Gemcitabine: a game changer in nasopharyngeal carcinoma
Mené en Chine sur 362 patients atteints d'un carcinome métastatique ou récidivant du rhino-pharynx, cet essai randomisé de phase III compare l'efficacité, du point de vue de la survie sans progression, et la toxicité d'une combinaison gemcitabine-cisplatine par rapport à une combinaison fluorouracil-cisplatine
For decades, the platinum doublet of fluorouracil plus cisplatin reigned as the first-line chemotherapeutic combination for recurrent or metastatic nasopharyngeal carcinoma.1 Although whether fluorouracil plus cisplatin represents the most efficacious treatment strategy in this incurable subgroup of patients has always been contentious, in reality, no level evidence existed to propose otherwise. Arguably, an abundance of single-arm phase 2 and 3 studies have been testing novel single or combination systemic drugs (gemcitabine, paclitaxel, docetaxel, vinorelbine, pemetrexed, and molecular-targeted treatments); however, these studies often had small sample sizes, catered to patients with treatment-refractory disease, and showed only slight gains in disease control and survival.
The Lancet , commentaire, 2015