplatin: 40 mg/m2. Standard arm only.
Overall Study
Withdrawal by Subject
8
28

Baseline Characteristics

Evaluation of De-escalated Adjuvant Radiation Therapy for Human Papillomavirus (HPV)-Associated Oropharynx Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
De-escalated Adjuvant Radiation Therapy (DART)
n=136 Participants
Docetaxel 15 mg/m2 days 1, 8 and Radiation Therapy (RT) 30 Gy/1.5 Gy fractions twice daily (b.i.d.) days 1-12 only (intermediate risk) or 36 Gy/1.8 Gy b.i.d. fractions (high risk)\> \> Adjuvant Radiation Therapy: 60 Gy / 2 Gy fractions (standard arm)\> 30 - 36 Gy / 1.5 - 1.8 Gy b.i.d. fractions (experimental arm)\> \> Docetaxel: 15 mg/m2. Experimental arm only.
Standard of Care Treatment (SOC)
n=92 Participants
RT 60 Gy/2 Gy fractions daily (qday) days 1-40. \> For high risk, add weekly Cisplatin 40 mg/m2 (Around days 1, 8, 15, 22, 29, 36)\> \> Adjuvant Radiation Therapy: 60 Gy / 2 Gy fractions (standard arm)\> 30 - 36 Gy / 1.5 - 1.8 Gy b.i.d. fractions (experimental arm)\> \> Cisplatin: 40 mg/m2. Standard arm only.
Total
n=228 Participants
Total of all reporting groups
Age, Continuous
59 years
n=5 Participants
58 years
n=7 Participants
59 years
n=5 Participants
Sex: Female, Male
Female
15 Participants
n=5 Participants
11 Participants
n=7 Participants
26 Participants
n=5 Participants
Sex: Female, Male
Male
121 Participants
n=5 Participants
81 Participants
n=7 Participants
202 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
n=5 Participants
1 Participants
n=7 Participants
4 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
123 Participants
n=5 Participants
84 Participants
n=7 Participants
207 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
10 Participants
n=5 Participants
7 Participants
n=7 Participants
17 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Asian
2 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
White
128 Participants
n=5 Participants
87 Participants
n=7 Participants
215 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
5 Participants
n=5 Participants
4 Participants
n=7 Participants
9 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 2 years

Population: All treated patients

To compare rate of late grade 3-5 toxicities between de-escalated adjuvant radiation therapy (DART) and standard adjuvant therapy.

Outcome measures

Outcome measures
Measure
Standard of Care Treatment (SOC)
n=64 Participants
RT 60 Gy/2 Gy fractions daily (qday) days 1-40. \> For high risk, add weekly Cisplatin 40 mg/m2 (Around days 1, 8, 15, 22, 29, 36)\> \> Adjuvant Radiation Therapy: 60 Gy / 2 Gy fractions (standard arm)\> 30 - 36 Gy / 1.5 - 1.8 Gy b.i.d. fractions (experimental arm)\> \> Cisplatin: 40 mg/m2. Standard arm only.
De-escalated Adjuvant Radiation Therapy (DART)
n=130 Participants
Docetaxel 15 mg/m2 days 1, 8 and Radiation Therapy (RT) 30 Gy/1.5 Gy fractions twice daily (b.i.d.) days 1-12 only (intermediate risk) or 36 Gy/1.8 Gy b.i.d. fractions (high risk)\> \> Adjuvant Radiation Therapy: 60 Gy / 2 Gy fractions (standard arm)\> 30 - 36 Gy / 1.5 - 1.8 Gy b.i.d. fractions (experimental arm)\> \> Docetaxel: 15 mg/m2. Experimental arm only.
Grade 3+ Adverse Events Rate
.115 events per participant
.032 events per participant

SECONDARY outcome

Timeframe: 2 years

Local/regional failure percentage as assessed by imaging or physical exam at 2 years after study registration for patients treated with DART vs standard therapy.

Outcome measures

Outcome measures
Measure
Standard of Care Treatment (SOC)
n=64 Participants
RT 60 Gy/2 Gy fractions daily (qday) days 1-40. \> For high risk, add weekly Cisplatin 40 mg/m2 (Around days 1, 8, 15, 22, 29, 36)\> \> Adjuvant Radiation Therapy: 60 Gy / 2 Gy fractions (standard arm)\> 30 - 36 Gy / 1.5 - 1.8 Gy b.i.d. fractions (experimental arm)\> \> Cisplatin: 40 mg/m2. Standard arm only.
De-escalated Adjuvant Radiation Therapy (DART)
n=130 Participants
Docetaxel 15 mg/m2 days 1, 8 and Radiation Therapy (RT) 30 Gy/1.5 Gy fractions twice daily (b.i.d.) days 1-12 only (intermediate risk) or 36 Gy/1.8 Gy b.i.d. fractions (high risk)\> \> Adjuvant Radiation Therapy: 60 Gy / 2 Gy fractions (standard arm)\> 30 - 36 Gy / 1.5 - 1.8 Gy b.i.d. fractions (experimental arm)\> \> Docetaxel: 15 mg/m2. Experimental arm only.
Local/Regional Control
98.3 percentage of participants
95.9 percentage of participants

SECONDARY outcome

Timeframe: 1 year

To compare the overall QOL between DART and standard adjuvant therapy at 1-year post-treatment as measured by the Functional Assessment of Cancer Therapy - Head \& Neck (FACT-HN) questionnaire. The FACT-HN consists of 12 questions related to symptoms and feeling over the past 7 days. Items are answered on a scale of 0-4 where 0=not at all, 1=a little bit, 2=somewhat, 3=quite a bit, and 4=very much.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 1 year

To compare the overall QOL between DART and standard adjuvant therapy at 1-year post-treatment as measured by the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) Head and Neck Module (EORTC-QLQ-HN35). The questionnaire consists of 35 items related to symptoms or problems during the past week. Thirty (30) items are answered on a scale of 0-4 where 0=not at all; 1=a little; 3=quite a bit, and 4=very much, and five (5) items are answered with yes/no.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 2 years

Percentage of patients alive at 2 years.

Outcome measures

Outcome measures
Measure
Standard of Care Treatment (SOC)
n=64 Participants
RT 60 Gy/2 Gy fractions daily (qday) days 1-40. \> For high risk, add weekly Cisplatin 40 mg/m2 (Around days 1, 8, 15, 22, 29, 36)\> \> Adjuvant Radiation Therapy: 60 Gy / 2 Gy fractions (standard arm)\> 30 - 36 Gy / 1.5 - 1.8 Gy b.i.d. fractions (experimental arm)\> \> Cisplatin: 40 mg/m2. Standard arm only.
De-escalated Adjuvant Radiation Therapy (DART)
n=130 Participants
Docetaxel 15 mg/m2 days 1, 8 and Radiation Therapy (RT) 30 Gy/1.5 Gy fractions twice daily (b.i.d.) days 1-12 only (intermediate risk) or 36 Gy/1.8 Gy b.i.d. fractions (high risk)\> \> Adjuvant Radiation Therapy: 60 Gy / 2 Gy fractions (standard arm)\> 30 - 36 Gy / 1.5 - 1.8 Gy b.i.d. fractions (experimental arm)\> \> Docetaxel: 15 mg/m2. Experimental arm only.
Overall Survival
98.3 percentage of participants
96.9 percentage of participants

SECONDARY outcome

Timeframe: 2 years

Percentage of patients disease free and alive at 2 years.

Outcome measures

Outcome measures
Measure
Standard of Care Treatment (SOC)
n=64 Participants
RT 60 Gy/2 Gy fractions daily (qday) days 1-40. \> For high risk, add weekly Cisplatin 40 mg/m2 (Around days 1, 8, 15, 22, 29, 36)\> \> Adjuvant Radiation Therapy: 60 Gy / 2 Gy fractions (standard arm)\> 30 - 36 Gy / 1.5 - 1.8 Gy b.i.d. fractions (experimental arm)\> \> Cisplatin: 40 mg/m2. Standard arm only.
De-escalated Adjuvant Radiation Therapy (DART)
n=130 Participants
Docetaxel 15 mg/m2 days 1, 8 and Radiation Therapy (RT) 30 Gy/1.5 Gy fractions twice daily (b.i.d.) days 1-12 only (intermediate risk) or 36 Gy/1.8 Gy b.i.d. fractions (high risk)\> \> Adjuvant Radiation Therapy: 60 Gy / 2 Gy fractions (standard arm)\> 30 - 36 Gy / 1.5 - 1.8 Gy b.i.d. fractions (experimental arm)\> \> Docetaxel: 15 mg/m2. Experimental arm only.
Disease-free Survival
96.6 percentage of participants
88.2 percentage of participants

SECONDARY outcome

Timeframe: 2 years

Distant failure is defined as cancer that has recurred or spread to a part of the body far away from the original tumor site

Outcome measures

Outcome data not reported

Adverse Events

De-escalated Adjuvant Radiation Therapy (DART)

Serious events: 0 serious events
Other events: 128 other events
Deaths: 2 deaths

Standard of Care Treatment (SOC)

Serious events: 1 serious events
Other events: 60 other events
Deaths: 9 deaths

Serious adverse events

Serious adverse events
Measure
De-escalated Adjuvant Radiation Therapy (DART)
n=136 participants at risk
Docetaxel: 15 mg/m2. Experimental arm only.
Standard of Care Treatment (SOC)
n=92 participants at risk
Cisplatin: 40 mg/m2. Standard arm only.
Blood and lymphatic system disorders
Febrile neutropenia
0.00%
0/136 • Adverse events were collected over 2 years and mortality was collected over 5 years
1.1%
1/92 • Number of events 1 • Adverse events were collected over 2 years and mortality was collected over 5 years

Other adverse events

Other adverse events
Measure
De-escalated Adjuvant Radiation Therapy (DART)
n=136 participants at risk
Docetaxel: 15 mg/m2. Experimental arm only.
Standard of Care Treatment (SOC)
n=92 participants at risk
Cisplatin: 40 mg/m2. Standard arm only.
Skin and subcutaneous tissue disorders
Alopecia
18.4%
25/136 • Number of events 25 • Adverse events were collected over 2 years and mortality was collected over 5 years
18.5%
17/92 • Number of events 17 • Adverse events were collected over 2 years and mortality was collected over 5 years
Psychiatric disorders
Anxiety
22.8%
31/136 • Number of events 31 • Adverse events were collected over 2 years and mortality was collected over 5 years
21.7%
20/92 • Number of events 20 • Adverse events were collected over 2 years and mortality was collected over 5 years
Respiratory, thoracic and mediastinal disorders
Aspiration
8.8%
12/136 • Number of events 12 • Adverse events were collected over 2 years and mortality was collected over 5 years
6.5%
6/92 • Number of events 6 • Adverse events were collected over 2 years and mortality was collected over 5 years
Nervous system disorders
Brachial plexopathy
7.4%
10/136 • Number of events 10 • Adverse events were collected over 2 years and mortality was collected over 5 years
5.4%
5/92 • Number of events 5 • Adverse events were collected over 2 years and mortality was collected over 5 years
Metabolism and nutrition disorders
Dehydration
35.3%
48/136 • Number of events 48 • Adverse events were collected over 2 years and mortality was collected over 5 years
39.1%
36/92 • Number of events 36 • Adverse events were collected over 2 years and mortality was collected over 5 years
Psychiatric disorders
Depression
14.0%
19/136 • Number of events 19 • Adverse events were collected over 2 years and mortality was collected over 5 years
17.4%
16/92 • Number of events 16 • Adverse events were collected over 2 years and mortality was collected over 5 years
Injury, poisoning and procedural complications
Dermatitis radiation
72.1%
98/136 • Number of events 98 • Adverse events were collected over 2 years and mortality was collected over 5 years
62.0%
57/92 • Number of events 57 • Adverse events were collected over 2 years and mortality was collected over 5 years
Gastrointestinal disorders
Dry mouth
94.1%
128/136 • Number of events 128 • Adverse events were collected over 2 years and mortality was collected over 5 years
65.2%
60/92 • Number of events 60 • Adverse events were collected over 2 years and mortality was collected over 5 years
Nervous system disorders
Dysarthria
8.8%
12/136 • Number of events 12 • Adverse events were collected over 2 years and mortality was collected over 5 years
8.7%
8/92 • Number of events 8 • Adverse events were collected over 2 years and mortality was collected over 5 years
Nervous system disorders
Dysesthesia
41.2%
56/136 • Number of events 56 • Adverse events were collected over 2 years and mortality was collected over 5 years
27.2%
25/92 • Number of events 25 • Adverse events were collected over 2 years and mortality was collected over 5 years
Nervous system disorders
Dysgeusia
91.2%
124/136 • Number of events 124 • Adverse events were collected over 2 years and mortality was collected over 5 years
62.0%
57/92 • Number of events 57 • Adverse events were collected over 2 years and mortality was collected over 5 years
Gastrointestinal disorders
Dysphagia
85.3%
116/136 • Number of events 116 • Adverse events were collected over 2 years and mortality was collected over 5 years
63.0%
58/92 • Number of events 58 • Adverse events were collected over 2 years and mortality was collected over 5 years
Ear and labyrinth disorders
Ear pain
14.7%
20/136 • Number of events 20 • Adverse events were collected over 2 years and mortality was collected over 5 years
16.3%
15/92 • Number of events 15 • Adverse events were collected over 2 years and mortality was collected over 5 years
General disorders
Edema face
13.2%
18/136 • Number of events 18 • Adverse events were collected over 2 years and mortality was collected over 5 years
13.0%
12/92 • Number of events 12 • Adverse events were collected over 2 years and mortality was collected over 5 years
Gastrointestinal disorders
Esophagitis
36.0%
49/136 • Number of events 49 • Adverse events were collected over 2 years and mortality was collected over 5 years
27.2%
25/92 • Number of events 25 • Adverse events were collected over 2 years and mortality was collected over 5 years
Nervous system disorders
Facial nerve disorder
5.1%
7/136 • Number of events 7 • Adverse events were collected over 2 years and mortality was collected over 5 years
1.1%
1/92 • Number of events 1 • Adverse events were collected over 2 years and mortality was collected over 5 years
General disorders
Fatigue
91.2%
124/136 • Number of events 124 • Adverse events were collected over 2 years and mortality was collected over 5 years
65.2%
60/92 • Number of events 60 • Adverse events were collected over 2 years and mortality was collected over 5 years
Musculoskeletal and connective tissue disorders
Fibrosis deep connect tissue
72.1%
98/136 • Number of events 98 • Adverse events were collected over 2 years and mortality was collected over 5 years
55.4%
51/92 • Number of events 51 • Adverse events were collected over 2 years and mortality was collected over 5 years
Ear and labyrinth disorders
Hearing impaired
14.0%
19/136 • Number of events 19 • Adverse events were collected over 2 years and mortality was collected over 5 years
17.4%
16/92 • Number of events 16 • Adverse events were collected over 2 years and mortality was collected over 5 years
Respiratory, thoracic and mediastinal disorders
Hoarseness
33.1%
45/136 • Number of events 45 • Adverse events were collected over 2 years and mortality was collected over 5 years
31.5%
29/92 • Number of events 29 • Adverse events were collected over 2 years and mortality was collected over 5 years
Respiratory, thoracic and mediastinal disorders
Laryngeal edema
2.9%
4/136 • Number of events 4 • Adverse events were collected over 2 years and mortality was collected over 5 years
5.4%
5/92 • Number of events 5 • Adverse events were collected over 2 years and mortality was collected over 5 years
Vascular disorders
Lymphedema
53.7%
73/136 • Number of events 73 • Adverse events were collected over 2 years and mortality was collected over 5 years
50.0%
46/92 • Number of events 46 • Adverse events were collected over 2 years and mortality was collected over 5 years
General disorders
Malaise
9.6%
13/136 • Number of events 13 • Adverse events were collected over 2 years and mortality was collected over 5 years
7.6%
7/92 • Number of events 7 • Adverse events were collected over 2 years and mortality was collected over 5 years
Infections and infestations
Mucosal infection
22.1%
30/136 • Number of events 30 • Adverse events were collected over 2 years and mortality was collected over 5 years
14.1%
13/92 • Number of events 13 • Adverse events were collected over 2 years and mortality was collected over 5 years
Gastrointestinal disorders
Mucositis oral
72.1%
98/136 • Number of events 98 • Adverse events were collected over 2 years and mortality was collected over 5 years
55.4%
51/92 • Number of events 51 • Adverse events were collected over 2 years and mortality was collected over 5 years
Gastrointestinal disorders
Nausea
25.0%
34/136 • Number of events 34 • Adverse events were collected over 2 years and mortality was collected over 5 years
31.5%
29/92 • Number of events 29 • Adverse events were collected over 2 years and mortality was collected over 5 years
General disorders
Neck edema
48.5%
66/136 • Number of events 66 • Adverse events were collected over 2 years and mortality was collected over 5 years
54.3%
50/92 • Number of events 50 • Adverse events were collected over 2 years and mortality was collected over 5 years
Gastrointestinal disorders
Oral pain
71.3%
97/136 • Number of events 97 • Adverse events were collected over 2 years and mortality was collected over 5 years
53.3%
49/92 • Number of events 49 • Adverse events were collected over 2 years and mortality was collected over 5 years
General disorders
Pain
74.3%
101/136 • Number of events 101 • Adverse events were collected over 2 years and mortality was collected over 5 years
58.7%
54/92 • Number of events 54 • Adverse events were collected over 2 years and mortality was collected over 5 years
Skin and subcutaneous tissue disorders
Pain of skin
6.6%
9/136 • Number of events 9 • Adverse events were collected over 2 years and mortality was collected over 5 years
31.5%
29/92 • Number of events 29 • Adverse events were collected over 2 years and mortality was collected over 5 years
Nervous system disorders
Paresthesia
53.7%
73/136 • Number of events 73 • Adverse events were collected over 2 years and mortality was collected over 5 years
41.3%
38/92 • Number of events 38 • Adverse events were collected over 2 years and mortality was collected over 5 years
Respiratory, thoracic and mediastinal disorders
Pharyngolaryngeal pain
22.8%
31/136 • Number of events 31 • Adverse events were collected over 2 years and mortality was collected over 5 years
22.8%
21/92 • Number of events 21 • Adverse events were collected over 2 years and mortality was collected over 5 years
Gastrointestinal disorders
Salivary duct inflammation
68.4%
93/136 • Number of events 93 • Adverse events were collected over 2 years and mortality was collected over 5 years
51.1%
47/92 • Number of events 47 • Adverse events were collected over 2 years and mortality was collected over 5 years
Musculoskeletal and connective tissue disorders
Superficial soft tissue fibrosis
74.3%
101/136 • Number of events 101 • Adverse events were collected over 2 years and mortality was collected over 5 years
54.3%
50/92 • Number of events 50 • Adverse events were collected over 2 years and mortality was collected over 5 years
Musculoskeletal and connective tissue disorders
Trismus
24.3%
33/136 • Number of events 33 • Adverse events were collected over 2 years and mortality was collected over 5 years
30.4%
28/92 • Number of events 28 • Adverse events were collected over 2 years and mortality was collected over 5 years
Respiratory, thoracic and mediastinal disorders
Voice alteration
39.0%
53/136 • Number of events 53 • Adverse events were collected over 2 years and mortality was collected over 5 years
33.7%
31/92 • Number of events 31 • Adverse events were collected over 2 years and mortality was collected over 5 years
Gastrointestinal disorders
Vomiting
2.2%
3/136 • Number of events 3 • Adverse events were collected over 2 years and mortality was collected over 5 years
6.5%
6/92 • Number of events 6 • Adverse events were collected over 2 years and mortality was collected over 5 years
Investigations
Weight loss
34.6%
47/136 • Number of events 47 • Adverse events were collected over 2 years and mortality was collected over 5 years
43.5%
40/92 • Number of events 40 • Adverse events were collected over 2 years and mortality was collected over 5 years
Nervous system disorders
Accessory nerve disorder
19.9%
27/136 • Number of events 27 • Adverse events were collected over 2 years and mortality was collected over 5 years
14.1%
13/92 • Number of events 13 • Adverse events were collected over 2 years and mortality was collected over 5 years

Additional Information

Katharine Price M.D.

Mayo Clinic

Phone: 507-284-6139

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place