Combination strategy exploration for prior treated recurrent or metastatic nasopharyngeal carcinoma in the era of immunotherapy.
Combination strategy exploration for prior treated recurrent or metastatic nasopharyngeal carcinoma in the era of immunotherapy.
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DOI：
10.1038/s41598-024-52326-7
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发表时间：
2024-01-20
影响因子：
4.6
通讯作者：
中科院分区：
文献类型：
--
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为了评估免疫检查点抑制剂（ICIs）联合靶向治疗（抗血管生成或EGFR抑制剂）作为复发或转移性鼻咽癌（R/M NPC）的二线或后续治疗的有效性和安全性，我们进行了一项回顾性研究。在本研究中，先前治疗过的R/M鼻咽癌患者接受以下治疗之一：ICIs联合靶向治疗和化疗（ITC）， ICIs单独联合靶向治疗（IT）， ICIs联合化疗（IC）或单独化疗(C)。考虑的主要终点是无进展生存期（PFS），次要终点包括总生存期（OS）、客观缓解率（ORR）、疾病控制率（DCR）和安全措施。共有226例患者参与了本研究，其中ITC方案70例，IT方案48例，IC方案48例，单独C方案60例。四个队列的中位PFS分别为20.67、13.63、12.47和7.93个月。值得注意的是，ITC方案在这些队列中产生了最有利的PFS。ITC组的肿瘤反应和安全性与IT组和IC组相当（p < 0.05），但与C组相比，ITC组的肿瘤反应更好（p < 0.05）。与单独使用C相比，ITC方案也显著改善了OS （HR 0.336, 95%CI 0.123-0.915, p = 0.033）。IT方案和IC方案获得了几乎相同的PFS (HR 0.955, 95%CI 0.515-1.77, p = 0.884)，尽管与IC方案相比，IT方案与较低的sae发生率相关（p < 0.05）。此外，与单独使用C相比，IT方案显示出更好的PFS （HR 0.583, 95%CI 0.345-0.985, p = 0.044）和更少的SAEs （p < 0.05）。这些发现共同支持了这样一种观点，即在先前治疗过的R/M NPC患者中，ICIs、靶向和化疗联合使用显示出强大的抗肿瘤活性，而不良事件没有显著增加。
To assess the efficacy and safety of the combination of immune checkpoint inhibitors (ICIs) and target therapy (anti-angiogenesis or EGFR inhibitors) as a second-line or subsequent treatment for recurrent or metastatic nasopharyngeal carcinoma (R/M NPC), we conducted a retrospective study. In this study, previously treated R/M NPC patients were administered one of the following treatment: ICIs combined with target therapy and chemotherapy (ITC), ICIs combined with target therapy alone (IT), ICIs combined with chemotherapy (IC), or chemotherapy alone (C). The primary endpoint under consideration was progression-free survival (PFS), while secondary endpoints included overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety measures. A total of 226 patients participated in this study, with 70 receiving the ITC regimen, 48 receiving IT, 48 treated with IC, and 60 undergoing C alone. The median PFS for the four cohorts was 20.67, 13.63, 12.47, and 7.93 months respectively. Notably, ITC regimen yielded the most favorable PFS among these cohorts. The ITC cohort exhibited a comparable tumor response and safety profile to the IT and IC cohorts (p > 0.05), but superior tumor response compared to the C cohort (p < 0.05). The ITC regimen also conferred a significant improvement in OS when comparing to C alone (HR 0.336, 95%CI 0.123–0.915, p = 0.033). The IT and IC regimens achieved a nearly identical PFS (HR 0.955, 95%CI 0.515–1.77, p = 0.884), although the IT regimen was associated with a lower occurrence of SAEs in contrast to the IC regimen (p < 0.05). In addition, the IT regimen demonstrated superior PFS (HR 0.583, 95%CI 0.345–0.985, p = 0.044) and fewer SAEs when compared to C alone (p < 0.05). These findings collectively support the notion that the combination of ICIs, target and chemotherapy exhibits robust antitumor activity in previously treated R/M NPC patients, without a significant increase in adverse events.
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