{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"Head and Neck Oncology Journal Club","title":"The METRO PLUS Trial: Metronomic Chemotherapy Added to Paclitaxel-Carboplatin in Advanced HNSCC ","html":"<iframe width=\"100%\" height=\"180\" frameborder=\"no\" scrolling=\"no\" seamless src=\"https://share.transistor.fm/e/71a45cfd\"></iframe>","width":"100%","height":180,"duration":394,"description":"Can a $180-a-year regimen close the access gap in advanced head and neck cancer?In this episode we cover METRO PLUS (Kapoor et al., JCO Global Oncology 2026), a single-center, open-label, phase III trial from Varanasi testing whether adding triple oral metronomic chemotherapy — erlotinib, celecoxib, and weekly methotrexate — to paclitaxel-carboplatin improves survival in platinum-sensitive, unresectable advanced HNSCC.238 patients, randomized 1:1, in a young, oral-cavity-predominant cohort. The combination doubled median overall survival (10 v 5 months; HR 0.54) and progression-free survival (6 v 2 months; HR 0.38), lifted the 6-month OS rate to 68.6% versus 36.5%, and did all of this without increasing grade 3-5 toxicity. Quality of life favored the combination across multiple domains.Paper: https://doi.org/10.1200/GO-25-00721","thumbnail_url":"https://img.transistorcdn.com/wW69kG2r-jYQMXR4U9tleugBoTcAFuL6BYoBlLOBcxo/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS84OWQ3/MWNhMGUxODZkMDJh/OTk1NDdmYmExNThm/MWQ1Yi5wbmc.webp","thumbnail_width":300,"thumbnail_height":300}