{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"Head and Neck Oncology Journal Club","title":"Weekly or 3-Weekly Cisplatin? JCOG1008 at Five Years","html":"<iframe width=\"100%\" height=\"180\" frameborder=\"no\" scrolling=\"no\" seamless src=\"https://share.transistor.fm/e/ae90a9fb\"></iframe>","width":"100%","height":180,"duration":403,"description":"Most units moved to weekly cisplatin years before the randomised evidence caught up. JCOG1008 gave us the interim answer in 2022. This month brings the five-year data — and a number that is easy to misread.In this episode:Why the trial was designed as a noninferiority study, and what the 1.32 margin was chosen to preserveThe five-year efficacy results across overall survival, relapse-free survival and local controlWhy \"not worse\" and \"better\" are different claims — and why the confidence intervals matter more than the gap between the curvesThe baseline imbalances that randomisation did not stratify forDose intensity as the likely explanation for why this trial and the Indian phase III trial disagreeLate toxicity, nutrition support–free survival, and the two treatment-related deathsKey numbers:261 patients randomised, 132 to 3-weekly cisplatin 100 mg/m² and 129 to weekly 40 mg/m². At a median follow-up of 5.6 years, five-year overall survival was 58.7% versus 71.2%, stratified HR 0.76 (95% CI 0.52–1.12) — noninferiority confirmed. Five-year relapse-free survival 53.0% versus 64.3% (HR 0.81), local relapse-free survival 57.2% versus 68.8% (HR 0.79). Adjusting for T stage, N stage and primary site moved the hazard ratio to 0.88 (95% CI 0.60–1.29). Estimated dose intensity was 33.6 versus 29.3 mg/m² per week. No late adverse event differed by 10% or more between the arms.Paper discussed:Tahara M, Kiyota N, Kodaira T, et al. Long-Term Follow-Up of JCOG1008, a Randomized Phase II/III Trial of Chemoradiotherapy Comparing 3-Weekly Cisplatin With Weekly Cisplatin in Postoperative Head and Neck Cancer. J Clin Oncol. Published online June 26, 2026. doi:10.1200/JCO-25-01708Trial registration: jRCTs031180135Links:Summary: hnoncology-journalclub.netlify.app\nVideo channel: youtube.com/@headandneckcancers","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}