Top Line: Is it ok to give weekly cisplatin instead of every three weeks cisplatin with adjuvant radiation for head and neck squamous cell carcinoma?
The Study: Two randomized trials have compared QW v Q3W cisplatin, JCOG1008 and a Tata Memorial trial. Initial results of JCOG1008 showed that 7 cycles of 40mg/m2 QW cisplatin was noninferior to 3 cycles of 100 mg/m2 Q3W cisplatin in patients with resected, high risk HNSCC. In contrast, QW cisplatin was not noninferior in the Tata Memorial trial, however they used a lower 30 mg/m2 QW dose than was used in JCOG1008. Here we have the final long term results of JCOG1008. It included a total of 261 patients who received adjuvant RT for high risk HNSCC with either QW or Q3W cisplatin. Cisplatin dose intensity was estimated to be higher in the QW arm compared to Q3W (33.6 mg/m2 per week v 29.3 mg/m2 per week). At 5 years, OS was deemed noninferior with QW cisplatin (71.2% v 58.7%). The rates of recurrence free survival (64.3% v 53%) and local recurrence free survival (68.8% v 57.2%) were also noninferior and numerically downright impressive compared to Q3W. Interestingly, distant metastasis was more common in the Q3W arm (25.8% v 18.6%).
TBL: The final, long term results of JCOG1008 show that once weekly cisplatin at a dose of 40 mg/m2 is noninferior to every three weeks cisplatin for patients receiving adjuvant chemoradiation for high risk HNSCC. | Tahara, J Clin Oncol 2026
The Study: Two randomized trials have compared QW v Q3W cisplatin, JCOG1008 and a Tata Memorial trial. Initial results of JCOG1008 showed that 7 cycles of 40mg/m2 QW cisplatin was noninferior to 3 cycles of 100 mg/m2 Q3W cisplatin in patients with resected, high risk HNSCC. In contrast, QW cisplatin was not noninferior in the Tata Memorial trial, however they used a lower 30 mg/m2 QW dose than was used in JCOG1008. Here we have the final long term results of JCOG1008. It included a total of 261 patients who received adjuvant RT for high risk HNSCC with either QW or Q3W cisplatin. Cisplatin dose intensity was estimated to be higher in the QW arm compared to Q3W (33.6 mg/m2 per week v 29.3 mg/m2 per week). At 5 years, OS was deemed noninferior with QW cisplatin (71.2% v 58.7%). The rates of recurrence free survival (64.3% v 53%) and local recurrence free survival (68.8% v 57.2%) were also noninferior and numerically downright impressive compared to Q3W. Interestingly, distant metastasis was more common in the Q3W arm (25.8% v 18.6%).
TBL: The final, long term results of JCOG1008 show that once weekly cisplatin at a dose of 40 mg/m2 is noninferior to every three weeks cisplatin for patients receiving adjuvant chemoradiation for high risk HNSCC. | Tahara, J Clin Oncol 2026