Phase 3 trial of loboplatin versus cisplatin added to fluorouracil followed by concurrent CRT in nasopharyngeal carcinoma: final survival analysis

Cisplatin in known to be associated with poor treatment compliance and notable side effects in patient with nasopharyngeal carcinoma (NPC). A multicenter phase 3 trial in China compared lobaplatin versus cisplatin, both added to fluoruracil as induction chemotherapy followed by concurrent chemoradiotherapy (cCRT) for locoregionally advanced NPC. In 2021 the trial reported non-inferior survival and fewer toxic effects in the lobaplatin group compared to the cisplatin group. Final survival analysis of the trial has now been published. With a median follow-up of 10.6 years, the 10-year progression-free survival rate is 70.7% in the lobaplatin group versus 71.9% in the cisplatin group (p=0.885; p for noniferiority= 0.015). The incidence of late toxic effects is similar between the groups, except for grade 1-2 peripheral neuropathy, grade 1-2 deafness/otitis, and grade 1-3 nephrotoxicity, with higher incidences in the cisplatin group. The authors conclude that lobaplatin plus fluorouracil induction chemotherapy plus lobaplatin-based cCRT is an alternative strategy for cisplatin-based therapy in patients with locoregionally advanced NPC.