Phase 2 Trial Launched for Neoadjuvant Radiation and Evorpacept Plus Pembrolizumab in Untreated HPV-Positive Oropharyngeal Cancer

Oral cavity and pharynx cancer, a form of head and neck squamous cell carcinoma, is a significant health concern with notable trends and statistics. In 2024, it's projected that approximately 58,450 individuals in the United States will be diagnosed with this type of cancer, resulting in an estimated 12,230 deaths. Men are more likely to develop oral cancer, particularly those with a history of tobacco or heavy alcohol use, or those infected with the human papillomavirus (HPV).

The rate of new cases stands at 11.5 per 100,000 individuals per year, with a higher rate observed among non-Hispanic White males (20.1) compared to females across all races (6.4). The median age at diagnosis is 64, and the cancer is most frequently diagnosed among people aged 55–64. Death rates are also higher among males, especially African American males, with an overall death rate of 2.6 per 100,000 individuals per year.

Survival statistics are crucial for understanding the prognosis of oral cavity and pharynx cancer. The relative 5-year survival rate is 69.0%, based on data from 2014 to 2020. This rate varies significantly depending on the stage at diagnosis. For localized cancer, the survival rate is 87.5%, while for regional and distant stages, the rates are 69.5% and 37.8%, respectively. The prevalence of this cancer in 2021 was estimated at 434,915 people living with the condition in the United States.

Risk factors for oral cavity and pharynx cancer include tobacco and alcohol use, as well as HPV infection. The most common age group for new cases is 55–64 years, and the lifetime risk of developing this cancer is about 1.2 percent. The cancer is more prevalent among non-Hispanic White males and least among Hispanic females.

Trends over time indicate that the age-adjusted rates for new cases have been rising by an average of 1.0% annually from 2012 to 2021. Similarly, death rates have been increasing by an average of 0.7% per year from 2013 to 2022. These trends underscore the need for continued research and improved treatment strategies.

In terms of treatment, the earlier the cancer is detected, the better the chances of survival. For localized cancer, the 5-year relative survival rate is significantly higher compared to regional or distant stages. The standard treatment options include chemoradiation or surgery, followed by risk-adapted adjuvant radiation with or without chemotherapy.

Despite advances in treatment, the 5-year survival rate for localized disease is 88%, but this drops significantly to 38% for metastatic disease. This highlights the importance of early detection and intervention, as well as the need for novel therapies to improve patient outcomes.

Innovative approaches, such as the combination of immunotherapy with stereotactic body radiation therapy, have shown promise in inducing immune-mediated anti-tumor responses. The development of next-generation therapies that block the CD47 immune checkpoint pathway, like evorpacept, offer new avenues for treatment, potentially leading to more effective strategies to downstage patients prior to surgery.

Overall, the statistics and trends related to oral cavity and pharynx cancer highlight the importance of continued research, early detection, and the development of novel therapies to improve patient outcomes and survival rates.