{"entity":{"id":"paper-zhang-gemcitabine-cisplatin-vs-fluorouracil-cisplatin-rm-npc-lancet-2016","kind":"paper","name":"Gemcitabine plus cisplatin versus fluorouracil plus cisplatin in recurrent or metastatic nasopharyngeal carcinoma","aka":[],"tldr":"The first phase 3 trial in metastatic nasopharyngeal cancer found gemcitabine with cisplatin held the disease back for longer than the older fluorouracil-cisplatin combination, and it became the chemotherapy backbone to which immunotherapy was later added.","summary":"Chinese multicentre open-label randomised phase 3 trial of 362 patients with recurrent or metastatic nasopharyngeal carcinoma assigned to gemcitabine plus cisplatin or fluorouracil plus cisplatin for up to six cycles.\n\nMedian progression-free survival was 7.0 months with gemcitabine-cisplatin against 5.6 months (hazard ratio 0.55), with a higher response rate and a later overall survival advantage; toxicity profiles differed (myelosuppression versus mucositis).","asOf":"2026-09-18","links":[{"label":"Lancet 2016","url":"https://doi.org/10.1016/S0140-6736(16)31388-5"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/27567279/"}],"tags":[],"related":[],"cancers":["recurrent-metastatic-nasopharyngeal-carcinoma"],"sections":[],"technologies":[],"targets":[],"drugs":["gemcitabine-cisplatin","fluorouracil","cisplatin"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet"],"dependsOn":[],"notes":[],"journal":"The Lancet","year":2016,"doi":"10.1016/S0140-6736(16)31388-5","pmid":"27567279","authors":"Zhang L, Huang Y, Hong S, et al.","paperType":"rct","findings":["Median progression-free survival 7.0 months with gemcitabine-cisplatin versus 5.6 months with fluorouracil-cisplatin; hazard ratio 0.55.","Higher objective response rate with gemcitabine-cisplatin."],"whatItMeans":"Gemcitabine and cisplatin is the first-line chemotherapy for recurrent or metastatic nasopharyngeal carcinoma and the backbone of the toripalimab, camrelizumab and tislelizumab combinations.","caveats":["Open-label; conducted entirely in China.","Median survival remained under two years with chemotherapy alone."],"changedPractice":true,"participants":362},"route":"/key-papers/paper-zhang-gemcitabine-cisplatin-vs-fluorouracil-cisplatin-rm-npc-lancet-2016/","neighbours":{"cancer":[{"id":"recurrent-metastatic-nasopharyngeal-carcinoma","kind":"cancer","name":"Recurrent and metastatic nasopharyngeal carcinoma","route":"/cancers/recurrent-metastatic-nasopharyngeal-carcinoma/"}],"drug":[{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"},{"id":"fluorouracil","kind":"drug","name":"Fluorouracil (5-FU)","route":"/drugs/fluorouracil/"},{"id":"gemcitabine-cisplatin","kind":"drug","name":"Gemcitabine + cisplatin","route":"/drugs/gemcitabine-cisplatin/"}],"journal":[{"id":"lancet","kind":"journal","name":"The Lancet","route":"/journals/lancet/"}]}}