Redefining Systemic Therapy Timing in Nasopharyngeal Cancer—Before, During, or After Radiation
Mené sur 420 patients atteintes d’un cancer du rhinopharynx de stade III/IVA et ayant reçu une chimiothérapie d’induction (durée médiane de suivi : 50 mois ; 25,5 % de femmes ; âge médian : 48 ans), cet essai randomisé multicentrique de phase III évalue la non-infériorité, du point de vue de la survie sans échec à 3 ans et de l’incidence de mucite aiguë de grade 3 ou plus, d'une radiothérapie associée à une chimiothérapie adjuvante (traitement séquentiel) par rapport à une chimioradiothérapie concomitante
Successful management of locally advanced nasopharyngeal carcinoma (LA-NPC) increasingly hinges on the effective treatment and prevention of distant metastatic disease. With significant advancements in radiotherapy (RT) techniques like intensity-modulated radiation therapy, locoregional control has become excellent, shifting the predominant pattern of failure to distant relapse. As a result, systemic therapy plays a critical role in eradicating micrometastatic disease and improving long-term outcomes. However, combining systemic therapy with RT introduces considerable toxicity, often limiting treatment compliance. These challenges have driven recent investigations to focus on optimizing patient selection and refining systemic therapy sequencing and regimens by balancing effective tumor control and treatment tolerability for patients.
JAMA Oncology , commentaire, 2025