Current Status and Future Directions of Treatment Deintensification in Human Papilloma Virus-associated Oropharyngeal Squamous Cell Carcinoma

The prevalence of patients with human papilloma virus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) is rapidly increasing, and it is now well known that these patients have a significantly better prognosis than patients with HPV-negative OPSCC. Though standard treatments result in excellent cancer control, they are also associated with substantial long-term toxicity. There is now great interest in evaluating less intensive (ie, deintensified) treatment regimens to improve the therapeutic ratio (maintain excellent cancer control and decrease toxicity). There are many different approaches that are being studied, and each have their own caveats, with varying degrees of actual deintensification. In this article, we critically review the current landscape of emerging deintensified treatment paradigms and future direction of the treatment of HPV-associated OPSCC.