Akhil Kapoor Highlights METRO-CHASE Phase 3 Trial Results in Advanced Head and Neck Cancer
Akhil Kapoor, Professor, Medical Oncologist at TMH Varanasi, shared a post on LinkedIn:
“While immunotherapy offers hope, its benefits in advanced head and neck squamous cell carcinoma (HNSCC) are modest and limited to a small fraction of patients — often inaccessible in low-resource settings.
Our METRO-CHASE phase III trial offers a cost-effective, broadly applicable alternative:
Triple oral metronomic chemotherapy (OMCT)
– 6-mo OS: 40.7% vs 26.2% (HR: 0.63; P=0.00011)
– Higher response rate: 41.1% vs 19.6%
– Consistent OS benefit across all subgroups
– Entirely oral and ~$15/monthImmunotherapy helps a few: Triple OMCT helps many.
Scientific Foundation:
Originally explored in a phase I/II study by Vijay Patil et al. (J Clin Oncol. 2019; DOI)
Dual-drug OMCT (methotrexate + celecoxib) was shown to be non-inferior to cisplatin in a landmark phase III trial (Lancet Glob Health, 2020; DOI)
Erlotinib was added for its ability to reverse drug resistance and synergize through antiangiogenic and EGFR-targeted pathways
This journey began in 2014, under the visionary mentorship of Prof. Shripad Banavali, Prof. Kumar Prabhash, Prof. Vanita Noronha, and Prof. Vijay Patil — who pioneered drug repurposing and metronomic therapy in Indian oncology.
This could shift the standard for platinum-refractory HNSCC globally.”
Title: Triple Oral Metronomic Chemotherapy Versus Chemotherapy of Physician Discretion After Failure of Platinum-Based Therapy in Advanced Head and Neck Cancer: A Phase III Randomized Study (METRO-CHASE Study)
Authors: Akhil Kapoor, Anuj Gupta, Bipinesh Sansar, Bal Krishna Mishra, Pooja Gupta, Arpita Singh, Arvind Upadhyay, Lakhan Kashyap, Ankita Pal, Amit Kumar, Sambit S. Nanda, Ashutosh Mukherji, Ankita Rungta Kapoor, Satyajit Pradhan, Aseem Mishra, Zachariah Chowdhury, Shashikant Patne, Ipsita Dhal, Neha Singh, Shreya Shukla, Satyendra Narayan Singh, Varun Shukla, M V Manikandan, Arvind Suresh, Shripad Banavali, Somnath Dey, Kunal Ranjan Vinayak, Praveen Lakshman, Lokendra Gupta, Pratibha Gavel, Bhavesh P. Bandekar, Vijay Patil, Vanita Noronha, Kumar Prabhash
Read Full Article on JCO Global Oncology.
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