Nimotuzumab combined with radiotherapy reduces primary tumor and nodal volume in advanced undifferentiated nasopharyngeal carcinoma

Gondhowiardjo, Soehartati; Muthalib, Abdul; Khotimah, Siti; Rachman, Andhika

doi:10.1111/j.1743-7563.2009.01227.x

Cited by 6 publications

(5 citation statements)

References 24 publications

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“…By binding to extracellular segments of EGFR, nimotuzumab blocks its activation pathways, including those linked to tumor angiogenesis factors, and potently inhibits tumor proliferation and metastasis. 36 , 37 Our results suggest that nimotuzumab synergizes with chemoradiotherapy, as reported in clinical populations. In the study of Nabid et al, the CR of patients treated with nimotuzumab for locally advanced squamous cell cancer of the head and neck after radiotherapy was 70%.…”

Section: Discussionsupporting

confidence: 82%

Nimotuzumab combined with concurrent chemoradiotherapy benefits patients with advanced nasopharyngeal carcinoma

Yan

et al. 2017

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BackgroundThe potential benefits and possible risks associated with combined nimotuzumab and concurrent chemoradiotherapy in patients with advanced nasopharyngeal carcinoma (NPC) have yet to be determined.MethodsThe databases PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang were systematically searched through February 2017 for studies comparing combined nimotuzumab and chemoradiotherapy versus chemoradiotherapy alone in the treatment of NPC. Primary outcomes were complete and partial responses, and the secondary outcome was adverse reactions. The random-effect model was used to pool relative risks (RRs) and 95% confidence intervals (CIs).ResultsNine randomized control trials and six cohort studies were included in the final analysis (n=1,015 patients). Compared with chemoradiotherapy alone, chemoradiotherapy combined with nimotuzumab was associated with an increased response rate (RR =1.11, 95% CI: 1.01–1.22). Combined treatment further reduced the occurrence rate of erythropenia (RR =0.11, 95% CI: 0.05–0.28) and neutropenia (RR =0.12, 95% CI: 0.05–0.27). The differences in the rates of other complications were not significant.ConclusionNimotuzumab combined with concurrent chemoradiotherapy is more effective in patients with advanced NPC than chemoradiotherapy alone. Patients receiving combination therapy did not have a higher rate of adverse reactions. Nimotuzumab can thus be recommended as an adjunct therapy in patients with advanced NPC.

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Section: Discussionsupporting

confidence: 82%

Nimotuzumab combined with concurrent chemoradiotherapy benefits patients with advanced nasopharyngeal carcinoma

Yan

et al. 2017

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“…13 This antibody has been extensively evaluated in the clinical setting, with very encouraging results on patients bearing advanced epithelial derived tumors. 9,10,14,15 This manuscript describes the results of a randomized trial, comparing radiotherapy and nimotuzumab vs. radiotherapy plus a placebo on advanced SCCHN patients. Mostly, patients that were unfit for radio-chemotherapy due to their performance status or co-morbidities were recruited after the modification of the national treatment normative.…”

Section: Resultsmentioning

confidence: 99%

Nimotuzumab plus radiotherapy for unresectable squamous-cell carcinoma of the head and neck

Mo¹,

Tc²,

R³

et al. 2010

Cancer Biology & Therapy

142

111

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The prognosis of patients with advanced head and neck cancer remain dismal. For this tumor type, elevated levels of EGFR are associated with a shorter disease free survival and time to treatment failure, reflecting a more aggressive phenotype. Nimotuzumab is a humanized monoclonal antibody that recognizes domain III of the extracellular region of the EGFR, within an area that overlaps with both the surface patch recognized by cetuximab and the binding site for EGF. In order to assess the efficacy of nimotuzumab in combination with radiotherapy, a controlled, double blind, randomized clinical trial was conducted in 106 advanced squamous cell carcinoma of the head and neck patients, mostly, unfit for chemoradiotherapy. Control patients received a placebo and radiotherapy. Treatment was safe and the most frequent adverse events consisted on grade I or II asthenia, fever, headache and chills. No skin rash was detected. A significant complete response rate improvement was found in the group of patients treated with nimotuzumab as compared to the placebo. In the intent to treat analysis, a trend towards survival benefit for nimotuzumab treated subjects was found. The survival benefit became significant when applying the Harrington-Fleming test, a weighted log-rank that underscores the detection of differences deferred on time. In addition, a preliminary biomarker investigation showed a significant survival improvement for nimotuzumab treated patients as compared to controls for subjects with EGFR positive tumors. All patients showed a quality of life improvement and a reduction of the general and specific symptoms of the disease.

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“…6, Jakarta, Indonesia 10430. 3 Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia / Cipto Mangunkusumo National General Hospital, Jakarta -Indonesia, Jl. Salemba Raya No.…”

Section: Abbreviationsmentioning

confidence: 99%

“…Nasopharyngeal cancer, especially the non-keratinized nasopharyngeal cancer, is one of the cancer that is related to viral Epstein Barr Virus (EBV) infection [1,2]. In Southern Asia and South East Asia, where nasopharyngeal cancer is endemic [1,3]. EBV is almost always detected in nasopharyngeal cancer specimen [4,5].…”

Section: Introductionmentioning

confidence: 99%

Immune cells markers within local tumor microenvironment are associated with EBV oncoprotein in nasopharyngeal cancer

et al. 2022

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Introduction EBV infection in nasopharyngeal cancer ensued in latent infection mode. In this latent infection various EBV oncoproteins such as EBNA1 and LMP1 was expressed. EBV oncoproteins could theoretically recruit immune cells, which might help to control cancer. Therefore, this study was aimed to elucidate the association with EBV oncoproteins (EBNA1 and LMP1), immune markers (CD4, CD8, and FOXP3) from nasopharyngeal cancer microenvironment with tumor progression. Method Nasopharyngeal biopsy was obtained from patients suspected to have nasopharyngeal cancer. Those samples with microscopically confirmed nasopharyngeal cancer were tested for EBNA1, LMP1, CD4, CD8, and FOXP3 concentration with ELISA, then verified with IHC. Each patient tumor volume was assessed for primary nasopharyngeal tumor volume (GTVp) and neck nodal metastases tumor volume (GTVn). Correlation test with Spearman correlation and scatterplot were carried out. Result Total 23 samples with nasopharyngeal cancer were analyzed. There was moderate correlation (ρ = 0.45; p value = 0.032) between LMP1 and GTVp. There was strong correlation (ρ = 0.81; p value < 0.001) between CD8 and GTVp. There was also moderate correlation (ρ = 0.6; p value = 0.002) between FOXP3 and GTVp. The CD8 concentration has moderate correlation with both EBNA1 (ρ = 0.46; p value = 0.026) and LMP1 (ρ = 0.47; p value = 0.023). While FOXP3 has moderate correlation with only LMP1 (ρ = 0.58; p value = 0.004). No correlation was found between all the markers tested here with GTVn. Discussion We found larger primary nasopharyngeal tumor was associated with higher CD8 marker. This was thought due to the presence of abundance CD8 T cells in the nasopharynx, but those abundance CD8 T cells were suspected to be dysfunctional. The nasopharyngeal cancer was also known to upregulate chemokines that could recruit T regulatory FOXP3 cells. Furthermore, T regulatory FOXP3 cells differentiation was induced through several pathways which was triggered by EBNA1. The correlation found in this study could guide further study to understand nasopharyngeal carcinogenesis and the relationship with our immune system.

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Nimotuzumab combined with radiotherapy reduces primary tumor and nodal volume in advanced undifferentiated nasopharyngeal carcinoma

Cited by 6 publications

References 24 publications

Nimotuzumab combined with concurrent chemoradiotherapy benefits patients with advanced nasopharyngeal carcinoma

Nimotuzumab combined with concurrent chemoradiotherapy benefits patients with advanced nasopharyngeal carcinoma

Nimotuzumab plus radiotherapy for unresectable squamous-cell carcinoma of the head and neck

Immune cells markers within local tumor microenvironment are associated with EBV oncoprotein in nasopharyngeal cancer

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