Comparison of efficacy and safety of three induction chemotherapy regimens with gemcitabine plus cisplatin (GP), cisplatin plus fluorouracil (PF) and cisplatin plus capecitabine (PX) for locoregionally advanced previously untreated nasopharyngeal carcinoma: A pooled analysis of two prospective studies

Chan, Sik-Kwan; Chan, Sum‐Yin; Tong, Chi-Chung; Lam, Ka-On; Kwong, Dora Lai-Wan; Leung, TW; Luk, Mai‐Yee; Lee, Anne W.M.; Choi, Hyun‐Seok; Lee, Victor

doi:10.1016/j.oraloncology.2020.105158

Cited by 8 publications

(10 citation statements)

References 38 publications

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“…Three literature studies [ 17 , 19 , 25 ] evaluated PFS, involving 615 patients. Divide them into different subgroups based on follow-up time, and the PFS in terms of 1-, 2-, and 3-year follow-up was, respectively, evaluated.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 9 studies [16][17][18][19][20][21][23][24][25] evaluated OS, involving 1596 patients with metastatic NPC. ey were divided into subgroups based on follow-up years.…”

Section: Meta-analysis Of Osmentioning

confidence: 99%

“…ree literature studies [17,19,25] in terms of 1-, 2-, and 3-year follow-up was, respectively, evaluated. Heterogeneity test was performed (I 2 � 78%, P � 0.0001).…”

Section: Meta-analysis Of Pfsmentioning

confidence: 99%

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Comparison Efficacy and Safety of Gemcitabine plus Cisplatin and 5-Fluorouracil plus Cisplatin for Metastatic Nasopharyngeal Carcinoma: A Meta-Analysis and Systematic Review

Yan

Zheng

Ren

et al. 2022

Journal of Oncology

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Objective. To compare the efficacy and safety of gemcitabine plus cisplatin (GP) and 5-fluorouracil plus cisplatin (PF) for metastatic nasopharyngeal carcinoma. Methods. The clinical trials of GP and PF in the treatment of metastatic nasopharyngeal carcinoma (NPC) were searched in PubMed, EMBASE, Cochrane Library, and Web of Science. The literature search met the inclusion and exclusion criteria. The software Revman 5.4 was used for data analysis, and STATA 15.0 was used for publication bias. Results. 10 studies were included in this meta-analysis. The results showed that the GP group had a higher clinical remission rate than the PF group (RR = 1.22, 95% CI (1.03–1.44), P = 0.02 , P = 0.02 ). GP and PF groups in OS, PFS, and DMFS had the same effect at 1, 2, and 3 years (OS at 1 year: RR = 1.04, 95% CI (0.95–1.15), P = 0.37 , P = 0.37 ; 2 years: RR = 1.08, 95% CI (0.94 1.23), P = 0.28 , P = 0.28 ; 3 years: RR = 1.07, 95% CI (0.89 1.29), P = 0.46 ; PFS at 1 year: RR = 1.98, 95% CI (0.29 13.44), P = 0.49 ; 2 years: RR = 3.09, 95% CI (0.10 97.55), P = 0.52 ; 3 years: RR = 0.95, 95% CI (0.73 1.24), P = 0.71 ; DMFS at 1 year: RR = 1.01, 95% CI (0.90–1.14), P = 0.83 ; 3 years: RR = 1.10, 95% CI (0.85–1.41), P = 0.47 . The number of hematological adverse reactions occurred in GP group was higher than the PF group. Conclusion. The GP and PF groups had similar OS, PFS, and DMFS, but the GP group had a higher clinical remission rate. Therefore, GP may be the first choice for metastatic NPC.

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Section: Resultsmentioning

confidence: 99%

“…A total of 9 studies [16][17][18][19][20][21][23][24][25] evaluated OS, involving 1596 patients with metastatic NPC. ey were divided into subgroups based on follow-up years.…”

Section: Meta-analysis Of Osmentioning

confidence: 99%

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Comparison Efficacy and Safety of Gemcitabine plus Cisplatin and 5-Fluorouracil plus Cisplatin for Metastatic Nasopharyngeal Carcinoma: A Meta-Analysis and Systematic Review

Yan

Zheng

Ren

et al. 2022

Journal of Oncology

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“…The study published by Mai and colleagues concluded that IMRT plus 2 cycles of concurrent 100 mg/m 2 cisplatin without induction chemotherapy could be an alternative option for patients with low-risk locoregionally advanced NPC with Epstein-Barr virus (EBV) DNA levels < 4000 copies/ml ( 28 ). But for LA NPC, several recently published randomized phase III trials conducted in a similar ethnic patient cohort demonstrated that IC followed by concurrent systemic therapy/RT had better survival benefit than concurrent systemic therapy/RT alone ( 10 – 12 , 29 , 30 ). Concerning different IC regimens in LA NPC, a network meta-analysis of 9 clinical trials showed that docetaxel + cisplatin (DC), gemcitabine + cisplatin (GP), and PX had favorable OS benefits.…”

Section: Discussionmentioning

confidence: 99%

A Single-Arm Phase 2 Trial on Induction Chemotherapy Followed by Concurrent Chemoradiation in Nasopharyngeal Carcinoma Using a Reduced Cumulative Dose of Cisplatin

Yang

et al. 2022

Front. Oncol.

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BackgroundWe conducted this study to evaluate if a reduced cumulative dose of induction and concurrent cisplatin conferred similar favorable outcomes when compared to trial NPC-0501.MethodsNewly diagnosed nasopharyngeal carcinoma (NPC) with stage III-IVA were prospectively recruited from January 2015 to September 2019. Induction chemotherapy (IC) consisted of cisplatin 80mg/m2 on day 1 and capecitabine 1000mg/m2 twice daily from day 1 to 14 every 3 weeks for 3 cycles followed by concurrent chemoradiotherapy (CCRT) with 2 cycles of cisplatin 100mg/m2 given every 3 weeks. Tumor response was evaluated according to RECIST v1.1. Acute and late adverse events (AEs) were graded with CTCAE v4.0 and Late Radiation Morbidity Scoring of the RTOG, respectively.Results135 patients were recruited. At 16 weeks after CCRT, all 130 patients who completed the entire course of radiotherapy (RT) had a complete response upon final assessment. With a median follow-up of 36.2 months, 22 treatment failures and 8 deaths were observed. The 3-year progression-free survival, overall survival, locoregional recurrence-free survival, and distant recurrence-free survival were 83.7%, 94.1%, 94.1%, and 85.9%, respectively. Our survival data outcomes were similar to those reported in the cisplatin and capecitabine (PX) induction arm of the 0501 trial. 103 patients (76.3%) reported acute grade 3-4 AEs. Two patients (1.5%) had late grade 3-4 complications, numerically fewer than those reported in the NPC-0501 trial.ConclusionsInduction PX and concurrent cisplatin with a reduced cumulative cisplatin dose yield survival outcomes comparable to those reported in the NPC-0501 trial with excellent tolerability. Therefore, a reduced cumulative dose of cisplatin is a promising treatment scheme for nasopharyngeal carcinoma.

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“…The total dosage of the radiotherapy was 70–74 Gy in 33 fractions of 2.12–2.24 Gy for 5 days in each week (Data S1, Supporting Information). During radiotherapy, 100 mg/m 2 of cisplatin was planned for 2–3 cycles 18,19 …”

Section: Methodsmentioning

confidence: 99%

Management of first‐line palliative chemotherapy for post‐treatment metastasis after gemcitabine plus cisplatin induction chemotherapy: Gemcitabine plus cisplatin and non‐gemcitabine plus cisplatin chemotherapy

Yang

Liu

et al. 2021

Head & Neck

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Background To evaluate whether patients with post‐treatment metastasis are suitable for GP first‐line palliative chemotherapy (PCT) after undergoing GP IC. Methods Seven hundred and forty‐six patients with post‐treatment metastasis after undergoing GP IC were eligible. Survival outcomes were compared. Results Significant differences in survival rates were observed between patients treated with GP and non‐GP chemotherapy (2‐year progression‐free survival [PFS]: 0.7% vs. 9.7%). We investigated survival outcomes of patients treated with GP PCT within 2 years after undergoing GP IC, treated with GP PCT 2 years after undergoing GP IC, and those of non‐GP PCT patients (2‐year PFS: 0.0%, 2.3%, 9.7%). However, there was no difference in the 2‐year PFS between the patients that received GP PCT 2 years after undergoing GP IC and the non‐GP PCT treated patients. Conclusions GP is not recommended for patients that have received GP IC within 2 years. Two years after undergoing GP IC, GP can be considered.

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Cited by 8 publications

References 38 publications

Comparison Efficacy and Safety of Gemcitabine plus Cisplatin and 5-Fluorouracil plus Cisplatin for Metastatic Nasopharyngeal Carcinoma: A Meta-Analysis and Systematic Review

Comparison Efficacy and Safety of Gemcitabine plus Cisplatin and 5-Fluorouracil plus Cisplatin for Metastatic Nasopharyngeal Carcinoma: A Meta-Analysis and Systematic Review

A Single-Arm Phase 2 Trial on Induction Chemotherapy Followed by Concurrent Chemoradiation in Nasopharyngeal Carcinoma Using a Reduced Cumulative Dose of Cisplatin

Management of first‐line palliative chemotherapy for post‐treatment metastasis after gemcitabine plus cisplatin induction chemotherapy: Gemcitabine plus cisplatin and non‐gemcitabine plus cisplatin chemotherapy

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