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Attempts to give HPV-positive throat cancer patients less radiation fell short: the standard dose remained better, so de-escalation is not yet routine.
HN002 (phase 2, 2021) found 60 Gy with weekly cisplatin met its acceptability threshold, but 60 Gy alone did not. HN005 (phase 2/3, presented 2025) was stopped after the de-intensified arms showed diminished progression-free survival while the 70 Gy control reached 2-year PFS of 98%. HPV status alone is an insufficient selector; ctHPV-DNA and imaging-response-adapted designs are the next approach.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
Both de-escalated arms failed non-inferiority (HR vs standard 7.42 and 5.55; non-inferiority margin HR 2.4); the trial did not proceed to phase III
Source306 patients; only the cisplatin arm met the PFS and swallowing (MDADI) criteria to advance
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| HN005: progression-free survival at 2 years (phase II non-inferiority)primary | 70 Gy + cisplatin (standard) | 136 | 98.1% | - | - | link |
| 60 Gy + cisplatin | 116 | 88.6% | ||||
| 60 Gy + nivolumab | 132 | 90.3% | ||||
| HN002: progression-free survival at 2 years (randomised phase II vs 85% historical control) | 60 Gy IMRT + weekly cisplatin | - | 90.5% | - | 0.04 (IMRT + cisplatin vs 85%) | link |
| 60 Gy IMRT alone | - | 87.6% |
The full inclusion and exclusion criteria are on the registry record. Read 2026-10-07. Recruiting overall does not mean a particular site is open; ask the study team.
ClinicalTrials.gov data courtesy of the US National Library of Medicine.
Shares Caution: de-escalating radiation on HPV status alone, ctHPV-DNA-adapted de-escalation of chemoradiation, HPV-positive (p16) head and neck cancer, HPV-positive oropharyngeal cancer.
Shares HPV-positive (p16) head and neck cancer, HPV-positive oropharyngeal cancer, NRG Oncology, Head and neck squamous cell carcinoma.
Shares HPV-positive oropharyngeal cancer, Oropharyngeal cancer (tonsil and base of tongue), NRG Oncology, Head and neck squamous cell carcinoma.
Shares HPV-positive (p16) head and neck cancer, HPV-positive oropharyngeal cancer, Oropharyngeal cancer (tonsil and base of tongue), IMRT / IGRT (modern external beam).
Shares HPV-positive (p16) head and neck cancer, HPV-positive oropharyngeal cancer, Oropharyngeal cancer (tonsil and base of tongue), IMRT / IGRT (modern external beam).
Shares HPV-positive oropharyngeal cancer, Oropharyngeal cancer (tonsil and base of tongue), Head and neck squamous cell carcinoma.
Shares HPV-positive oropharyngeal cancer, Oropharyngeal cancer (tonsil and base of tongue), Head and neck squamous cell carcinoma, IMRT / IGRT (modern external beam).
Shares HPV-positive oropharyngeal cancer, Oropharyngeal cancer (tonsil and base of tongue).
Every source this page cites, grouped by who published it. Grouping is read from the web address, not assigned by hand.
A source that has moved or gone is reported by the weekly link check. /audit/