Three Chemo Drugs Better Than Two for Advanced Head/Neck Cancers

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The study participants were randomly assigned to receive the standard two-drug regimen (cisplatin and fluorouracil) or the new three-drug treatment which included cisplatin, fluorouracil and docetaxel. People in both groups then received seven weeks of weekly chemoradiotherapy (chemotherapy and radiation combined) with carboplatin, and radiotherapy (radiation treatment) for five days a week. Those who became eligible for surgery were able to have surgery six to 12 weeks after completing chemoradiotherapy.

Overall survival after three years was estimated to be 62 percent for the three-drug group compared to 48 percent for the two-drug group. Median overall survival was 71 months for the newer treatment versus just 30 months for the older regimen, according to the study.

The second study, conducted by European researchers, randomly assigned 358 people with unresectable stage III or IV head and neck cancer to receive either the two-drug regimen or the newer three-drug treatment. If there was no progression of disease after the study participants completed chemotherapy, they were given radiotherapy.

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Overall survival increased from 14.5 months for the two-drug group to 18.8 months for the three-drug group in this study.

In both studies, the three-drug regimen had a similar, though slightly reduced, side-effect profile than the two-drug therapy. Posner said that's because they were able to use less fluorouracil in the three-drug regimen.

"We maximized efficacy and reduced toxicity. With the inclusion of the [three-drug induction chemotherapy] followed by chemoradiotherapy, we saw unprecedented survival," said Posner.

Of the new research, Dr. David Pfister, chief of the head and neck medical oncology service at Memorial Sloan-Kettering Cancer Center in New York City, said that the "triple-drug regimen is more effective than the standard regimen alone when given prior to radiation-based treatment and not at a cost of side effects. There was no increase in overall toxicity."

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