Multicenter phase 3 trial of toripalimab combination therapy without concurrent cisplatin for locoregionally advanced nasopharyngeal carcinoma

Among newly diagnosed cases of nasopharyngeal carcinoma (NPC), 70% are diagnosed as locoregionally advanced disease, which has poor prognosis and requires cisplatin-based chemoradiotherapy. The phase 3 DIAMOND trial, at 13 centers in China, evaluated omitting concurrent cisplatin from toripalimab-based chemoradiotherapy for newly diagnosed locoregionally advanced NPC. In this trial including 532 patients, those patients receiving toripalimab combined with induction chemotherapy and radiotherapy without concurrent cisplatin had noninferior 3-year failure-free survival (88.3% versus 87.6%) and lower incidence of all-grade vomiting (26.2% versus 59.8%) than the standard therapy group, in which concurrent cisplatin was retained. The authors conclude that the toripalimab-based concurrent cisplatin-free strategy offers a promising therapeutic approach with both high efficacy and low toxicity in patients with locoregionally advanced NPC (visual abstract).