Single-center phase 3 trial of induction versus concurrent chemotherapy for locally advanced nasopharyngeal carcinoma

Cisplatin-based concurrent chemoradiotherapy (CCRT) is the mainstay treatment for locoregionally advanced nasopharyngeal carcinoma (LA-NPC), which usually leads to intolerable toxicities. A pahse 3 noninferiority trial at Sun Yat-sen University (Guangzhou, China) compared induction chemotherapy (IC) with two cycles gemcitabine and cisplatin followed by IMRT (IC group) versus IMRT plus concomitant weekly cisplatin for up to seven cycles (CCRT group). Two-year failure-free survival rate was 90.2% in the IC group versus 86.3% in the CCRT group (HR 0.636; 95% CI 0.267-1.514). In the IC group fewer grade ≥ 3 adverse events occurred than in the CCRT group (47.5% versus 61.5%; p=0.029). IC was associated with better quality of life. The authors conclude that for 2-year FFS for LA-NPC, gemcitabine-cisplatin IC plus IMRT was noninferior to CCRT.