Adjuvant metronomic chemotherapy for locoregionally advanced nasopharyngeal carcinoma

It is a golden age for cancer drug development. There are frequent announcements of regulatory approvals of new drugs, or more commonly, an existing but fairly new drug or drug combination for yet another indication. Immune checkpoint inhibitors and antibody drug conjugates are among the most common of such recent approvals. One disadvantage of this otherwise remarkable development is the enormous cost of such drugs, thereby placing an ever increasing financial burden on health-care systems and making it virtually impossible for most patients with cancer, especially those who live in low-income and middle-income countries (LMICs), to benefit from these successes. The lack of access for many patients highlights the need to develop readily accessible, less toxic, and substantially less expensive treatments than currently available on-patent treatments, such as immune checkpoint inhibitors or targeted therapies, for patients without financial means and especially those in LMICs. Metronomic capecitabine as adjuvant therapy in locoregionally advanced nasopharyngeal carcinoma: a multicentre, open-label, parallel-group, randomised, controlled, phase 3 trialThe addition of metronomic adjuvant capecitabine to chemoradiotherapy significantly improved failure-free survival in patients with high-risk locoregionally advanced nasopharyngeal carcinoma, with a manageable safety profile. These results support a potential role for metronomic chemotherapy as an adjuvant therapy in the treatment of nasopharyngeal carcinoma. Full-Text PDF