Nasopharynx cancer: induction chemotherapy shows benefit in phase 3

  • Yang Q & al.
  • Eur J Cancer
  • 16 Aug 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Adding induction chemotherapy (IC) before concurrent chemoradiotherapy (CCRT) improves DFS, driven by distant metastasis-free survival (DMFS) in locoregionally advanced nasopharyngeal carcinoma (NPC).
  • There was no effect on locoregional relapse-free survival (LRRFS) or OS.

Why this matters

  • This study supports the findings from a prior follow-up at 3 years.

Key results

  • IC+CCRT was associated with improved 5-year DFS (73.4% vs 63.1%; HR, 0.68; P=.01) and DMFS (82.8% vs 73.1%; HR, 0.65; P=.03) compared with CCRT alone in multivariate analysis.
    • Results were not statistically significant for OS (80.8% vs 76.8%; P=.06) or LRRFS (87.9% vs 85.0%; P=.21).
  • IC+CCRT was associated with higher incidence of grade 3-4 adverse events compared with CCRT alone (66.3% vs 49.1%; P<.001 although a lower rate of eye damage was observed vs p=".029).</li">

Study design

  • 238 patients who received IC (cisplatin/fluorouracil) followed by CCRT (cisplatin/RT) and 238 who received CCRT alone were included.
  • Funding: Sun Yat-sen University; Guangdong Public Welfare Research and Capacity Building Projects; National Key Research and Development Program of China; Guangzhou Science and Technology Planning Project-Production and Research Collaborative Innovation Major Project; National Natural Science Foundation of China.

Limitations

  • Open-label trial.
  • Not all patients received intensity-modulated RT.