Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 15;16(6):2622-2632.
doi: 10.62347/PAAP2909. eCollection 2024.

PD-1 inhibitors combined with chemotherapy versus chemotherapy alone: efficacy and prognostic analysis in recurrent metastatic nasopharyngeal carcinoma

Yong Liu  1 , Zhongxun Wang  1 , Bo Wu  2 , Yinglan Zhu  3 , Xuzhong Liang  4
Affiliations

PD-1 inhibitors combined with chemotherapy versus chemotherapy alone: efficacy and prognostic analysis in recurrent metastatic nasopharyngeal carcinoma

Yong Liu et al. Am J Transl Res. .

Abstract

Objective: To evaluate the prognostic value of combining PD-1 inhibitors (toripalimab or karelizumab) with chemotherapy for treating recurrent or metastatic nasopharyngeal carcinoma (R/M NPC).

Methods: This study retrospectively analyzed 142 patients with R/M NPC diagnosed from January 2018 to January 2022. Patients were divided into PD-1 inhibitor combined with chemotherapy group (53 patients) and chemotherapy alone group (89 patients) according to the treatment regimen. Objective remission rate (ORR), progression-free survival (PFS), and treatment-related toxicity were evaluated in both groups.

Results: The overall response rate (P=0.006) and objective remission rate (ORR) (P=0.002) were significantly higher in the combination chemotherapy group than in the chemotherapy-alone group. The incidences of hypothyroidism (P<0.001) and reactive capillary hyperplasia (P<0.001) were significantly higher in the combination chemotherapy group than in the chemotherapy-alone group. Cox regression analysis showed that treatment regimen (P<0.001), age (P<0.001), treatment duration (P=0.002), and number of treatment lines (P=0.034) were independent prognostic factors affecting patients' PFS. The prediction model constructed based on these prognostic factors had high accuracy in predicting 1-year and 2-year PFS (AUC 0.746 and 0.760, respectively).

Conclusion: PD-1 inhibitors in combination with chemotherapy significantly improved the ORR and median PFS of patients with R/M NPC, while maintaining a favorable safety profile. Treatment regimen, age, number of lines and cycle of therapy were important independent prognostic factors for improving PFS in patients.

Keywords: Karelizumab; combination chemotherapy; prediction model; recurrent metastatic nasopharyngeal carcinoma; toripalimab.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Study flowchart.
Figure 2
Figure 2
Analysis of prognostic factors affecting patients’ PFS. A. One-way Cox regression analysis of prognostic factors affecting patients’ PFS. B. Multifactorial Cox regression analysis of prognostic factors affecting patients’ PFS. Note: PFS, progression-free survival.
Figure 3
Figure 3
K-M survival curves of independent prognostic factors for PFS. A. Comparison of PFS in patients of different ages. B. Comparison of PFS in patients with different treatment regimens. C. Comparison of PFS in patients with different numbers of treatment lines. D. Comparison of PFS in patients with different treatment duration. Note: PFS, progression-free survival.
Figure 4
Figure 4
Time-dependent ROC curves of Cox regression model in predicting patients’ PFS at 1, 2, and 3 years. Note: ROC, receiver operating characteristic; PFS, progression-free survival.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Su ZY, Siak PY, Lwin YY, Cheah SC. Epidemiology of nasopharyngeal carcinoma: current insights and future outlook. Cancer Metastasis Rev. 2024;3:1–9. - PubMed
    1. Shield KD, Ferlay J, Jemal A, Sankaranarayanan R, Chaturvedi AK, Bray F, Soerjomataram I. The global incidence of lip, oral cavity, and pharyngeal cancers by subsite in 2012. CA Cancer J Clin. 2017;67:51–64. - PubMed
    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209–249. - PubMed
    1. Yang Y, Pan J, Wang H, Zhao Y, Qu S, Chen N, Chen X, Sun Y, He X, Hu C, Lin L, Yu Q, Wang S, Wang G, Lei F, Wen J, Yang K, Lin Z, Guo Y, Chen S, Huang X, Wu Y, Liang L, Chen C, Bai F, Ma X, Zhang Y, Leaw S, Zhang L, Fang W. Tislelizumab plus chemotherapy as first-line treatment for recurrent or metastatic nasopharyngeal cancer: a multicenter phase 3 trial (RATIONALE-309) Cancer Cell. 2023;41:1061–1072. e1064. - PubMed
    1. Zhu Y, Yang S, Zhou S, Yang J, Qin Y, Gui L, Shi Y, He X. Nimotuzumab plus platinum-based chemotherapy versus platinum-based chemotherapy alone in patients with recurrent or metastatic nasopharyngeal carcinoma. Ther Adv Med Oncol. 2020;12:1758835920953738. - PMC - PubMed

LinkOut - more resources