{"entity":{"id":"paper-rtog-1016-lancet-2019","kind":"paper","name":"NRG Oncology RTOG 1016: radiotherapy plus cetuximab versus cisplatin in HPV-positive oropharyngeal cancer","aka":[],"tldr":"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.\n\nFive-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.","asOf":"2026-09-17","links":[{"label":"Lancet 2019","url":"https://doi.org/10.1016/S0140-6736(18)32779-X"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/30449625/"}],"tags":[],"related":[],"cancers":["hpv-positive-oropharyngeal-cancer","oropharyngeal-cancer"],"sections":[],"technologies":[],"targets":[],"drugs":["cetuximab","cisplatin"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["rtog-1016"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet"],"dependsOn":[],"notes":[],"journal":"The Lancet","year":2019,"doi":"10.1016/S0140-6736(18)32779-X","pmid":"30449625","authors":"Gillison ML, Trotti AM, Harris J, et al.","paperType":"rct","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."],"whatItMeans":"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."],"changedPractice":true,"participants":849},"route":"/key-papers/paper-rtog-1016-lancet-2019/","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/"}],"drug":[{"id":"cetuximab","kind":"drug","name":"Cetuximab","route":"/drugs/cetuximab/"},{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"}],"trial":[{"id":"rtog-1016","kind":"trial","name":"RTOG 1016","route":"/trials/rtog-1016/"}],"journal":[{"id":"lancet","kind":"journal","name":"The Lancet","route":"/journals/lancet/"}]}}