Graft-vs-tumor effect in patients with advanced nasopharyngeal cancer treated with nonmyeloablative allogeneic PBSC transplantation

Abstract

While nonmyeloablative peripheral blood stem cell transplantation (NST) has shown efficacy against several solid tumors, it is untested in nasopharyngeal cancer (NPC). In a phase II clinical trial, 21 patients with pretreated metastatic NPC underwent NST with sibling PBSC allografts, using CY conditioning, thymic irradiation and in vivo T-cell depletion with thymoglobulin. Stable lymphohematopoietic chimerism was achieved in most patients and prophylactic CYA was tapered at a median of day +30. Seven patients (33%) showed partial response and three (14%) achieved stable disease. Four patients were alive at 2 years and three showed prolonged disease control of 344, 525 and 550 days. With a median follow-up of 209 (4–1147) days, the median PFS was 100 days (95% confidence interval (CI), 66–128 days), and median OS was 209 days (95% CI, 128–236 days). Patients with chronic GVHD had better survival—median OS 426 days (95% CI, 194–NE days) vs 143 days (95% CI, 114–226 days) (P=0.010). Thus, NST may induce meaningful clinical responses in patients with advanced NPC.

Prognostic value of chronic hepatitis B virus infection in patients with nasopharyngeal carcinoma: Analysis of 1301 patients from an endemic area in China

“…In addition, the potential value of immunotherapeutic strategies in HBV-infected patients with locoregionally advanced NPC needs to be explored. 24 The results of the current study provide what to our knowledge is the first evidence of the poor prognostic impact of chronic HBV infection on the prognosis of patients with locoregionally advanced NPC. Therefore, researchers conducting clinical trials in patients with NPC should pay attention to the HBsAg seropositivity rates in different treatment arms, especially in regions of endemic chronic HBV infection.…”

“…However, this hypothesis needs to be addressed in future studies. In addition, the potential value of immunotherapeutic strategies in HBV‐infected patients with locoregionally advanced NPC needs to be explored …”

Reduced-intensity allografting in patients with therapy-related myeloid neoplasms and active primary malignancies

“…[30][31][32][33][34] However, it has also been observed in patients with solid tumours. [35][36][37] Similar to haematologic malignancies, the disease status at the time of HSCT and the occurrence of chronic GvHD are strong predictive outcome parameters. Patients with t-MNs and a primary malignancy not in CR are, however, ineligible for allo HSCT in many centres, donor registries and clinical studies.…”

Diagnosis and Treatment of Nasopharyngeal Carcinoma in Children and Adolescents – Recommendations of the GPOH-NPC Study Group

“…Major challenges to the treatment of relapse in NPC are the recurrence of disease at previously irradiated sites and maintenance of continuous remission after renewed chemotherapy. Therefore, strategies for treating patients with relapse should encompass the application of new methods of radiotherapy, e. g. proton-irradiation for local recurrences and new treatment modalities such as the application of EBV-specific T-cells for systemic recurrences or experimental allogeneic stem cell transplantation [11,15,49].…”