Circulating Tumor HPV DNA Driven Adjuvant Treatment Deintensification After Transoral Surgery for HPV+ OPSCC

Indiana University is conducting this Phase II trial to assess whether postoperative ctHPVDNA levels can guide adjuvant therapy deintensification after transoral surgery and neck dissection in HPV+ oropharyngeal cancer. Patients with low-risk features may be observed or receive lower-dose radiation (30 Gy), while those with positive ctHPVDNA undergo reimaging and potentially 40 Gy radiation based on nodal status.