Decreasing treatment burden in HPV-related OPSCC: A systematic review of clinical trials

Introduction: Favorable outcomes are observed after treatment with standard chemoradiotherapy (CRT) for Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) patients. The consistent growing interest on treatment-related toxicity burden, potentially jeopardizing survivors’ quality of life, led clinicians to investigate possible de-escalation strategies. Materials and Methods: A comprehensive systematic literature search of clinical trials was performed through the EMBASE database to provide an overview of the de-escalation strategies spectrum. Additionally, hand searching and clinicaltrials.gov were also used. Results: Herein, we report and discuss different approaches to de-escalation of therapy, with respect to both local and systemic strategies. Conclusions: Several promising de-escalation experiences have been published. However, while further evidence is awaited, no changes in the management nor deviation from the standard of care should be made outside of clinical trials.