Phase II trial of capecitabine plus cisplatin as first‐line therapy in patients with metastatic nasopharyngeal cancer

Chua, Daniel T.T.; Yiu, Harry; Seetalarom, Kasan; Ng, Alice Wan Ying; Kurnianda, Johan; Shotelersuk, Kanjana; Krishnan, Gopala; Hong, Ruey‐Long; Yang, Muh Hwa; Wang, Cheng‐Hsu; Sze, Wing Kin; Ng, Wai Tong

doi:10.1002/hed.21884

Cited by 39 publications

(35 citation statements)

References 24 publications

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“…However, the incidence rate is not higher than 1 per 100,000 people in Western countries (Zhou et al, 2007, Yu and Yuan, 2002). Unfortunately, distant metastasis is a main cause of death for NPC patients, which often has an unfavorable prognosis (Chen et al, 2012, Chua et al, 2012, Liu et al, 2003). Although computed tomography (CT) and magnetic resonance imaging (MRI) are effective, they cannot accurately provide a prognosis for NPC or predict the effectiveness of biological therapeutic targets (Lin et al, 2013, Gong et al, 1991).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Capacity of RASSF1A Promoter Methylation as a Biomarker in Tissue, Brushing, and Blood Samples of Nasopharyngeal Carcinoma

et al. 2017

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Methylation of the RAS association domain family protein 1A (RASSF1A) promoter has been observed in nasopharyngeal carcinoma (NPC). This study investigated the correlation of RASSF1A promoter methylation with clinicopathological features and its utility as a diagnostic biomarker in NPC. A total of 926 patients with NPC and 495 non-tumor controls were analyzed in this study. RASSF1A promoter methylation was notably higher in NPC compared with non-tumor tissue, brushing and blood samples. RASSF1A promoter methylation was associated with clinical stage, lymph node status, distant metastasis, and T classification of patients with NPC, although it was not linked to age and sex. The pooled sensitivity, specificity, and AUC (area under the curve) of RASSF1A promoter methylation were determined in NPC samples vs. non-tumor samples (tissue: sensitivity = 0.72, specificity = 0.99, AUC = 0.98; brushing: sensitivity = 0.56, specificity = 1.00, AUC = 0.94; blood: sensitivity = 0.11, specificity = 0.98, AUC = 0.97). Our findings show that RASSF1A promoter methylation may be correlated with the development, progression and metastasis of NPC. RASSF1A promoter methylation is a promising noninvasive biomarker for the diagnosis of NPC from tissue and brushing samples.

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Section: Introductionmentioning

confidence: 99%

Diagnostic Capacity of RASSF1A Promoter Methylation as a Biomarker in Tissue, Brushing, and Blood Samples of Nasopharyngeal Carcinoma

et al. 2017

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“…[5–10] Unfortunately, patients with distant metastasis have been demonstrated with even worse survival outcome, the progression-free interval (PFS) was only 7.3 to 10 months. [11–13] Because the application of additional treatment could cure or prolong the survival time in 10% to 20% of patients with local or distant progression, [14] thus there is pressing need to identify the high-risk patients with poor prognosis so that novel and intensive protocols could be initiated earlier to improve survival.…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of pretreated serum lactate dehydrogenase level in nasopharyngeal carcinoma among Chinese population

Zhang

Wei

et al. 2016

Medicine

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Background:A large number of studies have investigated the prognostic value of pretreated lactate dehydrogenase (LDH) level in nasopharyngeal carcinoma (NPC) patients while the role of it was inconsistent and inconclusive. Hence, the aim of the current study was to conduct a meta-analysis of all published studies to quantify the prognostic impact of pretreated serum LDH in NPC for Chinese population.Objectives:The aim of the current study was to conduct a meta-analysis of all published studies to quantify the prognostic impact of pretreated serum lactate dehydrogenase (LDH) in nasopharyngeal carcinoma (NPC) for Chinese population.Methods:The PubMed, Medline, Embase, and Web of Science databases were searched for studies that assessed survival outcome and LDH in NPC. Overall survival (OS) was the primary survival outcome. Distant metastasis-free survival (DMFS) and disease-free survival (DFS) were secondary outcomes. The pooled hazard ratios (HRs), associated with 95% confidence intervals (95% CIs), were combined to calculate overall effects. The Cochran Q and I2 statistics were used to assess heterogeneity. When apparent heterogeneity was observed, sensitivity and meta-regression analyses were performed to explore its origin.Results:Sixteen studies, which included 14,803 patients, were enrolled in the current meta-analysis to yield statistics. Overall, the pooled HR for OS in 11 eligible studies with high LDH level was 1.79 (95% CI = 1.47–2.12), and the pooled HR for DMFS in 9 eligible studies with high LDH level was 1.85 (95% CI = 1.48–2.22). Meanwhile, the pooled HR for DFS in 5 eligible studies with high LDH level was 1.63 (95% CI = 1.34–1.91). Egger test and funnel plots revealed that the publication bias in the current meta-analysis was insignificant.Conclusions:The present meta-analysis demonstrated that high pretreated LDH level is significantly associated with poorer OS, DMFS, and DFS, suggesting that pretreated LDH could sever as a prognostic factor in NPC among Chinese population.

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“…A phase II study in Chinese patients showed that the combination of capecitabine and cisplatin was effective and well-tolerated as a first-line treatment among metastatic NPC patients [27]. Similarly, Chua et al [19] conducted a multicenter phase II study involving 39 patients with metastatic NPC and reported that the overall response rate was 53.8% and the median OS was 28.0 months. However, due to the limitation of the small sample size, it was difficult to get the exact conclusion on whether capecitabine could further prolong the survival of patients with metastatic NPC.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, Chua et al. [19] conducted a multicenter phase II study involving 39 patients with metastatic NPC and reported that the overall response rate was 53.8% and the median OS was 28.0 months. However, due to the limitation of the small sample size, it was difficult to get the exact conclusion on whether capecitabine could further prolong the survival of patients with metastatic NPC.…”

Section: Discussionmentioning

confidence: 99%

The role of capecitabine as maintenance therapy in de novo metastatic nasopharyngeal carcinoma: A propensity score matching study

Sun

Liu

Lan

et al. 2020

Cancer Communications

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Background Capecitabine was previously used as a second‐line or salvage therapy for metastatic nasopharyngeal carcinoma (NPC) and has shown satisfactory curative effect as maintenance therapy in other metastatic cancers. This study aimed to explore the role of capecitabine as maintenance therapy in de novo metastatic NPC patients with different plasma Epstein‐Barr virus (EBV) DNA levels before treatment. Methods We selected de novo metastatic NPC patients treated with locoregional radiotherapy (LRRT) for this retrospective study. The propensity score matching (PSM) was applied to balance potential confounders between patients who underwent capecitabine maintenance therapy and those who did not with a ratio of 1:3. Overall survival (OS) was the primary endpoint. The association between capecitabine maintenance therapy and survival was assessed using the log‐rank test and a Cox proportional hazard model. Results Among all patients eligible for this study, 64 received capecitabine maintenance therapy after LRRT. After PSM, 192 patients were identified in the non‐maintenance group. In the matched cohort, patients treated with capecitabine achieved a higher 3‐year OS rate compared with patients in the non‐maintenance group (68.5% vs. 61.8%, P = 0.037). Multivariate analysis demonstrated that capecitabine maintenance therapy was an independent prognostic factor. In subgroup analysis, 3‐year OS rate was comparable between the maintenance and non‐maintenance groups in patients with high pretreatment EBV DNA levels (˃30,000 copies/mL) (54.8% vs. 45.8%, P = 0.835), whereas patients with low pretreatment EBV DNA levels (≤30,000 copies/mL) could benefit from capecitabine maintenance therapy in OS (90.0% vs. 68.1%, P = 0.003). Conclusion Capecitabine maintenance therapy may be superior to non‐maintenance therapy in prolonging OS for de novo metastatic NPC patients with pretreatment EBV DNA ≤ 30,000 copies/mL.

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Phase II trial of capecitabine plus cisplatin as first‐line therapy in patients with metastatic nasopharyngeal cancer

Abstract: Capecitabine plus cisplatin is an active first-line combination in metastatic NPC that requires a short hospital stay.

Cited by 39 publications

References 24 publications

Diagnostic Capacity of RASSF1A Promoter Methylation as a Biomarker in Tissue, Brushing, and Blood Samples of Nasopharyngeal Carcinoma

Diagnostic Capacity of RASSF1A Promoter Methylation as a Biomarker in Tissue, Brushing, and Blood Samples of Nasopharyngeal Carcinoma

Prognostic significance of pretreated serum lactate dehydrogenase level in nasopharyngeal carcinoma among Chinese population

The role of capecitabine as maintenance therapy in de novo metastatic nasopharyngeal carcinoma: A propensity score matching study

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