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Conference Paper: The most optimal induction chemotherapy regimen for loco-regionally advanced nasopharyngeal carcinoma: A network meta-analysis

TitleThe most optimal induction chemotherapy regimen for loco-regionally advanced nasopharyngeal carcinoma: A network meta-analysis
Authors
Issue Date2020
PublisherElsevier BV. The Journal's web site is located at https://www.journals.elsevier.com/annals-of-oncology
Citation
The ESMO Virtual Congress 2020, LUGANO, Switzerland, 19-21 September / 16-18 October 2020. In Annals of Oncology, 2020, v. 31 n. suppl. 4, p. S673, abstract no. 943P How to Cite?
AbstractBackground: Induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) in the treatment of locally advanced nasopharyngeal carcinoma (NPC) has gained increasing popularity. However, the optimal regimens for IC remain undefined. We performed a network meta-analysis to compare the survival benefits of all available IC regimens followed by CCRT. Methods: All randomized trials of CCRT with or without IC in non-metastatic NPC were included. Overall, 10 trials and 3,116 patients were included. IC regimens were grouped into eight categories: docetaxel + cisplatin (DC), cisplatin + epirubicin + paclitaxel (PET), gemcitabine + carboplatin + paclitaxel (GCP), docetaxel + cisplatin + fluorouracil (TPF), mitomycin + epirubicin + cisplatin + fluorouracil + leucovorin (MEPFL), cisplatin + fluorouracil (PF), cisplatin + capecitabine (PX) and gemcitabine + cisplatin (GP). Inverse variance heterogeneity model was applied for network meta-analysis. Results: The three IC regimens with the highest significant benefit on overall survival (OS) were DC, followed by PX and GP, with respective hazard ratios (HRs [95% CIs]) compared with CCRT alone of 0.24 (0.08 to 0.73), 0.38 (0.19 to 0.77) and 0.43 (0.24 to 0.77). PX, GP and TPF were the top three regimens showing significant improved progression-free survival (PFS) with their corresponding HRs of 0.39 (0.21 to 0.72), 0.51 (0.34 to 0.77) and 0.60 (0.42 to 0.86); and the only regimens which significantly improved both OS and PFS. Conclusions: PX achieved the highest survival benefit and consistent improvement for all end points among all regimens. Induction PX followed by CCRT should be the most effective regimen for loco-regionally advanced NPC. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
DescriptionScience weekend on 19-21 September 2020; Educational weekend on 16-18 October 2020
Persistent Identifierhttp://hdl.handle.net/10722/290550
ISSN
2019 Impact Factor: 18.274
2015 SCImago Journal Rankings: 4.362
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorCHAN, SK-
dc.contributor.authorChoi, CW-
dc.contributor.authorLam, KO-
dc.contributor.authorChan, SY-
dc.contributor.authorChau, SC-
dc.contributor.authorKwong, DLW-
dc.contributor.authorLeung, TW-
dc.contributor.authorLuk, MY-
dc.contributor.authorLee, AWM-
dc.contributor.authorLee, VHF-
dc.date.accessioned2020-11-02T05:43:50Z-
dc.date.available2020-11-02T05:43:50Z-
dc.date.issued2020-
dc.identifier.citationThe ESMO Virtual Congress 2020, LUGANO, Switzerland, 19-21 September / 16-18 October 2020. In Annals of Oncology, 2020, v. 31 n. suppl. 4, p. S673, abstract no. 943P-
dc.identifier.issn0923-7534-
dc.identifier.urihttp://hdl.handle.net/10722/290550-
dc.descriptionScience weekend on 19-21 September 2020; Educational weekend on 16-18 October 2020-
dc.description.abstractBackground: Induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) in the treatment of locally advanced nasopharyngeal carcinoma (NPC) has gained increasing popularity. However, the optimal regimens for IC remain undefined. We performed a network meta-analysis to compare the survival benefits of all available IC regimens followed by CCRT. Methods: All randomized trials of CCRT with or without IC in non-metastatic NPC were included. Overall, 10 trials and 3,116 patients were included. IC regimens were grouped into eight categories: docetaxel + cisplatin (DC), cisplatin + epirubicin + paclitaxel (PET), gemcitabine + carboplatin + paclitaxel (GCP), docetaxel + cisplatin + fluorouracil (TPF), mitomycin + epirubicin + cisplatin + fluorouracil + leucovorin (MEPFL), cisplatin + fluorouracil (PF), cisplatin + capecitabine (PX) and gemcitabine + cisplatin (GP). Inverse variance heterogeneity model was applied for network meta-analysis. Results: The three IC regimens with the highest significant benefit on overall survival (OS) were DC, followed by PX and GP, with respective hazard ratios (HRs [95% CIs]) compared with CCRT alone of 0.24 (0.08 to 0.73), 0.38 (0.19 to 0.77) and 0.43 (0.24 to 0.77). PX, GP and TPF were the top three regimens showing significant improved progression-free survival (PFS) with their corresponding HRs of 0.39 (0.21 to 0.72), 0.51 (0.34 to 0.77) and 0.60 (0.42 to 0.86); and the only regimens which significantly improved both OS and PFS. Conclusions: PX achieved the highest survival benefit and consistent improvement for all end points among all regimens. Induction PX followed by CCRT should be the most effective regimen for loco-regionally advanced NPC. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.-
dc.languageeng-
dc.publisherElsevier BV. The Journal's web site is located at https://www.journals.elsevier.com/annals-of-oncology-
dc.relation.ispartofAnnals of Oncology-
dc.titleThe most optimal induction chemotherapy regimen for loco-regionally advanced nasopharyngeal carcinoma: A network meta-analysis-
dc.typeConference_Paper-
dc.identifier.emailChoi, CW: hcchoi@hku.hk-
dc.identifier.emailLam, KO: lamkaon@hku.hk-
dc.identifier.emailKwong, DLW: dlwkwong@hku.hk-
dc.identifier.emailLeung, TW: ltw920@hkucc.hku.hk-
dc.identifier.emailLee, AWM: awmlee@hkucc.hku.hk-
dc.identifier.emailLee, VHF: vhflee@hku.hk-
dc.identifier.authorityLam, KO=rp01501-
dc.identifier.authorityKwong, DLW=rp00414-
dc.identifier.authorityLee, AWM=rp02056-
dc.identifier.authorityLee, VHF=rp00264-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.annonc.2020.08.1058-
dc.identifier.hkuros317721-
dc.identifier.volume31-
dc.identifier.issuesuppl. 4-
dc.identifier.spageS673, abstract no. 943P-
dc.identifier.epageS673, abstract no. 943P-
dc.identifier.isiWOS:000573469101231-
dc.publisher.placeNetherlands-
dc.identifier.issnl0923-7534-

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