LA-NPC: induction chemotherapy boosts CCRT survival benefit in Chinese phase 3 trial

  • Li WF & al.
  • Int J Cancer
  • 06.01.2019

  • von Brian Richardson, PhD
  • Studien – kurz & knapp
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Takeaway

  • Results from an open-label phase 3 randomized controlled trial suggest that adding induction chemotherapy (IC) with cisplatin/fluorouracil/docetaxel (TPF) to concurrent chemoradiotherapy (CCRT) is associated with superior survival outcomes in patients with locally advanced nasopharyngeal carcinoma (LA-NPC).

Why this matters

  • Results suggest a promising treatment option for patients with LA-NPC, who experience a high recurrence rate.

Key results

  • Adding IC to CCRT improved 5-year:
    • Failure-free survival (77.4% vs 66.4%; HR, 0.64; P=.011).
    • OS (85.6% vs 77.7%; HR, 0.61; P=.019).
    • Distant failure-free survival (88% vs 79.8%, P=.030).
    • Locoregional failure-free survival (90.7% vs 83.8%, P=.044). 
  • Grade 3/4 late toxicities were more common with IC+CCRT vs CCRT alone (72.8% vs 53.8%; P<.001>

Study design

  • 480 patients with stage III-IVB (except T3-4N0) NPC, randomly assigned to receive CCRT with or without IC (n=241, 239).
  • Funding: Shenzhen Main Luck Pharmaceuticals In.; Sun Yat-sen University; National Natural Science Foundation of China; Natural Science Foundation of Guang Dong Province; Health & Medical Collaborative Innovation Project of Guangzhou City; Innovation Team Development Plan of the Ministry of Education; Overseas Expertise Introduction Project for Discipline Innovation.

Limitations

  • Prognostic biomarkers not used for participant selection.
  • Patients ≥60 years not included.