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Two cheap tablets taken at home matched, and in fact beat, intravenous cisplatin for advanced head and neck cancer in a 422-patient Indian trial, with fewer side effects.
An open-label non-inferiority phase 3 randomised 422 patients (213 oral metronomic, 209 cisplatin). Median overall survival was 7.5 months with oral metronomic chemotherapy versus 6.1 months with cisplatin (hazard ratio 0.773; 95% CI 0.615-0.97; P=0.026), meeting non-inferiority and favouring the oral regimen, with grade 3 or worse adverse events in 19% versus 30%. The authors noted that NCCN-recommended options apply to fewer than 3% of patients in low- and middle-income settings because of cost. The regimen became the backbone for the later low-dose nivolumab trial and for METRO PLUS.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
Shares Vanita Noronha, Vijay Patil, Kumar Prabhash, Buccal mucosa and gingivobuccal cancer (oral cancer in India).
Shares Vanita Noronha, Vijay Patil, Kumar Prabhash, Tata Memorial Centre.
Shares Tata Memorial Centre, Chemotherapy roadmap: mustard gas → curative combinations → the warhead inside smarter drugs, No incentive to repurpose cheap drugs, Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation.
Shares Tata Memorial Centre, Chemotherapy roadmap: mustard gas → curative combinations → the warhead inside smarter drugs, No incentive to repurpose cheap drugs, Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation.
Shares Vijay Patil, Kumar Prabhash, Tata Memorial Centre, Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation.
Shares Oral tongue and floor of mouth cancer, Buccal mucosa and gingivobuccal cancer (oral cancer in India), Oral cavity cancer (mouth and tongue), Tata Memorial Centre.
Shares Vanita Noronha, Kumar Prabhash, Tata Memorial Centre, Prices and value.
Shares Oral tongue and floor of mouth cancer, Buccal mucosa and gingivobuccal cancer (oral cancer in India), Oral cavity cancer (mouth and tongue), Tata Memorial Centre.