FMISO PET-guided radiation dose de-escalation maintains long-term outcomes in HPV-associated oropharyngeal cancer

ASCO 2026

29 May - 2 Jun 2026

Published: 1 Jun 2026

Rating:

Save

Dr Nancy Y. Lee - Memorial Sloan Kettering, New York, USA

Dr Nancy Y. Lee talks to ecancer at ASCO 2026 about long-term follow-up data on FMISO PET-guided radiation dose de-escalation in patients with HPV-associated oropharyngeal cancer.

The study found that patients without tumour hypoxia who received substantially lower-dose radiotherapy achieved comparable five-year overall survival, progression-free survival, and local and regional control to those receiving standard-dose treatment, supporting a personalised approach to radiation de-escalation.

This is a study that is looking at the definitive treatment for HPV-driven oropharyngeal cancer. We used a personalised approach using a special PET-scan called 18-fluoromisonidazole FMISO PET-scan to determine what is the dose of radiation that patients should use.

Could you outline the methodology?

The idea is that one size does not fit all so we’re using FMISO PET-scan to select which HPV-driven oropharyngeal cancer can receive a reduced dose of chemoradiation.

What did you find?

We found that among 430 HPV-driven oropharyngeal cancers we were able to dose reduce to 30Gy from 70Gy in 75% of the patients.

What impact could these findings have?

The impact is tremendous. There’s a 67% reduction in the dose of radiation, 33% reduction in chemotherapy. What that means is that patients did not compromise in the outcome but actually had a dramatic reduction in toxicity. They had better quality of life.

Dr Eileen Morgan, Dr Isabelle Soerjomataram and Dr Shalaka Joshi