ASCO 2024 Top 3 Practice Changing Head & Neck Cancer Studies

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ASCO 2024 Highlights on Practice-Changing Head & Neck Cancer Studies by Dr. Shlomo Koyfman
IMRT vs. IMPT (Proton Therapy) Phase III Study:
Objective: Compare intensity-modulated radiotherapy (IMRT) with intensity-modulated proton therapy (IMPT) for head and neck cancer.
Findings: Cure rates and efficacy are comparable between IMRT and IMPT. Proton therapy significantly reduces the need for feeding tubes and duration of use.
Impact: Confirms the precision of proton therapy and its ability to reduce side effects, potentially changing the standard of care.
F MISO Biomarker Trial (Nancy Lee, Sloan Kettering):
Objective: Utilize F MISO, a hypoxia imager PET scan, to identify hypoxic tumors and adapt treatment accordingly.
Findings: Tumors with persistent hypoxia during treatment showed worse outcomes. However, most patients exhibited sufficient oxygenation, allowing for reduced chemo-radiation duration from 7 to 3 weeks, with high cure rates and reduced toxicity.
Future Prospects: A phase III trial is planned to validate F MISO's ability to halve the treatment duration for HPV-positive patients, pending FDA approval.
Pathway Study on Immunotherapy Post-Curative Treatment:
Objective: Assess the role of immunotherapy in high-risk head and neck cancer patients post-curative treatment.
Findings: Despite a progression-free survival benefit, the study showed no overall survival benefit. The small sample size (100 patients) limits the power to change current practices.
Conclusion: Future studies need better patient selection, focusing on PD-L1 high patients to explore adjuvant immunotherapy benefits.