Gemcitabine: a game changer in nasopharyngeal carcinoma

Chua, Melvin L.K.; Chan, Anthony T.C.

doi:10.1016/s0140-6736(16)31394-0

Cited by 19 publications

(17 citation statements)

References 10 publications

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“…As both low and extreme treatment intensities correlate with poorer survival outcomes, it is important to deliver the optimal treatment intensity to obtain the best prognosis. With regard to IC, more efficacious and less toxic regimens should be considered, such as gemcitabine plus cisplatin . In addition, the number of cycles of IC should be optimized; 2 cycles may be sufficient .…”

Section: Discussionmentioning

confidence: 99%

“…With regard to IC, more efficacious and less toxic regimens should be considered, such as gemcitabine plus cisplatin. 35,36 In addition, the number of cycles of IC should be optimized; 2 cycles may be sufficient. 37 For concurrent chemotherapy, an overdose of cisplatin should be In survival analysis, patients with an NRS2002 score >3 had significantly poorer survival outcomes than those with a NRS2002 score ≤3.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic value of nutritional risk screening 2002 scale in nasopharyngeal carcinoma: A large‐scale cohort study

et al. 2018

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Little is known about the value of the nutritional risk screening 2002 (NRS2002) scale in nasopharyngeal carcinoma (NPC). We conducted a large‐scale study to address this issue. We employed a big‐data intelligence database platform at our center and identified 3232 eligible patients treated between 2009 and 2013. Of the 3232 (12.9% of 24 986) eligible patients, 469 (14.5%), 13 (0.4%), 953 (29.5%), 1762 (54.5%) and 35 (1.1%) had NRS2002 scores of 1, 2, 3, 4 and 5, respectively. Survival outcomes were comparable between patients with NRS2002 <3 and ≥3 (original scale). However, patients with NRS2002 ≤3 vs >3 (regrouping scale) had significantly different 5‐year disease‐free survival (DFS; 82.7% vs 75.0%, P < .001), overall survival (OS; 88.8% vs 84.1%, P = .001), distant metastasis‐free survival (DMFS; 90.2% vs 85.9%, P = .001) and locoregional relapse‐free survival (LRRFS; 91.6% vs 87.2%, P = .001). Therefore, we proposed a revised NRS2002 scale, and found that it provides a better risk stratification than the original or regrouping scales for predicting DFS (area under the curve [AUC] = 0.530 vs 0.554 vs 0.577; P < .05), OS (AUC = 0.534 vs 0.563 vs 0.582; P < .05), DMFS (AUC = 0.531 vs 0.567 vs 0.590; P < .05) and LRRFS (AUC = 0.529 vs 0.542 vs 0.564; P < .05 except scale A vs B). Our proposed NRS2002 scale represents a simple, clinically useful tool for nutritional risk screening in NPC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prognostic value of nutritional risk screening 2002 scale in nasopharyngeal carcinoma: A large‐scale cohort study

et al. 2018

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“…Improved management has also been associated with the decline in NPC mortality . Diagnostic imaging accuracy improved and intensity modulated radiotherapy (IMRT) is established as the standard NPC treatment .…”

Section: Discussionmentioning

confidence: 99%

Global trends in nasopharyngeal cancer mortality since 1970 and predictions for 2020: Focus on low-risk areas

et al. 2017

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Nasopharyngeal cancer (NPC) mortality shows great disparity between endemic high risk areas, where non-keratinizing carcinoma (NKC) histology is prevalent, and non-endemic low risk regions, where the keratinizing squamous cell carcinoma (KSCC) type is more frequent. We used the World Health Organization database to calculate NPC mortality trends from 1970 to 2014 in several countries worldwide. For the European Union (EU), the United States (US) and Japan, we also predicted trends to 2020. In 2012, the highest age-standardized (world standard) rates were in Hong Kong (4.51/100,000 men and 1.15/100,000 women), followed by selected Eastern European countries. The lowest rates were in Northern Europe and Latin America. EU rates were 0.27/100,000 men and 0.09/100,000 women, US rates were 0.20/100,000 men and 0.08/100,000 women and Japanese rates were 0.16/100,000 men and 0.04/100,000 women. NPC mortality trends were favourable for several countries. The decline was -15% in men and -5% in women between 2002 and 2012 in the EU, -12% in men and -9% in women in the US and about -30% in both sexes in Hong Kong and Japan. The favourable patterns in Europe and the United States are predicted to continue. Changes in salted fish and preserved food consumption account for the fall in NKC. Smoking and alcohol prevalence disparities between sexes and geographic areas may explain the different rates and trends observed for KSCC and partially for NKC. Dietary patterns, as well as improvement in management of the disease, may partly account for the observed trends, too.

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“…Nasopharyngeal carcinoma (NPC) is a squamous epithelial cancer arising from the lateral wall surface of the nasopharynx 1 , 2 , and it has the highest metastatic potential among head and neck cancers. Distant metastasis is the major cause of treatment failure 3 .…”

Section: Introductionmentioning

confidence: 99%

Hypoxia-Induced Matrix Metalloproteinase-13 Expression in Exosomes from Nasopharyngeal Carcinoma Enhances Metastases

et al. 2018

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Exosomes are nano-vesicles secreted by tumor cells. Exosomes can transfer complex biological information and induce a diverse signaling response in a wide array of pathological conditions, such as hypoxia. Hypoxia is associated with aggressive phenotypes and poor outcomes in nasopharyngeal carcinoma (NPC) patients. Here, we analyzed the role of exosomes from hypoxic NPC cells in enhancing the metastases of normoxic cells in a hypoxia-induced factor-1α (HIF-1α)-dependent manner. HIF-1α rapidly accumulates and trans-activates hundreds of genes, such as matrix metalloproteinases (MMPs). We found that MMP-13 was over-expressed in exosomes and cells under hypoxic conditions. HIF-1α depletion in hypoxic CNE2 cells led to decreased MMP-13 levels in exosomes and significantly reduced cell migration and invasion. Moreover, exosomal MMP-13 significantly up-regulated Vimentin expression while decreasing E-cadherin levels in CNE2 cells in vitro and in vivo. Furthermore, MMP-13 levels were closely associated with HIF-1α expression (r = 0.679, P < 0.001), lymph node metastasis, clinical stage (all P < 0.05) and poor prognosis in NPC patients (P < 0.01). In conclusion, our findings suggest that the hypoxic exosomes were loaded with MMP-13, which could enhance migration and invasiveness and induce microenvironment changes to promote NPC aggressiveness.

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Gemcitabine: a game changer in nasopharyngeal carcinoma

Cited by 19 publications

References 10 publications

Prognostic value of nutritional risk screening 2002 scale in nasopharyngeal carcinoma: A large‐scale cohort study

Prognostic value of nutritional risk screening 2002 scale in nasopharyngeal carcinoma: A large‐scale cohort study

Global trends in nasopharyngeal cancer mortality since 1970 and predictions for 2020: Focus on low-risk areas

Hypoxia-Induced Matrix Metalloproteinase-13 Expression in Exosomes from Nasopharyngeal Carcinoma Enhances Metastases

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