Addition of bevacizumab to systemic therapy for locally advanced and metastatic nasopharyngeal carcinoma

Abstract

Radiotherapy is a vital treatment option for patients with nasopharyngeal carcinoma (NPC). Concurrent cisplatin-based radiochemotherapy with or without adjuvant chemotherapy had acquired good clinical effects with good local control rates. However, a number of patients present with metastasis following systemic regimens or initial diagnosis of locally advanced NPC, which cause difficulty for subsequent therapy. Therefore, there is an urgent requirement to discover novel targeted therapies. The present report describes one case of a patient with NPC and multiple metastases. The patient was treated with systemic therapy in combination with bevacizumab, palliative radiotherapy and chemotherapy following treatment with cetuximab and concurrent chemoradiotherapy in 2015. Following the addition of bevacizumab, metastases were reduced or disappeared after >2 months, and the duration of progression-free survival was 7 months. Bevacizumab is a monoclonal antibody that targets VEGF, and it is associated with angiogenesis, which causes the growth, invasion and progression of tumors. In previous studies, bevacizumab has been approved for the treatment of several types of malignant cancer and it has been able to effectively improve prognosis. In the present review, the effect of adding bevacizumab to systemic therapy for the treatment of NPC was analyzed, with a particular focus on advanced and metastatic diseases. A growing number of phase I/II clinical trials involving bevacizumab for NPC have been conducted with clinical outcomes showing improved rates of overall survival and progression-free survival as well as improvements in the quality of life of patients. However, severe or deadly toxicities can also result from combination treatment with bevacizumab. In the future, bevacizumab may become a common addition to systemic therapy for the treatment of locally advanced and metastatic NPC.

Effects of concurrent chemoradiotherapy with or without Endostar on the regression of retropharyngeal lymph node and prognosis of patients with locally advanced nasopharyngeal carcinoma: a retrospective study

“…In recent years, targeted therapy has become a promising anti-tumor treatment method. Researches have demonstrated that anti-angiogenic drugs and chemoradiotherapy have a synergistic effect on NPC (Lee et al 2012 ; Zhang et al 2018 ). Currently, the application of Endostar in NPC mainly focused on recurrent and metastatic patients (Guan et al 2015 ; Jin et al 2013 ), and had improved the complete remission rate of CLNs metastasis (Li et al 2020a , b ).…”

Angiogenesis in nasopharyngeal carcinoma: insights, imaging, and therapeutic strategies

“…Bevacizumab, a monoclonal antibody targeting VEGF, effectively inhibits VEGF activity, thereby achieving the objectives of anti-tumor angiogenesis and metastasis suppression in NPC ( 97 ). This therapy can be used for the treatment of locally advanced and metastatic NPC ( 98 – 100 ). Recent studies have demonstrated that Endostar, a recombinant human endostatin, is a targeted drug with antiangiogenic and antitumor effects, and when combined with other antitumor therapies, it significantly enhances the overall anticancer effect ( 101 , 102 ).…”