{"entity":{"id":"pathos","kind":"trial","name":"PATHOS","aka":[],"tldr":"PATHOS is the British trial asking whether people with HPV-positive throat cancer who have robotic surgery can safely be given less radiotherapy, or radiotherapy without chemotherapy, and keep better swallowing.","summary":"PATHOS enrols patients with HPV-positive oropharyngeal cancer whose tumours can be removed transorally. After surgery and neck dissection, intermediate-risk patients are randomised to 50 or 60 Gy of postoperative radiotherapy, and high-risk patients (extranodal extension or positive margins) to radiotherapy alone or radiotherapy with cisplatin. The phase 2 primary endpoint is patient-reported swallowing at one year; the phase 3 endpoint is overall survival.\n\nThe design mirrors ECOG-ACRIN E3311 but goes further by dropping chemotherapy in the high-risk group, which E3311 did not test. It also collects swallowing, feeding-tube use and quality-of-life data prospectively, since function is the reason for de-escalating.\n\nRecruitment across the United Kingdom, Ireland and other European centres continues; the phase 3 answer will decide whether reduced adjuvant treatment after transoral surgery becomes routine rather than a trial option.","status":"active","asOf":"2026-09-17","links":[{"label":"ClinicalTrials.gov NCT02215265","url":"https://clinicaltrials.gov/study/NCT02215265"}],"tags":[],"related":[],"cancers":["oropharyngeal-cancer","hpv-positive-oropharyngeal-cancer"],"sections":[],"technologies":["tors","imrt-igrt"],"targets":[],"drugs":["cisplatin"],"companies":[],"institutions":[],"pathways":[],"terms":["hpv-p16","chemoradiation"],"trials":["ecog-e3311"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT02215265","phase":"2/3","setting":"Resectable HPV-positive oropharyngeal cancer: transoral surgery and neck dissection, then risk-stratified reduction of adjuvant treatment (50 versus 60 Gy in intermediate risk; radiotherapy alone versus chemoradiation in high risk), with swallowing function and survival as endpoints","sponsor":"Velindre University NHS Trust","outcomes":[],"replication":"ECOG-ACRIN E3311 reported two-year progression-free survival near 95 percent with reduced-dose radiotherapy in the same intermediate-risk group."},"route":"/trials/pathos/","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/"}],"term":[{"id":"chemoradiation","kind":"term","name":"Chemoradiation (chemoradiotherapy, CRT)","route":"/terms/chemoradiation/"},{"id":"hpv-p16","kind":"term","name":"HPV-positive (p16) head and neck cancer","route":"/terms/hpv-p16/"}],"trial":[{"id":"ecog-e3311","kind":"trial","name":"ECOG-ACRIN E3311","route":"/trials/ecog-e3311/"}]}}