Multicenter phase 3 trial of induction chemotherapy with TP versus TPF followed by CRT for LA-NPC

Induction chemotherapy regimens of docetaxel and cisplatin plus fluorouracil (TPF) are currently used for patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC) but have well-known side effects, such as myelosuppression and diarrhea. A noninferiority phase 3 trial, at six centers in China evaluated leaving out flurouracil. LA-NPC patients were randomized 1:1 to TP or TPF, followed by concurrent chemoradiotherapy. The primary endpoint was two-year failure-free survival. The trial was stopped early because of strong evidence of noninferiority of TP to TPF. In addition TP was better tolerated than TPF. The authors conclude that the more convenient and beneficial TP regimen should be recommended to patients with LA-NPC.