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Attend this session at the
2017 ASCO Annual Meeting!


Session: Head and Neck Cancer

Type: Oral Abstract Session

Time: Monday June 5, 8:00 AM to 11:00 AM

Location: S100a

Neoadjuvant chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: A phase III multicentre randomised controlled trial.

Sub-category:
Advanced Disease

Category:
Head and Neck Cancer

Meeting:
2017 ASCO Annual Meeting

Abstract No:
6005

Citation:
J Clin Oncol 35, 2017 (suppl; abstr 6005)

Author(s): Ming-Yuan Chen, Su-Mei Cao, Qi Yang, Ling Guo, Hai-Qiang Mai, Hao-Yuan Mo, Ka-Jia Cao, Chao-Nan Qian, Chong Zhao, Xiang Yanqun, Xiu-Ping Zhang, Zhi-Xiong Lin, Wei-Xiong Li, Xiang Guo, Ming-Huang Hong; Sun Yat-Sen University Cancer Center, Guangzhou, China; Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China; Department of Radiation Oncology, Cancer Center of Guangzhou Medical University, Guangzhou, China; The Affiliated Cancer Hospital of Shantou University, Shantou, China; Department of Radiation Oncology, Guangdong General Hospital, Guangzhou, China; Cancer Center of Sun Yat-Sen University, Guangzhou, China; Department of Clinical Trial Center, Sun Yat-sen University Cancer Center, Guangzhou, China

Abstract Disclosures

Abstract:

Background: The role of neoadjuvant chemotherapy (NACT) for locoregionally advanced nasopharyngeal carcinoma (NPC) is unclear. We aimed to evaluate the feasibility and efficacy of NACT followed by concurrent chemoradiotherapy (CCRT) versus CCRT alone in locoregionally advanced NPC. Methods: Patients with stage III-IVB (excluding T3N0-1) NPC were randomly assigned to receive NACT followed by CCRT (investigational arm) or CCRT alone (control arm). Both arms were treated with 80 mg/m² cisplatin every three weeks concurrently with radiotherapy. The investigational arm received cisplatin (80 mg/m² d1) and fluorouracil (800 mg/m² civ d1-5) every three weeks for two cycles before CCRT. The primary endpoint was disease-free survival (DFS) and distant metastasis-free survival (DMFS). Secondary endpoint was overall survival (OS). Results: 476 patients were randomly assigned to the investigational (n = 238) and control arms (n = 238). The investigational arm achieved higher 3-year DFS rate (82.0%, 95% CI = 0.77-0.87) than the control arm (74.1%, 95% CI = 0.68-0.80, P = 0.028). The 3-year DMFS rate was 86.0% for the investigational arm versus 82.0% for the control arm, with marginal statistical significance (P = 0.056). However, there were no statistically significant differences in OS or locoregional relapse-free survival (LRRFS) rates between two arms (OS: 88.2% vs 88.5%, P = 0.815; LRRFS: 94.3% vs 90.8%, P = 0.430). The most common grade 3–4 toxicity during NACT was neutropenia (16.0%). During CCRT, the investigational arm experienced statistically significantly more grade 3–4 toxicities (P < 0.001). Conclusions: NACT improved tumor control compared with CCRT alone in locoregionally advanced NPC, particularly at distant sites. However, there was no early gain in overall survival. Longer follow-up is needed to determine the eventual therapeutic efficacy. Clinical trial information: NCT00705627

 
Other Abstracts in this Sub-Category:

 

1. Phase III randomized trial of chemotherapy with or without bevacizumab (B) in patients (pts) with recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN): Survival analysis of E1305, an ECOG-ACRIN Cancer Research Group trial.

Meeting: 2017 ASCO Annual Meeting Abstract No: 6000 First Author: Athanassios Argiris
Category: Head and Neck Cancer - Advanced Disease

 

2. A multicenter randomized controlled trial (RCT) of adjuvant chemotherapy (CT) in nasopharyngeal carcinoma (NPC) with residual plasma EBV DNA (EBV DNA) following primary radiotherapy (RT) or chemoradiation (CRT).

Meeting: 2017 ASCO Annual Meeting Abstract No: 6002 First Author: Anthony T. C. Chan
Category: Head and Neck Cancer - Advanced Disease

 

3. Genomic determinants of response to pembrolizumab in head and neck squamous cell carcinoma (HNSCC).

Meeting: 2017 ASCO Annual Meeting Abstract No: 6009 First Author: Robert I. Haddad
Category: Head and Neck Cancer - Advanced Disease

 

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