Metastatic nasopharyngeal carcinoma: Patterns of care and survival for patients receiving chemotherapy with and without local radiotherapy

Rusthoven, Chad G.; Lanning, Ryan M.; Jones, Bernard L.; Amini, Arya; Koshy, Matthew; Sher, David J.; Bowles, Daniel W.; McDermott, Jessica D.; Jimeno, Antonio; Karam, Sana D.

doi:10.1016/j.radonc.2017.03.019

Cited by 82 publications

(64 citation statements)

References 31 publications

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“…Population-based data appear to support the role of earlier RT in the management of metastatic disease. 42 Active combination regimens for these patients include gemcitabine/cisplatin (category 1) 43,44 ; cisplatin or carboplatin, plus a taxane 45,46 ; cisplatin/5-FU 46,47 ; or carboplatin/cetuximab. 48 Results from a trial that compared 5 different cisplatin-based regimens for NPC showed that a gemcitabine/cisplatin regimen was effective, although not better than either cisplatin/5-FU or cisplatin/paclitaxel.…”

Section: Metastatic Diseasementioning

confidence: 99%

NCCN Guidelines Insights: Head and Neck Cancers, Version 1.2018

Colevas¹,

Yom²,

Pfister³

et al. 2018

J Natl Compr Canc Netw

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479

411

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The NCCN Guidelines for Head and Neck (H&N) Cancers provide treatment recommendations for cancers of the lip, oral cavity, pharynx, larynx, ethmoid and maxillary sinuses, and salivary glands. Recommendations are also provided for occult primary of the H&N, and separate algorithms have been developed by the panel for very advanced H&N cancers. These NCCN Guidelines Insights summarize the panel's discussion and most recent recommendations regarding evaluation and treatment of nasopharyngeal carcinoma.

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Section: Metastatic Diseasementioning

confidence: 99%

NCCN Guidelines Insights: Head and Neck Cancers, Version 1.2018

Colevas¹,

Yom²,

Pfister³

et al. 2018

J Natl Compr Canc Netw

Self Cite

479

411

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“…According to NCCN guidelines, chemotherapy with platinum‐based regimens is the first‐line treatment for patients with metastatic NPC (mNPC), with overall response rates of 70%‐80% . However, the 3‐year overall survival (OS) is only 33.7%‐60.7% for mNPC treated with first‐line chemotherapy . Therefore, it is necessary to develop treatment strategies that can effectively improve survival in patients with mNPC.…”

Section: Introductionmentioning

confidence: 99%

Effects of oral maintenance chemotherapy and predictive value of circulating EBV DNA in metastatic nasopharyngeal carcinoma

Zhou

Guo

et al. 2020

Cancer Medicine

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Background/Objectives: Oral maintenance chemotherapy can effectively prolong overall survival (OS) in many types of metastatic cancer, but its role in metastatic nasopharyngeal carcinoma (mNPC) is unclear. In this study, the efficacy of oral maintenance chemotherapy in mNPC and the effectiveness of circulating tumor EBV-DNA for screening patients were evaluated. Methods: Between June 2016 and December 2017, 141 patients with mNPC who received platinum-based systemic chemotherapy were included (median follow-up time, 21 months). Patients were classified into two groups according to the administration of oral maintenance chemotherapy. Plasma samples were collected before, during, and after treatment for the measurement of circulating EBV DNA. Results: The 2-year OS was higher for patients who received maintenance chemotherapy than for patients without maintenance chemotherapy (78.9% vs 62.7%, P = .016). Patients with undetectable posttreatment EBV-DNA after 4-6 cycles of systemic chemotherapy (n = 73) had a higher 2-year OS than that of patients with detectable EBV-DNA (n = 68) (82.16% vs 51.45%, P = .001). For patients with undetectable posttreatment EBV-DNA, OS was better for those with maintenance chemotherapy than for those without (86.7% vs 73%, P = .027). For patients with detectable posttreatment EBV-DNA, maintenance chemotherapy did not improve outcomes (49.5% vs 55.4%, P = .824). The most common acute events were hematological toxicity, and all were tolerable and curable. Conclusions: Oral maintenance chemotherapy with S1 or capecitabine can improve OS in mNPC. Posttreatment EBV-DNA was not only an independent prognosis factor for mNPC but also can screen out beneficiaries of maintenance chemotherapy. K E Y W O R D S EBV-DNA, metastatic nasopharyngeal carcinoma, oral maintenance chemotherapy, overall survival | 2733 ZHOU et al. How to cite this article: Zhou H, Lu T, Guo Q, et al. Effects of oral maintenance chemotherapy and predictive value of circulating EBV DNA in metastatic nasopharyngeal carcinoma. Cancer Med.

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“…As shown in Figure 4, only three published studies assessed the proportion of HBV-monoinfected patients with cirrhosis using TE, including a total of 677 individuals. In community-based studies from West Africa, between 2% and 10% of patients were eligible for antiviral therapy according to WHO guidelines 38,59 . In contrast, a hospital-based study from Ethiopia found a much higher proportion, with approximately one quarter of patients having an indication to start treatment 55 .…”

Section: Fibrosis Assessmentmentioning

confidence: 99%

“…In contrast, a hospital-based study from Ethiopia found a much higher proportion, with approximately one quarter of patients having an indication to start treatment 55 . Importantly, the study by Jaquet et al highlights the need for prospective studies of patients without an immediate indication for therapy as nearly 50% of the participants had some degree of HBV-related disease activity, which warranted follow-up measurements 59 . In summary, there is an alarming paucity of data available on HBV treatment needs in SSA, which is essential information for the planning of resource allocation to fight the global HBV epidemic.…”

Section: Fibrosis Assessmentmentioning

confidence: 99%

The current situation and challenges of screening for and treating hepatitis B in sub-Saharan Africa

Béguelin

Fall

Seydi

et al. 2018

Expert Review of Gastroenterology & Hepatology

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Hepatitis B virus (HBV) infection is the most important cause of hepatocellular carcinoma in sub-Saharan Africa (SSA). Although the tools to curb the epidemic are known, only a minority of HBV-infected persons are currently diagnosed and treated. Areas covered: We discuss HBV epidemiological trends in SSA, describe important determinants of its natural history, and summarize current knowledge on the continuum of HBV care. Using the results of a systematic review of the literature, we describe the proportion of patients with liver fibrosis at presentation for care. Throughout the manuscript, we highlight major research gaps and explore potential ways to improve uptake of HBV testing, evaluation of liver disease, access to antiviral therapy and monitoring of complications. Expert commentary: Less than 1% of HBV-infected individuals are diagnosed in SSA, despite the availability of rapid tests with good diagnostic accuracy. Up to 15% of individuals enter care with liver cirrhosis, a clear indication for antiviral therapy. Although the proportion of patients eligible for immediate antiviral treatment is generally below 20%, there are few published data from prospective cohort studies. The incidence of hepatocellular carcinoma could be reduced with improved access to antiviral therapy.

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Metastatic nasopharyngeal carcinoma: Patterns of care and survival for patients receiving chemotherapy with and without local radiotherapy

Cited by 82 publications

References 31 publications

NCCN Guidelines Insights: Head and Neck Cancers, Version 1.2018

NCCN Guidelines Insights: Head and Neck Cancers, Version 1.2018

Effects of oral maintenance chemotherapy and predictive value of circulating EBV DNA in metastatic nasopharyngeal carcinoma

The current situation and challenges of screening for and treating hepatitis B in sub-Saharan Africa

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