Induction chemotherapy regimen of docetaxel plus cisplatin versus docetaxel, cisplatin plus fluorouracil followed by concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma: Preliminary results of an open-label, noninferiority, multicentre, randomised, controlled phase 3 trial

Wang, Yan; Wang, Chengtao; He, Shasha; Li, Bai; Kong, Fei; Wang, Siyang; Cui, Lei; Qin, Qiang; Yang, Yunying; Xiao, Wei; Zhu, Miao; Zhang, Zeyu; Lai, YuLin; Bao, Wenjing; Peng, Zhenwei; Chen, Yong

doi:10.1016/j.eclinm.2022.101625

Cited by 11 publications

(17 citation statements)

References 29 publications

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“…The cumulative TRAE rate of 65% is similar to other studies (ranging from 66-76%) [6,7,8]. Previous studies [6,7] showed that the proportion of patients completing 3 cycles of IC and 2 cycles of CCRT ranges from 88-97% and 88-92%, respectively 30 . In the present study, 100% (49/49) and 87% (41/47) patients received 3 cycles of induction chemotherapy and 2 cycles of CCRT, respectively.…”

Section: Discussionsupporting

confidence: 84%

Camrelizumab, apatinib plus induction chemotherapy and concurrent chemoradiotherapy in stage N3 nasopharyngeal carcinoma

Xiang,

Liang,

Jiang

et al. 2023

Preprint

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Antiangiogenic agent apatinib has shown synergetic antitumoral efficacy in combination with camrelizumab in several solid tumors. Immunotherapy combination with standard treatment regimen was reported benefit in nasopharyngeal carcinoma (NPC), however, N3 patients did not show the benefit. In this phase II clinical trial (ChiCTR2000032317), 49 eligible patients with stage TanyN3M0 NPC were enrolled and received the combination of induction chemotherapy, camrelizumab and apatinib followed by chemoradiotherapy. After induction therapy, all patients had objective response, including 13 patients (26.5%) with complete response. After a median follow-up of 28.7 months, the primary endpoint of 1-year distant metastasis-free survival was met (98%, 95% confidence interval 88–100). The 2-year failure-free survival was 96%. Grade ≥ 3 toxicity appeared in 32 (65.3%) patients, with the most common being mucositis (14[28.6%]) and nausea/vomiting (9[18.4%]). Camrelizumab and apatinib in combination with induction chemotherapy shows promising distant metastasis control with acceptable safety profile in stage TanyN3M0 NPC.

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Section: Discussionsupporting

confidence: 84%

Camrelizumab, apatinib plus induction chemotherapy and concurrent chemoradiotherapy in stage N3 nasopharyngeal carcinoma

Xiang,

Liang,

Jiang

et al. 2023

Preprint

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“…This might be attributed to the short follow-up period and the insufficient number of cases. Furthermore, the clinical practice of LA-NPC patients involves the application of various IC regimens, such as TPF, TP, PF, and GP, all of these chemotherapy regimens showed similar clinical efficacy and favorable safety profiles in their respective clinical studies (10)(11)(12)(13)(14). We made a subgroup analysis of the shortterm efficacy of 121 patients treated with induction chemotherapy alone.…”

Section: Discussionmentioning

confidence: 99%

“…Following the LA-NPC diagnosis, the standard treatment option is IC, followed by CCRT. The common chemotherapy protocols mainly consist of TPF (docetaxel, cisplatin, and fluorouracil), TPC (aclitaxel, cisplatin, and capecitabine), TP (docetaxel, cisplatin), PF (cisplatin, fluorouracil), GP (gemcitabine, cisplatin) and so on (10)(11)(12)(13)(14). These chemotherapy regimens showed similar clinical efficacy and favorable safety profiles in their respective clinical studies.…”

Section: Introductionmentioning

confidence: 99%

The short-term efficacy and safety of induction chemotherapy combined with PD-1 inhibitor or anti-EGFR in locoregionally advanced nasopharyngeal carcinoma

et al. 2023

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PurposeThis study aimed to investigate the short-term efficacy and safety of induction chemotherapy (IC) combined with PD-1 inhibitor or anti-EGFR in the treatment of locoregionally advanced nasopharyngeal carcinoma (LA-NPC).Methods and materialsWe retrospectively reviewed the clinical data of 206 patients with LA-NPC, including IC combined with anti-PD-1 (57 patients), IC combined with anti-EGFR (28 patients), and IC alone (121 patients). The short-term efficacy was assessed at the end of IC and one month after overall treatment. According to the RECIST v1.1, the short-term efficacy of cervical lymph nodes and primary nasopharynx foci was divided into complete remission (CR), partial remission (PR), stable disease (SD), and progressive disease (PD). The overall response (ORR) was defined as the sum of CR and PR. Acute toxicities were graded according to the CTCAE v5.0. One-way analysis of variance (ANOVA) was used to compare differences in the numerical variables among groups. Fisher Freeman-Halton test or Pearson Chi-square test was used to compare classified variables.ResultsThe ORR rates of primary nasopharynx foci in IC, anti-EGFR, and anti-PD-1 group were 68.60%, 67.9%, and 94.7%, respectively, and the corresponding rates of ORR in cervical lymph nodes were 78.5%, 71.4%, and 93.0%, respectively. There was a statistical difference in the ORR between the three groups. Further analysis showed that after IC or overall treatment, the CR rate of primary nasopharynx foci in the anti-PD-1 group was significantly higher than the other two groups. The most common adverse effects were hematotoxicity, gastrointestinal toxicity, and transaminase elevation. However, there were no statistical differences in the frequency of any common adverse effects between the three groups.ConclusionsThe addition of anti-PD-1 based on IC significantly improved the short-term efficacy of LA-NPC and toxicities were tolerable.

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“…A number of large-scale studies have reported CR rates ranging from 82.4% to 98% after CCRT for nasopharyngeal carcinoma patients ( 24 – 27 ). However, our study yields a lower CR rate of 61.5%.…”

Section: Discussionmentioning

confidence: 99%

MRI-based clinical radiomics nomogram may predict the early response after concurrent chemoradiotherapy in locally advanced nasopharyngeal carcinoma

Fei

et al. 2023

Front. Oncol.

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ObjectiveTumor residue after concurrent chemoradiotherapy (CCRT) in nasopharyngeal carcinoma (NPC) patients often predicts poor prognosis. Thus, the objective of this retrospective study is to develop a nomogram that combines magnetic resonance (MRI) radiomics features and clinical features to predict the early response of locally advanced nasopharyngeal carcinoma (LA-NPC).MethodsA total of 91 patients with LA-NPC were included in this study. Patients were randomly divided into training and validation cohorts at a ratio of 3:1. Univariate and multivariate analyses were performed on the clinical parameters of the patients to select clinical features to build a clinical model. In the training cohort, the Least Absolute Shrinkage and Selection Operator (LASSO) regression model was used to select radiomics features for construction of a radiomics model. The logistic regression algorithm was then used to combine the clinical features with the radiomics features to construct the clinical radiomics nomogram. Receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were drawn to compare and verify the predictive performances of the clinical model, radiomics model, and clinical radiomics nomogram.ResultsPlatelet lymphocyte ratio (PLR) and nasopharyngeal tumor volume were identified as independent predictors of early response in patients with locally advanced nasopharyngeal carcinoma. A total of 5502 radiomics features were extracted, from which 25 radiomics features were selected to construct the radiomics model. The clinical radiomics nomogram demonstrated the highest AUC in both the training and validation cohorts (training cohort 0.975 vs 0.973 vs 0.713; validation cohort 0.968 vs 0.952 vs 0.706). The calibration curve and DCA indicated good predictive performance for the nomogram.ConclusionA clinical radiomics nomogram, which combines clinical features with radiomics features based on MRI, can predict early tumor regression in patients with LA-NPC. The performance of the nomogram is superior to that of either the clinical model or radiomics model alone. Therefore, it can be used to identify patients without CR at an early stage and provide guidance for personalized therapy.

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Cited by 11 publications

References 29 publications

Camrelizumab, apatinib plus induction chemotherapy and concurrent chemoradiotherapy in stage N3 nasopharyngeal carcinoma

Camrelizumab, apatinib plus induction chemotherapy and concurrent chemoradiotherapy in stage N3 nasopharyngeal carcinoma

The short-term efficacy and safety of induction chemotherapy combined with PD-1 inhibitor or anti-EGFR in locoregionally advanced nasopharyngeal carcinoma

MRI-based clinical radiomics nomogram may predict the early response after concurrent chemoradiotherapy in locally advanced nasopharyngeal carcinoma

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