Nasopharyngeal Carcinoma: Clinical Achievements and Considerations Among Treatment Options.

Zheran Liu,Ye Chen,Yonglin Su,Xiaolin Hu,Xingchen Peng

doi:10.3389/fonc.2021.635737

Abstract

Nasopharyngeal carcinoma (NPC) is a severe malignancy arising from the nasopharyngeal epithelium and is southern China’s third most common cancer. With the advancement of treatment methods, early-stage NPC patients usually have a better prognosis and more prolonged survival period than those with other malignant tumors. Most treatment failures are due to distant metastasis or a locally advanced stage of NPC in the initial diagnosis. In addition, approximately 10% of patients develop local recurrence, and 10%–20% of patients experience distant metastasis after treatment. These patients have a poor prognosis, with a median survival of only approximately 10–15 months. In the rapid development of treatment options, the efficacy and safety of some treatments have been validated and approved for first-line treatment, while those of other treatments remain unclear. The present study aims to provide a comprehensive overview of recent advances in NPC treatment and explain the various therapeutic possibilities in treating locally advanced, recurrent, and metastatic NPC patients.

Highlights

Nasopharyngeal carcinoma (NPC) is a malignant tumor arising from the nasopharyngeal epithelium
The results showed that an anti-EGFR antibody could significantly improve OS (HR = 0.51, 95% CI = 0.39–0.66) and disease-free survival (DFS) (HR = 0.68, 95% CI = 0.54– 0.86) compared to RT or chemoradiotherapy alone, but concurrent anti-EGFR antibody plus radiotherapy failed to achieve survival benefits compared with traditional cytotoxicdrug-based Concurrent chemoradiation therapy (CCRT) in locoregionally advanced NPC patients [37]
The results demonstrated that concurrent cetuximab and cisplatin with Intensity-modulated radiotherapy (IMRT) had 86.5% 2-year disease-free survival (DFS) in treating locoregionally advanced NPC with accepted side effects [38]

Summary

INTRODUCTION

Nasopharyngeal carcinoma (NPC) is a malignant tumor arising from the nasopharyngeal epithelium. For the assessment of the antitumor efficacy of the additional anti-EGFR antibody to cytotoxic regime-based CCRT, a phase II study demonstrated the clinical efficiency of treating locoregionally advanced NPC patients with concurrent cetuximab, cisplatin, and IMRT in stage III, IVa, and IVb (according to the AJCC 7th edition staging system) NPC patients. Findings from a recent phase III RCT suggested that additional metronomic capecitabine as an adjuvant therapy could significantly improve failure-free survival in patients with locoregionally advanced NPC compared with standard therapy (CCRT with or without induction chemotherapy, HR = 0.5, 95% CI = 0.32–0.79) [55]. 6 cycles, gemcitabine 1,000 mg/m2, day 1 and day 8 of each 21 days, maximum 6 cycles

82 Spartalizumab 400 mg once every 4 weeks

Findings

CONCLUSION