ZHANG-2019

NCT01872962 📎

Regimen

Experimental
Induction gemcitabine 1000 mg/m² d1,8 + cisplatin 80 mg/m² d1 q3w ×3 cycles, then CCRT (cisplatin 100 mg/m² q3w ×3 + IMRT 70 Gy)
Control
Concurrent CCRT alone (cisplatin 100 mg/m² q3w ×3 + IMRT)

Population

Locoregionally advanced NPC (stage III-IVB, M0), IMRT-era, multicentre China

Key finding

Published in NEJM, this trial demonstrated that gemcitabine-cisplatin (GP) induction chemotherapy, compared with TPF, offers a more tolerable profile (lower myelosuppression from omitting docetaxel) while achieving superior recurrence-free survival and, uniquely among NPC induction trials, a statistically significant overall survival benefit at 3 years. The GP doublet also achieved 96.7% completion rate for three induction cycles, significantly higher than historical TPF completion rates. This paper rebalanced global expert opinion toward GP as the preferred induction backbone.

Source: PMID 31150573

Timeline

    Guideline citations

    • NCCN NPC (p.42)