Presented during the Head and Neck Cancer Oral Abstract Session at the 2026 ASCO Annual Meeting, Jian Guan, MD, shared phase III data comparing carboplatin-based versus cisplatin-based induction and concurrent chemoradiotherapy in patients with locoregionally advanced nasopharyngeal cancer
The study’s first author was Xiaoqing Wang, with Jian Guan, MD, serving as presenter.
This randomized non-inferiority trial evaluated whether carboplatin could offer comparable efficacy to cisplatin while reducing treatment-related toxicity and improving tolerability.
Study Design
This multicenter, parallel-group, non-inferiority phase III trial was conducted across six institutions in China.
Patients with newly diagnosed, non-keratinizing nasopharyngeal carcinoma and stage III–IVA disease were randomly assigned to receive either carboplatin-based or cisplatin-based treatment.
Both groups received two cycles of induction chemotherapy, followed by concurrent chemoradiotherapy with the assigned platinum agent for two or three cycles.
The primary endpoint was 3-year failure-free survival. Secondary endpoints included overall survival, distant metastasis-free survival, locoregional failure-free survival, and toxicity. Non-inferiority was met if the upper limit of the 95% confidence interval for the difference in 3-year failure-free survival did not exceed 10%.
Key Results
From April 16, 2018, to August 7, 2024, a total of 482 patients were enrolled and randomized equally between the carboplatin and cisplatin groups.
After a median follow-up of 40.0 months, the 3-year failure-free survival was 85.7% in the carboplatin group and 87.6% in the cisplatin group. The difference met the study’s predefined criteria for non-inferiority.
The stratified hazard ratio was 1.234 with a 95% confidence interval of 0.744–2.045, and the non-inferiority p value was 0.0112.
The cisplatin group had higher rates of several toxicities, including grade 3 or 4 neutropenia and anorexia, as well as more nausea, vomiting, and nephrotoxicity. No treatment-related deaths were reported.
Why This Matters
These findings suggest that carboplatin-based induction and concurrent chemoradiotherapy may be a reasonable alternative for patients with locoregionally advanced nasopharyngeal carcinoma, especially when cisplatin toxicity or tolerability is a concern.
The trial is clinically relevant because it addresses a common treatment challenge: maintaining disease control while improving treatment compliance and reducing toxicity.
Conclusion
In this randomized phase III non-inferiority trial, carboplatin-based induction and concurrent chemoradiotherapy showed comparable 3-year failure-free survival to cisplatin-based treatment in locoregionally advanced nasopharyngeal carcinoma, with a more favorable toxicity profile.
Longer follow-up will be important to confirm the durability of this promising regimen.
Abstract link