Top Line: Randomized data suggests weekly cisplatin dosed at 40–but not 30!– mg/m² concurrent to head and neck radiation confers superior outcomes to q3 weekly cisplatin.
The Study: We now have even more supporting data. The phase 3 ConCERT trial randomized 272 eligible patients receiving definitive radiation for non-nasopharyngeal locally advanced head and neck squamous cell carcinoma with concurrent cisplatin delivered 100 mg/m² q3 weeks versus 40 mg/m² weekly. At 2 years, locoregional control was actually higher with weekly cisplatin (61% vs 51%), easily meeting the prespecified non-inferiority margin (HR 0.72). This could be due to improved tolerability: Even though the intended dose of q3 weekly cisplatin x 3 (300 mg/m²) exceed the intended dose of weekly cisplatin x 7 (280 mg/m²), the median dose received was 225 mg/m² versus 240 mg/m². Indeed, grade 3+ events occurred in 61% with q3 weekly versus 45% with weekly, hospitalizations in 37% versus 20%, and IV fluid requirement in 62% versus 35%. Specifically, there was a notable divergence in severe mucositis (54% with q3 weekly versus 41% with weekly), >10% weight loss (41% versus 35%), and acute kidney injury(18%, 24/133 versus 4%, 5/133).
TBL: Weekly cisplatin at 40 mg/m² versus the longtime standard q3-weekly cisplatin concurrent to definitive head and neck radiation resulted in substantially less toxicity which translated to a higher median received dose and numerically better locoregional control. | Sharma, JNCI 2026
The Study: We now have even more supporting data. The phase 3 ConCERT trial randomized 272 eligible patients receiving definitive radiation for non-nasopharyngeal locally advanced head and neck squamous cell carcinoma with concurrent cisplatin delivered 100 mg/m² q3 weeks versus 40 mg/m² weekly. At 2 years, locoregional control was actually higher with weekly cisplatin (61% vs 51%), easily meeting the prespecified non-inferiority margin (HR 0.72). This could be due to improved tolerability: Even though the intended dose of q3 weekly cisplatin x 3 (300 mg/m²) exceed the intended dose of weekly cisplatin x 7 (280 mg/m²), the median dose received was 225 mg/m² versus 240 mg/m². Indeed, grade 3+ events occurred in 61% with q3 weekly versus 45% with weekly, hospitalizations in 37% versus 20%, and IV fluid requirement in 62% versus 35%. Specifically, there was a notable divergence in severe mucositis (54% with q3 weekly versus 41% with weekly), >10% weight loss (41% versus 35%), and acute kidney injury(18%, 24/133 versus 4%, 5/133).
TBL: Weekly cisplatin at 40 mg/m² versus the longtime standard q3-weekly cisplatin concurrent to definitive head and neck radiation resulted in substantially less toxicity which translated to a higher median received dose and numerically better locoregional control. | Sharma, JNCI 2026