Induction chemotherapy followed by concurrent chemoradiation and nimotuzumab for locoregionally advanced nasopharyngeal carcinoma: preliminary results from a phase II clinical trial

Jian-Feng Huang, Fu-Zheng Zhang, Qin-Zhou Zou, Le-Yuan Zhou, Bo Yang, Jian-Jun Chu, Jia-Hua Yu, Hao-Wen Zhang, Xiao-Peng Yuan, Guo-Mei Tai, Fen-Ju Liu, C-M Charlie Ma, Jian-Feng Huang, Fu-Zheng Zhang, Qin-Zhou Zou, Le-Yuan Zhou, Bo Yang, Jian-Jun Chu, Jia-Hua Yu, Hao-Wen Zhang, Xiao-Peng Yuan, Guo-Mei Tai, Fen-Ju Liu, C-M Charlie Ma

Abstract

Overexpression of epidermal growth factor receptor can be found in more than 80% of patients with locoregionally advanced nasopharyngeal carcinoma and is associated with shorter survival. In this work, we evaluated the feasibility of adding nimotuzumab to chemoradiation in locoregionally advanced nasopharyngeal carcinoma. Twenty-three patients with clinically staged T3-4 or any node-positive disease were enrolled. They were scheduled to receive one cycle of induction chemotherapy followed by intensity-modulated radiotherapy, weekly administration of nimotuzumab and concurrent chemotherapy. Results showed that all patients received a full course of radiotherapy, 19(82.6%)patients completed the scheduled neoadjuvant and concurrent chemotherapy, and 22(95.7%) patients received ≥6 weeks of nimotuzumab. During the period of concurrent chemoradiation and nimotuzumab, grade 3-4 toxicities occurred in 14(60.9%) patients: 8 (34.8%) had grade 3-4 oral mucositis, 6(26.1%) had grade 3 neutropenia, and 1(4.3%) had grade 3 dermatitis. No acne-like rash was observed. With a median follow-up of 24.1 months, the 2-year progression-free survival and overall survival were 83.5% and 95.0%, respectively. In conclusion, concurrent administration of chemoradiation and nimotuzumab was well-tolerated with good compliance. Preliminary clinical outcome data appear encouraging with favorable normal tissue toxicity results comparing with historical data of concurrent chemoradiation plus cetuximab.

Keywords: chemoradiotherapy; induction chemotherapy; nasopharyngeal carcinoma; nimotuzumab.

Conflict of interest statement

CONFLICTS OF INTEREST

The authors have no conflict of interest to declare.

Figures

Figure 1. Multidisciplinary management of LA NPC…
Figure 1. Multidisciplinary management of LA NPC in our study
Abbreviations: LA NPC, Locoregionally advanced nasopharyngeal carcinoma; RT, Radiotherapy; IMRT, Intensity-modulated radiotherapy; ICT, Induction chemotherapy; CCRT, Concurrent chemotherapy; ACT, Adjuvant chemotherapy; N, Nimotuzumab
Figure 2. Kaplan–Meier survival estimate of PFS
Figure 2. Kaplan–Meier survival estimate of PFS
Abbreviations: PFS, Progression-free survival.
Figure 3. Kaplan–Meier survival estimate of OS
Figure 3. Kaplan–Meier survival estimate of OS
Abbreviations: OS, Overall survival.

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Source: PubMed

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