# CONTINUUM: induction-concurrent chemoradiotherapy with or without sintilimab in locoregionally advanced nasopharyngeal carcinoma

Source: https://onco.cc/key-papers/paper-continuum-sintilimab-nasopharyngeal-liu-lancet-2024/  
OnCo record `paper-continuum-sintilimab-nasopharyngeal-liu-lancet-2024` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Adding the PD-1 antibody sintilimab to chemotherapy and radiotherapy for advanced, non-metastatic nasopharyngeal cancer raised three-year event-free survival from 76 to 86 percent, with more but manageable side effects.

## Summary

Multicentre open-label randomised phase 3 trial at nine hospitals in China: 425 adults with high-risk stage III to IVa nasopharyngeal carcinoma were randomised to gemcitabine-cisplatin induction and concurrent cisplatin radiotherapy with (210) or without (215) 12 cycles of sintilimab.

At a median follow-up of 41.9 months, three-year event-free survival was 86 percent with sintilimab against 76 percent without (stratified hazard ratio 0.59, p 0.019). Grade 3 to 4 adverse events occurred in 74 against 65 percent; grade 3 to 4 immune-related adverse events in 10 percent of the sintilimab group, with two immune-related deaths.

## Fields

- Kind: Key paper
- Last checked: 2026-09-22
- Journal: The Lancet
- Year: 2024
- DOI: 10.1016/S0140-6736(24)00594-4
- Authors: Liu X, Zhang Y, Yang KY, et al.
- Findings: Three-year event-free survival 86 percent (95% CI 81 to 90) versus 76 percent (70 to 81); hazard ratio 0.59 (0.38 to 0.92), p 0.019.; Grade 3 to 4 adverse events 74 versus 65 percent; grade 3 to 4 immune-related events 10 percent with sintilimab.
- What it means: PD-1 blockade added to chemoradiotherapy is a new option for high-risk locoregionally advanced nasopharyngeal carcinoma; longer follow-up will show whether it lengthens survival.
- Caveats: Chinese population with endemic EBV-related disease; open-label; overall survival immature.

## Sources

- Lancet 2024: https://doi.org/10.1016/S0140-6736(24)00594-4
- PubMed: https://pubmed.ncbi.nlm.nih.gov/38824941/

## Connected records

- cancers: [Locoregionally advanced nasopharyngeal carcinoma (stage III to IVA)](https://onco.cc/cancers/locoregionally-advanced-nasopharyngeal-carcinoma/), [Nasopharyngeal carcinoma](https://onco.cc/cancers/nasopharyngeal/)
- drugs: [Sintilimab](https://onco.cc/drugs/sintilimab/)
- trials: [CONTINUUM](https://onco.cc/trials/continuum/)
- journals: [The Lancet](https://onco.cc/journals/lancet/)

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