METRO PLUS (Tata Memorial Centre, Varanasi)
Adding low-cost oral metronomic tablets to standard paclitaxel-carboplatin doubled median survival from 5 to 10 months in a randomised trial run in Varanasi.
Overview
238 patients (119 per arm) with advanced unresectable head and neck cancer were randomised to paclitaxel-carboplatin plus oral metronomic chemotherapy or paclitaxel-carboplatin alone. Median overall survival was 10 months with the combination versus 5 months with chemotherapy alone (hazard ratio 0.54; 95% CI 0.41-0.72; P<0.001). Published in JCO Global Oncology in 2026 and framed by its authors as a trial addressing global cancer care equity, it extends the Tata Memorial metronomic programme to the Gangetic plain and to patients fit for platinum doublets.
- Median 10 vs 5 months with Paclitaxel-carboplatin + oral metronomic chemotherapy compared with Paclitaxel-carboplatin; about 5 months longer for half the group.
- A median is a midpoint: half the people did better than this and half did worse, so it is not a prediction for any one person.
- Put another way, the treated group had about 46 percent lower chance of the event at any given time (hazard ratio 0.54, likely range 0.41 to 0.72).
- Overall survival counts deaths from any cause, so it is the most direct measure of whether a treatment helps people live longer.
- These results apply to the people the trial enrolled: Advanced unresectable head and neck cancer: paclitaxel-carboplatin with or without oral metronomic chemotherapy. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
Pages like this
not linked directly; found by shared links- IdeaValidate low-cost metronomic oral regimens in phase 3 and carry them into guidelines
Shares Tata Memorial Centre, No incentive to repurpose cheap drugs, Most of the world has almost no cancer care, Cytotoxic chemotherapy.
- IdeaA strategic reserve of essential generic cancer drugs to end recurring shortages
Shares Carboplatin, Paclitaxel / nab-paclitaxel, No incentive to repurpose cheap drugs, Most of the world has almost no cancer care.
- IdeaA platform trial of very-low-cost metronomic chemotherapy in LMIC common cancers
Shares Tata Memorial Centre, No incentive to repurpose cheap drugs, Most of the world has almost no cancer care, Cytotoxic chemotherapy.
- IdeaA non-profit manufacturer for generic cancer drugs in chronic shortage
Shares Carboplatin, Paclitaxel / nab-paclitaxel, Most of the world has almost no cancer care, Cytotoxic chemotherapy.
- IdeaChoose regimens by infusion-chair hours, not just efficacy, where chairs are the constraint
Shares Carboplatin, Paclitaxel / nab-paclitaxel, Most of the world has almost no cancer care, Cytotoxic chemotherapy.
- IdeaPublic-option manufacturing for essential generic cancer drugs in shortage
Shares Carboplatin, Paclitaxel / nab-paclitaxel, Most of the world has almost no cancer care, Cytotoxic chemotherapy.
- IdeaCommunity health workers with smartphone AI screen for mouth cancer in South Asia
Shares Tata Memorial Centre, Most of the world has almost no cancer care, Head and neck squamous cell carcinoma.
- TrialLow-dose nivolumab plus metronomic chemotherapy (Tata Memorial)
Shares Methotrexate, Tata Memorial Centre, Most of the world has almost no cancer care, Cytotoxic chemotherapy.