Multicenter phase 2-3 trial of adjuvant CRT with 3-weekly cisplatin versus weekly cisplatin in LA-SCCHN: long-term follow-up

The multicenter phase 2-3 JCOG1008 trial in Japan compared chemoradiotherapy (CRT) with cisplatin 40 mg/m² once a week for seven cycles (‘weekly cisplatin’) versus CRT with cisplatin 100 mg/m² once every three weeks for three cycles (‘three-weekly cisplatin’) for postoperative high-risk locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). Interim analysis of the trial showed that weekly cisplatin was noninferior to three-weekly cisplatin in terms of overall survival. Long-term follow-up results of the trial have now been published. A total of 261 patients were enrolled. At the final analysis, with a median follow-up of 5.6 years, the 5-year overall survival rate was 58.7% in the three-weekly arm and 71.2% in the weekly arm (HR 0.76; 95% CI 0.52-1.12), confirming the noninferiority of the weekly regimen, whereas both relapse-free survival and 5-year local relapse-free survival were numerically better in the weekly arm. No late adverse events showed more than a 10% difference between the two arms. The authors conclude that 5-year follow-up of JCOG1008 confirmed that CRT with weekly cisplatin is noninferior to CRT with three-weekly cisplatin in patients with postoperative high-risk LA-SCCHN.