Combination Therapy May Improve Survival in Nasopharyngeal Carcinoma

Induction chemotherapy with concurrent chemoradiotherapy may improve survival of patients with nasopharyngeal cancer, according to a study published in The Lancet Oncology.¹

Distant metastases are the most common reason for a patient’s failing treatment. For this phase 3 study, researchers tested whether induction chemotherapy, consisting of docetaxel, cisplatin, and fluorouracil, plus concurrent chemoradiotherapy is more efficacious than concurrent chemoradiotherapy alone.

Of 480 enrolled patients, 241 were randomized to induction plus concurrent therapy, and 239 were randomized to concurrent therapy only. Karnofsky performance status, age, and disease stage were balanced between the 2 groups.

After 3 years, 26 patients in the combination group and 43 patients in the concurrent therapy group had died. Failure-free survival and distant failure-free survival were 80% and 90% in the combination group, respectively, and 72% and 83% in the concurrent therapy group, respectively.

Response to treatment was, however, nearly the same between the 2 groups. There were 42 grade 4 adverse events in the combination group; there were only 3 in the concurrent therapy group.

The authors conclude that induction and concurrent therapy may improve survival over concurrent chemoradiotherapy only, though further follow-ups must confirm this finding. The toxicity of the combination therapy suggests it should not be used for elderly patients.

Five-year follow-up findings of overall survival and late toxic effects will be reported.

Reference

1. Sun Y, Li WF, Chen NY, et al. Induction chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: a phase 3, multicentre, randomised controlled trial. Lancet Oncol. 2016 Sep 26. doi: 10.1016/S1470-2045(16)30410-7 [Epub ahead of print]