Nasopharyngeal carcinoma is a type of cancer that occurs in the nasopharynx, a region located behind the nose and above the back of the throat. Gemcitabine and cisplatin induction chemotherapy has shown promising results in the standard care of nasopharyngeal carcinoma, but their efficacy is yet to be evaluated. The objective of this study is to assess the efficacy of gemcitabine and cisplatin induction chemotherapy in patients with nasopharyngeal carcinoma.

This is a parallel-group, randomized, multicenter, controlled, phase-3 trial that included a total of 480 patients with locoregionally advanced nasopharyngeal carcinoma. The participants were randomly assigned in a 1:1 ratio to gemcitabine plus cisplatin plus chemoradiotherapy, or chemoradiotherapy alone. The primary outcome was recurrence-free survival, and the secondary outcomes were overall survival and safety. 

At a median follow-up of 42.7 months, three 3-year recurrence-free survival was 85.3% in the induction (combined) chemotherapy group and 76.5% in the standard therapy group. Overall survival after three years was 96.7% in the induction therapy group and 90.3% in the standard therapy group. The incidence of adverse events in the induction and standard therapy groups was 75.7% and 55.7%, respectively.

The research concluded that induction chemotherapy offered improved recurrence-free survival and overall survival in patients with nasopharyngeal carcinoma. However, the risk of adverse events was also high with induction chemotherapy.

Ref: https://www.nejm.org/doi/full/10.1056/NEJMoa1905287