|Table of Contents|

Efficacy and safety of toripalimab combined with apatinib as second-line treatment of recurrent/metastatic nasopharyngeal carcinoma

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 10
Page:
1809-1814
Research Field:
Publishing date:

Info

Title:
Efficacy and safety of toripalimab combined with apatinib as second-line treatment of recurrent/metastatic nasopharyngeal carcinoma
Author(s):
LU Dasong; FENG Yongjun; WANG Wufeng; MOU Zhonglin; ZHAO Na
Department of Otolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Hainan Medical College,Hainan Haikou 570311,China.
Keywords:
toripalimab; apatinib; recurrent/metastatic nasopharyngeal carcinoma; efficacy; safety
PACS:
R739.63
DOI:
10.3969/j.issn.1672-4992.2024.10.008
Abstract:
Objective：To explore the efficacy and safety of toripalimab plus apatinib in the second-line treatment of recurrent/metastatic nasopharyngeal carcinoma (RM-NPC),and analyze the prognostic factors.Methods:From March 2020 to March 2022,37 cases of RM-NPC patients who prior platinum based chemotherapy failure were selected and received toripalimab 3 mg/kg every 2 weeks and apatinib 250 mg once per day.The efficacy and safety were observed,and the progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier method.COX proportional hazard model was used to analyze the prognostic factors.Results:The median treatment time of 37 cases RM-NPC patients was 8 cycles (3~32 cycles).The objective response rate was 67.6%.The disease control rate was 86.5%.The median duration of response was 12.4 months (95%CI：10.1~14.7 months).The median PFS was 11.6 months (95%CI：9.9~13.4 months).The 1-year progression-free survival rate was 42.0%,and the 1-year overall survival rate was 82.9%.Multiple factor COX regression analysis showed that initial metastasis and EBV-DNA titer ≥10 000 IU/mL were independent factors affecting the prognosis of patients.Most of the adverse reactions were less than grade Ⅱ,and the adverse reactions above grade Ⅲ were hypertension,nasopharyngeal necrosis,elevated aminotransferase and hand-foot syndrome.Conclusion:The combination of toripalimab and apatinib can significantly improve the clinical efficacy and survival prognosis of RM-NPC patients who prior platinum based chemotherapy failure,and the safety is controllable,which can be a second-line treatment option for patients with RM-NPC.

References:

［1］ 朱文鹏,韩梦琦,王雨欣,等.1990-2019年中国鼻咽癌发病与死亡的趋势及预测研究［J］.中国全科医学,2023,26(34):4269-4276. ZHU WP,HAN MQ,WANG YX,et al.Trends and projections of incidence and mortality of nasopharyngeal carcinoma in China from 1990 to 2019［J］.Chinese General Practice,2023,26(34):4269-4276.
［2］ AHN MJ,CHIROVSKY D,KUYAS H,et al.Global longitudinal assessment of treatment outcomes in recurrent/metastatic nasopharyngeal carcinoma:GLANCE-NPC study ［J］.Future Oncol,2021,17(16):2015-2025.
［3］ TAN LLY,LE QT,LEE NYY,et al.JUPITER-02 trial:advancing survival for recurrent metastatic nasopharyngeal carcinoma and next steps ［J］.Cancer Commun (Lond),2022,42(1):56-59.
［4］ BOSSI P,CHAN AT,EVEN C,et al.ESMO-EURACAN clinical practice guideline update for nasopharyngeal carcinoma:adjuvant therapy and first-line treatment of recurrent/metastatic disease ［J］.Ann Oncol,2023,34(3):247-250.
［5］ 谢雪琪,葛中宽,胡漫.转移/复发性鼻咽癌的内科治疗新进展［J］.中华转移性肿瘤杂志,2022,05(2):177-181. XIE XQ,GE ZK,HU M.Advances in the treatment of recurrent metastatic nasopharyngeal carcinoma ［J］.Chinese Journal of Metastatic Cancer,2022,05(2):177-181.
［6］ 许磊,汪义纯,康梅,等.卡瑞利珠单抗联合阿帕替尼治疗原发性肝癌的疗效评估［J］.中国肿瘤生物治疗杂志,2023,30(4):331-337. XU L,WANG YC,KANG M,et al.Efficacy evaluation of camrelizumab combined with apatinib in the treatment of primary hepatocellular carcinoma ［J］.Chinese Journal of Cancer Biotherapy,2023,30(4):331-337.
［7］ 肖鹏,李伟娟,梅家转,等.阿帕替尼联合PD-1单抗后线治疗晚期结直肠癌患者的疗效和安全性［J］.实用医学杂志,2023,39(2):255-261. XIAO P,LI WJ,MEI JZ,et al.Efficacy and safety of apatinib plus PD-1 blockades as subsequent line therapy for patients with advanced colorectal ［J］.The Journal of Practical Medicine,2023,39(2):255-261.
［8］ ZHANG Y,CHEN X,ZHENG H,et al.Expression of cancer cell-intrinsic PD-1 associates with PD-L1 and p-S6 and predicts a good prognosis in nasopharyngeal carcinoma ［J］.J Cancer,2021,12(20):6118-6125.
［9］ LIANG L,LI Y,HONG Y,et al.Nomogram based on liver function test indicators for survival prediction in nasopharyngeal carcinoma patients receiving PD-1 inhibitor therapy ［J］.Curr Oncol,2023,30(8):7189-7202.
［10］ YANG Y,QU S,LI J,et al.Camrelizumab versus placebo in combination with gemcitabine and cisplatin as first-line treatment for recurrent or metastatic nasopharyngeal carcinoma (CAPTAIN-1st):a multicentre,randomised,double-blind,phase 3 trial ［J］.Lancet Oncol,2021,22(8):1162-1174.
［11］ WANG FH,WEI XL,FENG J,et al.Efficacy,safety,and correlative biomarkers of toripalimab in previously treated recurrent or metastatic nasopharyngeal carcinoma:a phase II clinical trial (POLARIS-02) ［J］.J Clin Oncol,2021,39(7):704-712.
［12］ MA BBY,LIM WT,GOH BC,et al.Antitumor activity of nivolumab in recurrent and metastatic nasopharyngeal carcinoma:an international,multicenter study of the mayo clinic phase 2 consortium (NCI-9742) ［J］.J Clin Oncol,2018,36(14):1412-1418.
［13］ CHEN L,JIANG YZ,WU SY,et al.Famitinib with camrelizumab and nab-paclitaxel for advanced immunomodulatory triple-negative breast cancer (FUTURE-C-Plus):an open-label,single-arm,phase II trial ［J］.Clin Cancer Res,2022,28(13):2807-2817.
［14］ CHEN D,CHEN X,XU L,et al.Camrelizumab combined with apatinib in the treatment of patients with hepatocellular carcinoma:a real-world assessment ［J］.Neoplasma,2023,70(4):580-587.
［15］ DING X,ZHANG WJ,YOU R,et al.Camrelizumab plus apatinib in patients with recurrent or metastatic nasopharyngeal carcinoma:an open-label,single-arm,phase II study ［J］.J Clin Oncol,2023,41(14):2571-2582.
［16］ 谢康,张鹏,黄雪梅,等.非高发地区初诊远处转移鼻咽癌患者生存及预后的单中心分析［J］.中国肿瘤临床,2021,48(1):14-18. XIE K,ZHANG P,HUANG XM,et al.Survival and prognosis of patients with newly diagnosed distant metastatic nasopharyngeal carcinoma in non-endemic areas:a single-center analysis ［J］.Chinese Journal of Clinical Oncology,2021,48(1):14-18.
［17］ BUDININGSIH I,VERKUIJLEN SAWM,DACHLAN YP,et al.EBV-IgA antibody responses in endemic and nonendemic populations with nasopharyngeal carcinoma:tumour marker prognostication study and a cross-sectional study ［J］.Ann Med Surg (Lond),2023,85(9):4394-4403.
［18］ ZHENG XH,DENG CM,ZHOU T,et al.Saliva biopsy:detecting the difference of EBV DNA methylation in the diagnosis of nasopharyngeal carcinoma ［J］.Int J Cancer,2023,153(4):882-892.
［19］ 魏雪玲,兰美,彭新皓,等.鼻咽癌患者免疫功能状态与EBV DNA的相关性及对预后的影响［J］.肿瘤防治研究,2021,48(6):600-606. WEI XL,LAN M,PENG XH,et al.Correlation between immune function status and EBV DNA in patients with nasopharyngeal carcinoma and their influence on prognosis ［J］.Cancer Research on Prevention and Treatment,2021,48(6):600-606.
［20］ 朱加作,赵吉光,程志原.不同剂量阿帕替尼联合卡瑞利珠单抗对肝癌患者晚期治疗的疗效及安全性观察［J］.肝脏,2023,28(4):457-460. ZHU JZ,ZHAO JG,CHENG ZY.The efficacy and safety of different doses of apatinib combined with carelizumab in the treatment of advanced liver cancer ［J］.Chinese Hepatology,2023,28(4):457-460.
［21］ MAO L,LIAN B,LI C,et al.Camrelizumab plus apatinib and temozolomide as first-line treatment in patients with advanced acral melanoma:the CAP 03 phase 2 nonrandomized clinical trial ［J］.JAMA Oncol,2023,9(8):1099-1107.

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海南省卫生健康行业科研项目（编号：20A200337）
Last Update: 1900-01-01