Clinical trial finds weekly chemotherapy offers no toxicity advantage over standard dosing schedule

A Phase II clinical trial comparing two cisplatin dosing regimens for treating advanced head and neck cancer found that weekly administration did not significantly reduce acute toxicity compared to the standard three-week dosing schedule in p16-negative patients. The study, presented at the 2026 American Society for Radiation Oncology Annual Meeting, revealed that while the two approaches produced different side effect profiles, neither demonstrated the expected reduction in serious treatment-related complications. These findings suggest that both chemotherapy schedules result in similar overall treatment burdens for this patient population.

The NRG-HN009 trial involved 234 patients with p16-negative head and neck squamous cell carcinoma who received identical radiation doses but different cisplatin schedules. Researchers measured treatment burden using a T-score tracking all grade 3-4 adverse events during and six months after therapy. The every-three-week regimen produced mean T-scores of 2.23, while weekly dosing yielded 2.48, a statistically insignificant difference that failed to meet the study's success threshold for advancing to Phase III testing.

The two dosing approaches generated distinct toxicity patterns rather than uniform differences. Patients receiving three-week intervals experienced more nausea, dehydration, and kidney complications, while those on weekly schedules showed greater drops in white blood cells and magnesium. Notably, the weekly arm exhibited higher locoregional cancer recurrence rates at six months, introducing additional clinical considerations beyond toxicity profiles.