Anti‐epidermal growth factor receptor therapy concurrently with induction chemotherapy in locoregionally advanced nasopharyngeal carcinoma

Abstract

Little is known about the efficacy and toxicity of anti‐epidermal growth factor receptor therapy concurrently with induction chemotherapy (IC) in locoregionally advanced nasopharyngeal carcinoma (LA‐NPC). The present study aimed to address this question. We identified 2848 patients with newly diagnosed LA‐NPC receiving IC between January 2012 and May 2015. The propensity score matching (PSM) method was used to balance various factors and to match patients. Survival outcomes and toxicities between different groups were compared. In total, 596 patients were selected at a 1:3 ratio, with 149 in the IC + CTX/NTZ group and 447 in the IC alone group. The 3‐year disease‐free survival, overall survival, distant metastasis‐free survival and locoregional relapse‐free survival rates for IC + CTX/NTZ vs IC alone were 84.3% vs 75.2% (P = .059), 94.0% vs 87.9% (P = .053), 88.0% vs 84.9% (P = .412) and 93.3% vs 88.2% (P = .242). Multivariate analysis established a treatment group (IC vs IC + CTX/NTZ) as a prognostic predictor for DFS (hazard ratio [HR], 1.497; 95% confidence interval [CI], 1.016‐2.206; P = .041) and OS (HR, 1.984; 95%, CI, 1.023‐3.848; P = .043). Grade 3‐4 skin reaction (15.4% vs 0.4%, P < .001) and mucositis (10.1% vs 2.7%, P < .001) were more common in the IC + CTX/NTZ group than that in the IC alone group. Our findings suggested that CTX/NTZ in combination with IC may be a more effective and promising strategy for patients with LA‐NPC treated with intensity‐modulated radiotherapy.

Anti‐epidermal growth factor receptor monoclonal antibody plus palliative chemotherapy as a first‐line treatment for recurrent or metastatic nasopharyngeal carcinoma

“…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 . However, the antitumor activity of anti‐EGFR mAbs for RM‐NPC has rarely been reported .…”

“…Several studies have indicated that treatment with CTX or NTZ enhances the efficacy of chemoradiotherapy for locoregionally advanced NPC. [11][12][13][14][15] However, 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 Efficacy and Safety of Anti-epidermal Growth Factor Receptor Monoclonal Antibodies in Nasopharyngeal Carcinoma: Literature-based Meta-analyses

“…However, what are the effects of anti-EGFR mAbs when incorporated into the induction or adjuvant phase? Peng et al 54 conducted a retrospective analysis suggesting that anti-EGFR mAbs in combination with IC may be a more effective and promising strategy for patients with locoregionally advanced NPC. Further investigations are required to explore the application of anti-EGFR mAbs in NPC.…”

Administration of nimotuzumab combined with cisplatin plus 5-fluorouracil as induction therapy improves treatment response and tolerance in patients with locally advanced nasopharyngeal carcinoma receiving concurrent radiochemotherapy: a multicenter randomized controlled study

“…Overexpression of EGRF significantly increases the risk of adverse prognosis of NPC OS (HR = 1.86, 95%CI 1.25–2.77; P = 0.000),disease-free survival (DFS) (HR = 2.25, 95%CI 1.66–3.04; P = 0.000), locoregional recurrence free survival (LRFS) (HR = 2.93, 95%CI 1.71–5.02; P = 0.000) [15]. In patients with locally advanced NPC receiving IMRT, combined anti-EGFR receptor therapy may be a more effective treatment strategy [18].…”