{"entity":{"id":"paper-zhang-gemcitabine-cisplatin-induction-nasopharyngeal-nejm-2019","kind":"paper","name":"Gemcitabine and cisplatin induction chemotherapy in nasopharyngeal carcinoma","aka":[],"tldr":"Three cycles of gemcitabine and cisplatin before chemoradiotherapy cut recurrences and improved survival in locoregionally advanced nasopharyngeal cancer, making induction chemotherapy the standard in endemic regions.","summary":"Chinese multicentre randomised phase 3 trial of 480 patients with locoregionally advanced nasopharyngeal carcinoma (stage III to IVB, excluding T3-4N0 and T3N1) comparing three cycles of induction gemcitabine and cisplatin followed by concurrent cisplatin chemoradiotherapy with chemoradiotherapy alone.\n\nThree-year recurrence-free survival was 85.3 percent with induction against 76.5 percent, and overall survival 94.6 percent against 90.3 percent, with the largest reduction in distant metastases; acute toxicity was higher during induction but late toxicity was similar.","asOf":"2026-09-18","links":[{"label":"N Engl J Med 2019","url":"https://doi.org/10.1056/NEJMoa1905287"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/31150573/"}],"tags":[],"related":[],"cancers":["locoregionally-advanced-nasopharyngeal-carcinoma"],"sections":[],"technologies":[],"targets":[],"drugs":["gemcitabine-cisplatin","cisplatin"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2019,"doi":"10.1056/NEJMoa1905287","pmid":"31150573","authors":"Zhang Y, Chen L, Hu GQ, et al.","paperType":"rct","findings":["Three-year recurrence-free survival 85.3 percent with induction gemcitabine-cisplatin versus 76.5 percent with chemoradiotherapy alone.","Three-year overall survival 94.6 percent versus 90.3 percent; fewer distant metastases."],"whatItMeans":"Induction gemcitabine and cisplatin followed by chemoradiotherapy is the standard for locoregionally advanced nasopharyngeal carcinoma in endemic regions and in guidelines internationally.","caveats":["Conducted in an endemic Chinese population with non-keratinising EBV-related tumours; applicability to non-endemic disease is assumed.","Excluded the lower-risk N0 to N1 subgroups."],"changedPractice":true,"participants":480},"route":"/key-papers/paper-zhang-gemcitabine-cisplatin-induction-nasopharyngeal-nejm-2019/","neighbours":{"cancer":[{"id":"locoregionally-advanced-nasopharyngeal-carcinoma","kind":"cancer","name":"Locoregionally advanced nasopharyngeal carcinoma (stage III to IVA)","route":"/cancers/locoregionally-advanced-nasopharyngeal-carcinoma/"}],"drug":[{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"},{"id":"gemcitabine-cisplatin","kind":"drug","name":"Gemcitabine + cisplatin","route":"/drugs/gemcitabine-cisplatin/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}