How would you approach post-op radiation recommendations in patients who had neoadjuvant chemoimmunotherapy for HPV mediated OPSCC s/p TORS who have a complete pathologic response (pCR)?

Neoadjuvant immunotherapy for patients with TORS-eligible HPV-positive malignancies should not be done off study. KEYNOTE-689 did not include early-stage HPV+ oropharyngeal cancer patients, and as such, there is no prospective data to suggest a benefit to neoadjuvant immunotherapy in this patient po...

First, I agree with Dr @Dr. First Last that it is very unfortunate if this approach is being done off trial. If it were on trial or even off trial, there should have been an understanding of what the role of radiation would be before starting therapy.

The other issue from the question is that we are...

This is a very good question, and to date, we don't have data to address it. In the C--IO induction scenario, we have up to 20-25% pCR reported, but to date, we don't have data to address your question. Given this is HPV-positive disease, until we get further data, I would suggest a lower dose of RT...