# NRG Oncology RTOG 1016: radiotherapy plus cetuximab versus cisplatin in HPV-positive oropharyngeal cancer

Source: https://onco.cc/key-papers/paper-rtog-1016-lancet-2019/  
OnCo record `paper-rtog-1016-lancet-2019` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Trying to reduce toxicity by swapping cisplatin for cetuximab during radiotherapy in HPV-positive oropharyngeal cancer backfired: cetuximab gave worse survival and more recurrences with no reduction in toxicity, so cisplatin remains standard.

## Summary

Phase 3 non-inferiority trial of 849 patients with HPV-positive (p16-positive) oropharyngeal cancer randomised to accelerated intensity-modulated radiotherapy with cisplatin or with cetuximab.

Five-year overall survival was 77.9 percent with cetuximab against 84.6 percent with cisplatin (hazard ratio 1.45, non-inferiority not met) and five-year locoregional failure 17.3 versus 9.9 percent; acute and late toxicity rates were similar.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet
- Year: 2019
- DOI: 10.1016/S0140-6736(18)32779-X
- Authors: Gillison ML, Trotti AM, Harris J, et al.
- Findings: Five-year overall survival 77.9 percent (cetuximab) vs 84.6 percent (cisplatin); hazard ratio 1.45.; Five-year locoregional failure 17.3 percent vs 9.9 percent.
- What it means: Cisplatin chemoradiation is the standard for HPV-positive oropharyngeal cancer; cetuximab is reserved for patients who cannot receive cisplatin.
- Caveats: Accelerated radiotherapy fractionation differs from standard practice in some countries.

## Sources

- Lancet 2019: https://doi.org/10.1016/S0140-6736(18)32779-X
- PubMed: https://pubmed.ncbi.nlm.nih.gov/30449625/

## Connected records

- cancers: [HPV-positive oropharyngeal cancer](https://onco.cc/cancers/hpv-positive-oropharyngeal-cancer/), [Oropharyngeal cancer (tonsil and base of tongue)](https://onco.cc/cancers/oropharyngeal-cancer/)
- drugs: [Cetuximab](https://onco.cc/drugs/cetuximab/), [Cisplatin](https://onco.cc/drugs/cisplatin/)
- trials: [RTOG 1016](https://onco.cc/trials/rtog-1016/)
- journals: [The Lancet](https://onco.cc/journals/lancet/)

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