Maintenance Capecitabine in Recurrent or Metastatic Nasopharyngeal Carcinoma—Magic Bullet or Pandora’s Box?
Mené sur 104 patients atteints d'un carcinome métastatique du rhinopharynx (âge médian : 47 ans ; durée médiane de suivi : 33,8 mois), cet essai de phase III évalue l'efficacité, du point de vue de la survie sans progression, et la toxicité de l'ajout de la capécitabine aux "meilleurs soins de support" en traitement d'entretien
The natural history of recurrent or metastatic nasopharyngeal carcinoma (R/M-NPC) is highly variable. Prognoses of patients with R/M-NPC are influenced by factors such as disease burden (oligometastatic [<3-5 lesions] vs polymetastatic), sites of involvement (lung and lymph nodes vs other visceral and skeletal involvement), and timing of distant metastatic recurrences (de novo vs metachronous). For patients who are fit for systemic therapy, gemcitabine-cisplatin (GP) doublet therapy is the current chemotherapy recommendation, achieving a progression-free survival (PFS) of 7.9 months and overall survival (OS) of 22.1 months. More recently, 2 large randomized clinical phase 3 trials—CAPTAIN-1st and JUPITER-02—reported that the addition of anti–programmed cell death-1 (anti-PD-1) antibodies (camrelizumab and toripalimab) in combination with GP, followed by maintenance anti-PD-1 antibody treatment until disease progression or up to 2 years, was superior to GP alone (median PFS for combination therapy, 10.8 months and 11.7 months).
JAMA Oncology , éditorial, 2021