The following is a summary of “A prospective, single-arm trial of PD-1 inhibitors plus chemoradiotherapy for solitary metachronous metastasis nasopharyngeal carcinoma,” published in the March 2024 issue of Oncology by Li, et al.
When treating Recurrent/Metastatic Nasopharyngeal Carcinoma (R/M NPC), gemcitabine and cisplatin are frequently used in combination or separately from PD-1 inhibitors. However, the efficacy of PD-1 inhibitors varies, which calls for improved therapies. The study investigated the safety and efficacy of combining PD-1 inhibitors with chemoradiotherapy for patients with oligometastatic NPC. Patients with oligometastatic NPC had aggressive treatment consisting of PD-1 inhibitors and chemotherapy, which was followed by concomitant chemoradiotherapy and PD-1 inhibitors, and finally, maintenance of PD-1 inhibitors. CTCAE-4.0 was used to assess the toxicity, and irRECIST-1.1 was utilized to determine the objective response rate (ORR) and disease control rate (DCR).
A median radiation dose of 45 Gy was administered to lesions with metastases during the 16.5-month follow-up period. The median number of chemotherapy and PD-1 inhibitor treatments was five, and 9.5 for both. Lung (40.8%), liver (21.1%), mediastinal lymph node (7.9%), abdominal lymph nodes (3.9%), bone (21.1%), adrenal gland (3.9%), and brain (1.3%) were among the metastatic locations. Three months following radiation, the ORR and DCR were 85.1% and 100%, respectively. There was still a gap in the median survival, with 1- and 2-year OS rates of 93.1% and 78.4%, respectively. With 1- and 2-year PFS rates of 70.2% and 47.7%, respectively, the median PFS was eighteen months.
There was a favorable connection between PFS and PD-L1 expression. Twenty-five individuals had adverse events (AEs) of grade 3 or 4, which the treatment could have caused. There were no grade 5 AEs noted. For patients with oligometastasis NPC, the combination of concurrent PD-1 inhibitors and chemoradiotherapy exhibits promising effectiveness with tolerable toxicity.47 participants with a median age of 46 were enrolled in the trial. A median radiation dose of 45 Gy was administered to lesions with metastases during the 16.5-month follow-up period. The median number of chemotherapy and PD-1 inhibitor treatments was five, and 9.5 for both. Lung (40.8%), liver (21.1%), mediastinal lymph node (7.9%), abdominal lymph nodes (3.9%), bone (21.1%), adrenal gland (3.9%), and brain (1.3%) were among the metastatic locations. 85.1% for ORR and DCR, and
Source:sciencedirect.com/science/article/abs/pii/S1368837524000137