Phase II trial of recombinant interferon gamma in refractory undifferentiated carcinoma of the nasopharynx

Abstract

The presence of Epstein-Barr virus (EBV) genomes in the DNA of tumor cells of undifferentiated carcinoma of nasopharyngeal type (UCNT), associated with significant lymphocytic infiltration of tumor led to therapeutic trials with interferon (IFN) because of its antiviral, antiproliferative, and immunomodulatory properties. Fourteen patients with histologically proven UCNT (2 had locoregional disease alone and 12 metastatic disease) who were refractory to conventional chemotherapy, were treated with IFN gamma 20 x 10(6) U twice a week. Treatment was well tolerated. No objective response were achieved in the 13 evaluated patients, and all patients progressed after a median treatment duration of 10 weeks (6-32). IFN gamma seems unable to induce antitumor activity alone in such heavily pretreated patients. Its possible place in the management of UCNT is probably earlier in the natural history of this disease.

Palliative treatment with low-dose continuous infusion 5-fluorouracil in recurrent and/or metastatic undifferentiated nasopharyngeal carcinoma type

“…This treatment modality failed to achieve any activity in this disease. 39,40 The results presented here, with CI 5-FU in this population with bulky refractory disease are encouraging, with an objective response rate of 25% (2 CRs and 3 PRs) and durable stabilizations in patients refractory to cisplatin and/or anthracycline-containing regimens. The median duration of response (greater than 5 months) and the median survival (more than 10 months) can be considered good in this patient population ( Figure 1).…”

Expression of indoleamine 2,3-dioxygenase in nasopharyngeal carcinoma impairs the cytolytic function of peripheral blood lymphocytes

“…Although IFNγ was first used to treat patients with NPC in 1987 [6], there was no further report on IFNγ therapy for NPC since 1993 due to some cases were shown to be unresponsive. In most cases of NPC, the dense infiltration of lymphocytes is observed in the tumor site, and EBV-associated viral antigens in tumor cells are presented for lymphocyte recognition, nevertheless IFNγ fails to exert its intended anti-viral and anti-tumor effects in the patients with NPC [7,8]. …”

In Regards to: Dr. N. Lance Downing et al. (Int J Radiat Oncol Biol Physics 2009;75:1064-1070)

“…First, interferon beta was used in the recurrent/metastatic NPC (2)(3)(4)(5). Because of the promising results, Mertens et al (6,7) included an adjuvant interferon-beta application in children treated with radiochemotherapy in the NPC-91-GPOH trial (Nasopharynxkarzinom-91-Gesellschaft für Pädiatri-sche Onkologie und Hämatologie).…”