Neoadjuvant chemotherapy with TPF shows greater survival benefit over TP in borderline resectable oral cancers

A recent study suggests that neoadjuvant chemotherapy (NACT) along with TPF (docetaxel, cisplatin, and 5FU) shows higher survival benefit over TP (docetaxel and cisplatin) in treating borderline resectable oral cancers. The study findings were published in the European Journal of Cancer.

This phase 3, randomized, superiority study included 495 adult patients with borderline resectable locally advanced oral cancers. These participants were randomized in a 1:1 ratio to receive either TP (N=248) or TPF (N=247). The primary endpoint of the study was overall survival (OS) while the secondary endpoints were adverse events and progression-free survival (PFS).

At the end of 5 years, the OS in TP and TPF arms were 18.5% and 23.9%, respectively. Post NACT, 43.8% of the patients were deemed resectable, but only 34.5% underwent surgery. The 5-year OS was found to be 50.7% in the surgically resected cohort while it was 5% in the unresected cohort following NACT. Adverse events of Grade 3 or above were seen in 97 patients in the TP arm and 179 patients in the TPF arm.

Based on the above results, it can be concluded that NACT with TPF may show greater survival benefit over TP in case of patients with borderline resectable oral cancers and those who can undergo surgery may achieve a relatively good and sustained survival.