Treatment of Recurrent or Metastatic Nasopharyngeal Carcinoma by Targeting the Epidermal Growth Factor Receptor Combined with Gemcitabine Plus Platinum

Abstract

Chen Chen,1,2,* Xuanye Zhang,2,3,* Yixin Zhou,2,4,* Sha Fu,5 Zuan Lin,2,6 Shaodong Hong,2,3 Li Zhang2,3 1Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People’s Republic of China; 2State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People’s Republic of China; 3Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People’s Republic of China; 4Department of VIP Region, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People’s Republic of China; 5Pathology Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China; 6Department of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shaodong Hong; Li ZhangSun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou 510060, People’s Republic of ChinaTel [phone]; [phone]Fax [phone]Email [email protected]; [email protected]: The purpose of this study was to evaluate the anti-tumor activity and safety of anti-epidermal growth factor receptor (EGFR) monoclonal antibody combined with gemcitabine plus platinum (GP) as a first-line treatment for recurrent or metastatic nasopharyngeal carcinoma (RM-NPC).Patients and Methods: This retrospective study analyzed RM-NPC patients at Sun Yat-sen University Cancer Center who received anti-EGFR antibody plus GP as a first-line treatment between July 2007 and November 2018. Survival analyses were performed using the Kaplan–Meier method with Log rank test. Cox proportional hazards model was used for the multivariate analysis.Results: A total of 84 patients were enrolled. The median progression-free survival (PFS) was 10.3 months (95% CI, 6.9– 13.6 months), and the median overall survival (OS) was 42.8 months (95% CI, 24.6– 60.9 months). The objective response rate and disease control rate were 67.9% and 92.9%, respectively. The multivariate analysis identified a higher baseline EBV DNA level as a risk factor for both PFS (P=0.025) and OS (P=0.013). Additionally, age≥ 44 years (P =0.003), non-cisplatin (P= 0.009), and poor KPS (≤ 80) (P =0.034) were other risk factors for OS. The most common adverse events were leukopenia (n=73, 86.9%). The most common grade 3– 4 AEs were leukopenia (n=30, 35.7%) and thrombocytopenia (n=22, 26.2%).Conclusion: Anti-EGFR monoclonal antibody plus GP achieved promising antitumor activity with a tolerable toxicity profile in RM-NPC as a first-line treatment. Randomized clinical trials are warranted to compare the efficacy of GP with or without anti-EGFR antibody in these patients.Keywords: advanced cancer, chemotherapy, oncology, targeted therapy

Keywords

• advanced cancer
• chemotherapy
• oncology
• targeted therapy