Radiotherapy Dose De-escalation in HPV-Associated Cancers of the Oropharynx

NCT ID: NCT04667585

Last Updated: 2025-08-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-04-12

Study Completion Date

2028-01-31

Brief Summary

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The purpose of this study is to use intra-treatment 18FDG-PET/CT during definitive radiation therapy for human papillomavirus (HPV)-related oropharyngeal cancer (OPC) as an imaging biomarker to identify and select patients with a favorable response for chemoradiation dose de-escalation. This study will prospectively evaluate the clinical outcomes for patients undergoing dose de-escalation.

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Detailed Description

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Conditions

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Oropharynx Cancer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Participants undergo either reduced radiation dose or standard radiation dose based on the metabolic signature from an Interim 18FDG-PET/CT
Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Participants

Study Groups

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Interim PET-CT with dose de-escalation

Participants will receive an interim PET-CT approximately 2 weeks into radiation therapy.

Group Type EXPERIMENTAL

De-escalated radiation dose

Intervention Type RADIATION

Reduced dose of radiation applied to remaining radiation therapy when favorable interim PET-CT signature is produced

18 fluorodeoxyglucose (FDG)-positron emission tomography (PET)-Computed Tomography (CT)

Intervention Type OTHER

The CT scan - also called computerized tomography or just CT - combines a series of X-ray views taken from many different angles to produce cross-sectional images of the bones and soft tissues inside the body. CT scans in planning radiation therapy are standard of care. A PET is a highly specialized imaging technique that uses short-lived radioactive substances (such as FDG a simple sugar labeled with a radioactive atom) to produce three-dimensional colored images of those substances functioning within the body. These images are called PET scans and the technique is termed PET scanning. PET scanning provides information about the body's chemistry not available through other procedures. Unlike CT or MRI (magnetic resonance imaging), techniques that look at anatomy or body form, PET studies metabolic activity or body function.

Interim PET-CT with standard radiation

Group Type ACTIVE_COMPARATOR

Standard radiation dose

Intervention Type RADIATION

Standard dose of radiation applied to remaining radiation therapy when favorable PET-CT signature is not produced

18 fluorodeoxyglucose (FDG)-positron emission tomography (PET)-Computed Tomography (CT)

Intervention Type OTHER

The CT scan - also called computerized tomography or just CT - combines a series of X-ray views taken from many different angles to produce cross-sectional images of the bones and soft tissues inside the body. CT scans in planning radiation therapy are standard of care. A PET is a highly specialized imaging technique that uses short-lived radioactive substances (such as FDG a simple sugar labeled with a radioactive atom) to produce three-dimensional colored images of those substances functioning within the body. These images are called PET scans and the technique is termed PET scanning. PET scanning provides information about the body's chemistry not available through other procedures. Unlike CT or MRI (magnetic resonance imaging), techniques that look at anatomy or body form, PET studies metabolic activity or body function.

Interventions

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De-escalated radiation dose

Reduced dose of radiation applied to remaining radiation therapy when favorable interim PET-CT signature is produced

Intervention Type RADIATION

Standard radiation dose

Standard dose of radiation applied to remaining radiation therapy when favorable PET-CT signature is not produced

Intervention Type RADIATION

18 fluorodeoxyglucose (FDG)-positron emission tomography (PET)-Computed Tomography (CT)

The CT scan - also called computerized tomography or just CT - combines a series of X-ray views taken from many different angles to produce cross-sectional images of the bones and soft tissues inside the body. CT scans in planning radiation therapy are standard of care. A PET is a highly specialized imaging technique that uses short-lived radioactive substances (such as FDG a simple sugar labeled with a radioactive atom) to produce three-dimensional colored images of those substances functioning within the body. These images are called PET scans and the technique is termed PET scanning. PET scanning provides information about the body's chemistry not available through other procedures. Unlike CT or MRI (magnetic resonance imaging), techniques that look at anatomy or body form, PET studies metabolic activity or body function.

Intervention Type OTHER

Other Intervention Names

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18 FDG-PET/CT

Eligibility Criteria

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Inclusion Criteria

* Histologic documentation of squamous cell carcinoma of the oropharynx with p16-positive immunohistochemical staining and/or positive HPV in situ hybridization (ISH) and/or positive HPV PCR
* Stage I-III (AJCC 8th edition) with plan for concurrent chemotherapy per standard of care treatment
* Zubrod/ECOG score of 0-1
* Weight loss \<10% in the 3 months prior to diagnosis
* ≥ 18 years of age
* No prior chemotherapy for their current cancer diagnosis

Exclusion Criteria

* Prior radiotherapy to the head and neck
* Medical contraindications to radiation therapy
* Absence of gross disease on imaging prior to beginning radiation therapy
* Distant metastatic disease
* Medical contraindication to PET/CT
* History of active cancer other than non-melanoma skin cancer within the last 5 years
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Duke University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jared Robbins, MD

Role: PRINCIPAL_INVESTIGATOR

DUHS

Locations

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Duke University Medical Center

Durham, North Carolina, United States

Site Status RECRUITING

Duke Raleigh Hospital

Raleigh, North Carolina, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Heather Franklin, BSN, RN, OCN

Role: CONTACT

(919) 668-3726

Facility Contacts

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Heather Franklin, RN BSN OCN

Role: primary

919 668 3726

Heather Franklin, BSN RN OCN

Role: primary

(919) 668-3726

Other Identifiers

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Pro00105899

Identifier Type: -

Identifier Source: org_study_id

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