OPTIMA: a phase II dose and volume de-escalation trial for human papillomavirus-positive oropharyngeal cancer

Human papillomavirus (HPV)+ oropharyngeal squamous cell carcinoma (OPSCC) is a distinct entity with RTOG 0129 reporting long-term overall survival (OS) of 71% for stage III/IV HPV+ disease compared with 30% for HPV-negative tumors after concurrent chemoradiotherapy (CRT) [1]. Since full-dose CRT imparts considerable toxicity, [2, 3] de-escalation for favorable HPV+ OPSCC represents a rational strategy.