Akhil Kapoor, Professor of Medical Oncology at Tata Memorial Centre, shared a post on LinkedIn:
“Can a low-cost oral metronomic regimen double survival in advanced head and neck cancer?
Delighted to share our publication in JCO Global Oncology:
METRO PLUS Trial
Integrating Metronomic Therapy With Standard Chemotherapy in Advanced Unresectable Head and Neck Cancer: A Randomized Trial Addressing Global Cancer Care Equity
Key Findings
- Phase III randomized trial (N = 238)
- Platinum-sensitive advanced unresectable HNSCC
- Primary endpoint met
• Median Overall Survival: 10 vs 5 months
• HR 0.54 (95% CI 0.41–0.72)
• P < 0.001
- Progression-Free Survival
• 6 vs 2 months
• HR 0.38
• P < 0.001 - Response Outcomes
• ORR: 36.9% vs 6.7%
• DCR: 75.5% vs 42.9% - Quality of Life
• Clinically meaningful preservation across multiple domains - Safety
• No increase in grade ≥3 toxicities with addition of triple oral metronomic chemotherapy
Why this matters.
In many low- and middle-income countries, access to immunotherapy and cetuximab remains limited. The METRO PLUS study demonstrates that a simple, affordable, and scalable treatment strategy can significantly improve outcomes without compromising tolerability.
A sincere thank you to all patients and families who participated in this study, my co-authors, research staff, collaborators, and mentors Prof. Kumar Prabhash and Prof. Vanita Noronha who made this work possible.
Title: Integrating Metronomic Therapy With Standard Chemotherapy in Advanced Unresectable Head and Neck Cancer: A Randomized Trial Addressing Global Cancer Care Equity (METRO PLUS)
Authors: Akhil Kapoor, Anuj Gupta, Bipinesh Sansar, Bal Krishna Mishra, Arpita Singh, Arvind Upadhyay, Ankita Pal, Rukmeena Kumari, Natasha Sisodia, Amit Kumar, Sambit Swarup Nanda, Ashutosh Mukherji, Ankita Rungta Kapoor, Ajay Choubey, Satyajit Pradhan, Aseem Mishra, Zachariah Chowdhury, Shashikant Patne, Ipsita Dhal, Neha Singh, Shreya Shukla, Satyendra Narayan Singh, Arvind Suresh, Somnath Dey, Kunal Ranjan Vinayak, Praveen Lakshman, Lokendra Gupta, Pratibha Gavel, Vijeta Bajpai, Bhavesh Bandekar, Shripad Dinanath Banavali, Vijay Maruti Patil, Vanita Noronha and Kumar Prabhash
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