Induction chemotherapy with lobaplatin and fluorouracil versus cisplatin and fluorouracil followed by chemoradiotherapy in patients with stage III–IVB nasopharyngeal carcinoma: an open-label, non-inferiority, randomised, controlled, phase 3 trial
RCT (n=502, China) found lobaplatin (3rd-generation platinum drug)-based induction chemotherapy plus chemoradiotherapy resulted in non-inferior survival (5-year PFS 75.0 vs 75.5%, respectively; HR 0.98, 95% CI 0.69–1.39;p=0.92) and fewer toxic effects than cisplatin-based therapy
Source:
The Lancet Oncology
SPS commentary:
According to the commentary, special caution should be paid before generalising study results. First, there was a strong positive patient selection. Only young (aged <60 years) and fit patients with good renal function (creatinine clearance ≥80 mL/min) and without major comorbidities were included in the study. Second, the platinum-based comparator for lobaplatin had a lower cumulative dose than that usually considered as standard of care. It also points out that the stage distribution of the study population was in favour of stage IV disease (~55%), and non-inferiority of lobaplatin was recorded in this patient population. It suggests that taken all together, and given the encouraging results of this study, lobaplatin might overtake carboplatin in cisplatin-ineligible patients with nasopharyngeal cancer.