Induction chemotherapy plus nimotuzumab followed by concurrent chemoradiotherapy for advanced nasopharyngeal carcinoma

Abstract

Introduction: This study investigated the best mode for the application of nimotuzumab (Nimo) in combination with chemoradiotherapy to treat nasopharyngeal carcinoma (NPC). Material and methods: Data were prospectively collected from 168 patients with NPC from September 2009 to February 2014. One hundred twelve patients received 2-3 cycles of induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT), and 56 patients with well-matched propensity scores received IC + CCRT + Nimo. Patients were divided into 3 subgroups according to the application schedule of Nimo: group A, IC + CCRT; group B: IC (combined with Nimo) + CCRT; and group C: IC + CCRT (combined with Nimo). The 5-year overall survival (OS) and progression-free survival (PFS) and adverse events were investigated. Results: With a median follow-up of 61.4 months (range: 1.7-96.5 months), the 5-year OS and PFS for group A vs. groups B + C were 74.8 ±4.1% versus 87.0 ±4.6% (p = 0.043) and 72.7 ±4.3% vs. 83.1 ± 5.1% (p = 0.243), respectively. The 5-year OS of group B was significantly improved over that of group A (93.0 ±4.8% vs. 74.8 ±4.1%, p = 0.038); however, there was no benefit to the 5-year PFS (89.3 ±5.9% vs. 72.7 ±4.3%, p = 0.144). The 5-year OS and PFS for group C were 80.4 ±7.9% and 76.4 ±8.5%, respectively, and there was no statistically significant difference from group A (p = 0.257 and p = 0.611, respectively). No significant increase in toxicities was observed with the addition of Nimo. Conclusions: Nimo administered with chemoradiotherapy is effective for NPC. Nimo concurrent with IC followed by CCRT could be the optimal mode of sequential treatment.

Precision medicine in nasopharyngeal carcinoma: comprehensive review of past, present, and future prospect

“…Nimotuzumab was recently evaluated for its best mode of application whether it is best applied along with induction chemotherapy or along with CCRT in a regimen that includes induction chemotherapy and chemoradiotherapy [ 420 ]. The enrollment criteria were: age 17–73 years old; KPS ≥ 70; adequate organ function; no known allergies; no history of mental illness; no drug abuse or other unhealthy habits; no metastasis or malignancy in other organ; no history of other malignancy, participation in other clinical trials, severe allergies, pregnancies, lactations, treatment of anti-EGFR; and tolerance to therapy.…”

Case report of chemoradiotherapy combined with immunotherapy for liver metastasis and lymph node metastases in the head of the pancreas of nasopharyngeal carcinoma

“…Our patient not only achieved a good curative effect, but also the adverse reactions were controllable. Generally, patients will have many common adverse reactions after chemotherapy, such as nausea/vomiting, bone marrow suppression, and liver damage [ 15 ]. In our case, the patient only experienced grade 2 gastrointestinal reactions and grade 2 bone marrow suppression during the period after chemotherapy combined with immunotherapy.…”

“…In addition to the patient’s good tolerance, this is also due to the low toxicity of nab-paclitaxel. Radiotherapy also has many adverse reactions, such as skin reaction and mucositis [ 15 ]. In our case, the patient only experienced grade 2 oral mucosal reactions, grade 2 bone marrow suppression, and grade 2 gastrointestinal reactions after concurrent radiotherapy and chemotherapy combined with immunotherapy.…”