SNUC: CCRT tops surgery after favorable response to IC

  • Amit M & al.
  • J Clin Oncol
  • 7 Jan 2019

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

  • Response to induction chemotherapy (IC) is associated with a relative survival benefit from definitive concurrent chemoradiotherapy (CCRT) vs surgery with postoperative RT/CRT in patients with sinonasal undifferentiated carcinoma (SNUC).

Why this matters

  • Response to IC can be used to guide definitive therapy.

Key results

  • The overall response rate to IC was 67%.
  • In patients with a response to IC, 5-year DSS was 81% in patients who received CCRT and 54% in patients who received surgery with postoperative RT/CRT (P=.001).
  • In patients without a response to IC, 5-year DSS was 0% in patients who received CCRT and 39% in patients who received surgery with postoperative RT/CRT (P=.001).
  • In multivariate analysis, surgery with postoperative CRT was associated with worse DSS and OS vs CCRT in IC responders (aHR, 3.43 and 4.19; both P<.001>
  • CCRT was associated with higher aHRs than surgery for DSS (12.4 vs 5.68) and OS (12.03 vs 4.20) in IC nonresponders (P<.001 for all vs the reference group of ic responders who received ccrt>

Study design

  • 95 treatment-naive patients with SNUC who received IC, 66% treated with CCRT and 34% treated with surgery and postoperative RT/CRT, were analyzed for outcomes.
  • Funding: NIH Cancer Center Support Grant.

Limitations

  • Retrospective study.

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