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.