{"entity":{"id":"ecog-e3311","kind":"trial","name":"ECOG-ACRIN E3311","aka":[],"tldr":"E3311 showed that after robotic surgery for HPV-positive throat cancer, patients at intermediate risk could safely have a lower radiotherapy dose, with about 95 in 100 free of progression at two years, so surgery-first de-escalation became a recognised option.","summary":"E3311 enrolled 519 patients with HPV-positive oropharyngeal cancer suitable for transoral surgery. After resection and neck dissection they were assigned by pathology: low-risk patients had no further treatment, intermediate-risk patients were randomised to 50 Gy or the standard 60 Gy of radiotherapy, and high-risk patients (extranodal extension or positive margins) had 66 Gy with cisplatin.\n\nReported by Robert Ferris in the Journal of Clinical Oncology in 2022, two-year progression-free survival was 96.9 percent with observation, 94.9 percent with 50 Gy, 96.0 percent with 60 Gy and 90.7 percent in the high-risk chemoradiation arm. Swallowing scores were good and the reduced-dose arm had less toxicity. Transoral surgery was safe in experienced hands, with low rates of serious bleeding.\n\nThe trial, alongside the phase 2 PATHOS study in Britain, made surgery followed by pathology-guided reduced adjuvant treatment a standard route to de-escalation for HPV-positive disease, in contrast to the definitive chemoradiation setting where reduced doses failed in NRG-HN005.","status":"positive","asOf":"2026-09-17","links":[{"label":"ClinicalTrials.gov NCT01898494","url":"https://clinicaltrials.gov/study/NCT01898494"}],"tags":[],"related":[],"cancers":["oropharyngeal-cancer","hpv-positive-oropharyngeal-cancer"],"sections":[],"technologies":["tors","imrt-igrt"],"targets":[],"drugs":["cisplatin"],"companies":[],"institutions":["ecog-acrin"],"pathways":[],"terms":["hpv-p16","pfs"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT01898494","phase":"2","setting":"Resectable HPV-positive oropharyngeal cancer: transoral surgery and neck dissection, then adjuvant treatment by pathological risk, with intermediate-risk patients randomised to 50 or 60 Gy of radiotherapy","sponsor":"ECOG-ACRIN Cancer Research Group","result":"Two-year progression-free survival 96.9% (observation), 94.9% (50 Gy), 96.0% (60 Gy) and 90.7% (high-risk chemoradiation).","yearReported":2022,"enrolled":519,"outcomes":[{"endpoint":"Progression-free survival at 2 years","primary":true,"unit":"%","arms":[{"name":"Low risk, observation","value":96.9},{"name":"Intermediate risk, 50 Gy","value":94.9},{"name":"Intermediate risk, 60 Gy","value":96},{"name":"High risk, 66 Gy + cisplatin","value":90.7}]}],"replication":"PATHOS (phase 2/3, United Kingdom) is testing the same design with swallowing and survival endpoints; the Mayo Clinic MC1273 series reported similar control with even lower postoperative doses."},"route":"/trials/ecog-e3311/","neighbours":{"cancer":[{"id":"hpv-positive-oropharyngeal-cancer","kind":"cancer","name":"HPV-positive oropharyngeal cancer","route":"/cancers/hpv-positive-oropharyngeal-cancer/"},{"id":"oropharyngeal-cancer","kind":"cancer","name":"Oropharyngeal cancer (tonsil and base of tongue)","route":"/cancers/oropharyngeal-cancer/"}],"technology":[{"id":"imrt-igrt","kind":"technology","name":"IMRT / IGRT (modern external beam)","route":"/technologies/imrt-igrt/"},{"id":"tors","kind":"technology","name":"Transoral robotic surgery (TORS)","route":"/technologies/tors/"}],"drug":[{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"}],"institution":[{"id":"ecog-acrin","kind":"institution","name":"ECOG-ACRIN Cancer Research Group","route":"/institutions/ecog-acrin/"}],"term":[{"id":"hpv-p16","kind":"term","name":"HPV-positive (p16) head and neck cancer","route":"/terms/hpv-p16/"},{"id":"pfs","kind":"term","name":"Progression-free survival (PFS)","route":"/terms/pfs/"}],"trial":[{"id":"pathos","kind":"trial","name":"PATHOS","route":"/trials/pathos/"}]}}