"A prospective, single-arm trial of PD-1 inhibitors plus chemoradiotherapy for solitary metachronous metastasis nasopharyngeal carcinoma"

作者全名："Li, Lu; Chen, Lu; Fan, Ming; Tian, Yue; Ai, Hangyu; Yan, Lu; Li, Fang; Lan, Mei; Lai, Xin; Huang, Yecai; Xu, Peng; Feng, Mei; Lang, Jinyi"

作者地址："[Li, Lu; Fan, Ming; Li, Fang; Lan, Mei; Lai, Xin; Huang, Yecai; Xu, Peng; Feng, Mei; Lang, Jinyi] Univ Elect Sci & Technol China, Dept Radiat Oncol, Radiat Oncol Key Lab Sichuan Prov,Sichuan Canc Ctr, Sichuan Clin Res Ctr Canc,Sichuan Canc Hosp & Inst, Chengdu, Peoples R China; [Chen, Lu] Leshan Peoples Hosp, Leshan, Peoples R China; [Tian, Yue] North Sichuan Med Coll, Nanchong, Peoples R China; [Ai, Hangyu] Santai Cty Peoples Hosp, Mianyang, Peoples R China; [Yan, Lu] Chongqing Med Univ, Affiliated Hosp 1, Chongqing, Peoples R China; [Feng, Mei] Third Peoples Hosp Sichuan, Dept Med Oncol, Chengdu, Peoples R China"

通信作者："Feng, M; Lang, JY (通讯作者)，Univ Elect Sci & Technol China, Dept Radiat Oncol, Radiat Oncol Key Lab Sichuan Prov,Sichuan Canc Ctr, Sichuan Clin Res Ctr Canc,Sichuan Canc Hosp & Inst, Chengdu, Peoples R China."

来源：ORAL ONCOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001173231100001

JCR分区：Q1

影响因子：4

年份：2024

卷号：150

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：Oligometastasis; Nasopharyngeal carcinoma; Radiotherapy; PD-1 inhibitors; Chemotherapy

摘要："Purpose: Initial treatment for Recurrent/Metastatic Nasopharyngeal Carcinoma (R/M NPC) often involves Gemcitabine plus cisplatin with or without PD-1 inhibitors. However, PD-1 inhibitors' effectiveness varies, prompting for better treatments. This study explores effect and safety of combining PD-1 inhibitors with chemoradiotherapy for oligometastatic NPC patients. Methods: Oligometastatic NPC patients underwent radical treatment with PD-1 inhibitors and chemotherapy, followed by concurrent PD-1 inhibitors and chemoradiotherapy, and then maintenance PD-1 inhibitors. Objective response rate (ORR) and disease control rate (DCR) were calculated by irRECIST-1.1, and CTCAE-4.0 was used to evaluate the toxicity. Results: The study enrolled 47 patients with a median age of 46. The median follow-up lasted 16.5 months, with metastatic lesions receiving a median radiation dose of 45 Gy. The median courses of PD-1 inhibitors and chemotherapy were 9.5 and 5 respectively. The metastasis sites included lung (40.8 %), liver (21.1 %), mediastinal lymph node (7.9 %), abdominal lymph nodes (3.9 %), bone (21.1 %), adrenal gland (3.9 %), and brain (1.3 %). ORR and DCR were 85.1 % and 100 % at 3 months after radiotherapy. The median survival was not reached yet, and 1 and 2-year OS rates were 93.1 % and 78.4 %. The median PFS was 18 months, with 1 and 2year PFS rates of 70.2 % and 47.7 % respectively. PD-L1 expression showed a positive correlation for PFS. Twenty-five patients experienced grade 3 or 4 adverse events (AE) that were possibly related to chemotherapy. No grade 5 AE was observed. Conclusions: The synergy of concurrent PD-1 inhibitors and chemoradiotherapy shows promising efficacy and an acceptable toxicity for oligometastasis NPC patients."

基金机构："University of Electronic Science and Technology, Sichuan Cancer Hospital Oncology Medical Industry Innovation Fund [2022YFS0047]; Open Project of Radiation Oncology Key Laboratory of Sichuan Province [ZYGX2021 YGCX006]; [2021ROKF04]"

基金资助正文："This work was supported by the Sichuan Science and Technology Department Key Research and Development Project (No.r 2022YFS0047) ; University of Electronic Science and Technology, Sichuan Cancer Hospital Oncology Medical Industry Innovation Fund (No. ZYGX2021 YGCX006) ; Open Project of Radiation Oncology Key Laboratory of Sichuan Province (No. 2021ROKF04) ."