March 3, 2026Translational Cancer Research0 citationsOpen Access

Optimizing the therapeutic ratio: a narrative review of de-escalation and response-adapted strategies in series including human papillomavirus negative head and neck cancer

ICIcaro Thiago de Carvalho SFSérgio Leonardo Favareto RBRenata Jane Chaves Bernardo

Key Points

Dose and volume de-escalation maintain oncologic efficacy while reducing toxicities in HPV-negative cases.
Findings highlight the potential to apply de-escalation strategies previously limited to HPV-positive disease.
Narrative review examines treatment responses across series of HPV-negative head and neck cancer patients.
Implications suggest a shift towards more tolerable treatments for head and neck cancers without compromising outcomes.

Abstract

Dose and volume de-escalation appear feasible and beneficial in series that included HPV-negative HNSCC and NPC patients, maintaining oncologic efficacy while significantly reducing treatment-related toxicities. These findings expand the de-escalation paradigm beyond HPV-positive disease, offering a more tolerable therapeutic landscape.

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