Abstract
BackgroundPlatinum‐based chemotherapy is the standard of care as first‐line treatment for recurrent or metastatic nasopharyngeal carcinoma (RM‐NPC); however, the prognosis of patients with RM‐NPC remains poor. The aim of this study was to evaluate the role of anti‐epidermal growth factor receptor (anti‐EGFR) antibody plus chemotherapy for RM‐NPC.MethodsRM‐NPC patients who received first‐line chemotherapy plus an anti‐EGFR antibody were recruited from Sun Yat‐Sen University Cancer Center between July 2007 and November 2017. Survival analyses were performed using the Kaplan‐Meier method with a log‐rank test. A Cox proportional hazards model was used for the multivariate analyses.ResultsA total of 203 patients were enrolled in the present study. The median follow‐up time was 34.3 months (interquartile range: 19.7‐66.5 months). The median progression‐free survival (PFS) was 8.9 months (95% CI: 7.7‐10.0 months) and the median overall survival (OS) was 29.1 months (95% CI: 23.5‐34.6 months). The 1‐, 3‐, and 5‐year PFS and OS rates were 35.5% and 79.6%, 15.2% and 42.5%, and 11.6% and 23.6%, respectively. The objective response rate (ORR) was 67.5% and the disease control rate (DCR) was 91.1%. The multivariate analysis identified the following prognostic factors for PFS: anti‐EGFR agent (P = .010), recurrence/metastasis sequence (P = .016), KPS (P = .017), and combined chemotherapy regimen (P = .015). Independent risk factors for OS included age >43 years (P = .002), Karnofsky performance score ≤80 (P < .001), and higher level of baseline Epstein‐Barr virus (EBV) DNA (P = .008). Leukopenia was the most common adverse event (AE) in this cohort (any grade, 84.2%; grades 3‐4, 43.4%).ConclusionsAnti‐EGFR antibody plus chemotherapy achieved promising antitumor activity with a tolerable toxicity profile in RM‐NPC. Thus, randomized clinical trials are warranted to compare the efficacy of chemotherapy with or without anti‐EGFR antibody in these patients.
Highlights
Nasopharyngeal carcinoma (NPC) is an endemic tumor in the eastern and southeastern regions of Asia
Our findings indicate that anti-Epidermal growth factor receptor (EGFR) monoclonal antibodies (mAbs) plus chemotherapy achieved a promising response rate, progressionfree survival (PFS), and overall survival (OS) for recurrent or metastatic nasopharyngeal carcinoma (RM-NPC)
It has been recognized that patients with RM-NPC are likely to harbor platinum-resistant tumor clones, which may be partially due to the activation of the EGFR signaling pathway.[21,22]
Summary
Nasopharyngeal carcinoma (NPC) is an endemic tumor in the eastern and southeastern regions of Asia. Most patients eventually develop locoregional recurrence and/or distant metastasis.[2-4]. For those with recurrence or metastatic NPC (RM-NPC), the prognosis remains extremely poor, with a median OS ranging from 15 to 29 months.[5]. Cetuximab (CTX) and nimotuzumab (NTZ) are two major anti-EGFR mAbs that have frequently been used for the treatment of NPC. Several studies have indicated that treatment with CTX or NTZ enhances the efficacy of chemoradiotherapy for locoregionally advanced NPC.[11-15]. The antitumor activity of anti-EGFR mAbs for RM-NPC has rarely been reported.[16,17]. The aim of the present study was to evaluate the antitumor efficacy and safety of anti-EGFR mAbs (CTX or NTZ) plus palliative chemotherapy as a first-line treatment for RM-NPC The antitumor activity of anti-EGFR mAbs for RM-NPC has rarely been reported.[16,17] The aim of the present study was to evaluate the antitumor efficacy and safety of anti-EGFR mAbs (CTX or NTZ) plus palliative chemotherapy as a first-line treatment for RM-NPC
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
