Capecitabine combined with immunotherapy as maintenance therapy improves survival in recurrent/metastatic nasopharyngeal carcinoma: a retrospective cohort study
Menée à partir de données portant sur 257 patients atteints d'un carcinome du rhinopharynx de stade métastatique ou récidivant, cette étude de cohorte rétrospective évalue l'efficacité, du point de vue de la survie sans progression et de la survie globale, et la toxicité d'un traitement d'entretien combinant capécitabine et immunothérapie
Background: We evaluated the clinical impact of combining capecitabine with immunotherapy (Immu/Cape) compared to immunotherapy monotherapy (Immu) as maintenance in recurrent/metastatic (R/M) nasopharyngeal carcinoma (NPC) patients following initial chemo-immunotherapy.
Methods: We retrospectively analyzed 257 R/M NPC patients who achieved disease control after chemo-immunotherapy and received either Immu/Cape or Immu maintenance. Propensity score matching (PSM) was performed to balance baseline characteristics. Endpoints included progression-free survival (PFS) and overall survival (OS).
Results: Following PSM, the Immu/Cape group exhibited prolonged PFS (median, 27.87 vs 8.5 months, p = 0.016) and OS (3-year rate, 80.8% vs. 65.4%; p = 0.027). This survival benefit was most pronounced in patients with high-burden disease: >5 metastatic lesions, ≥2 involved organs, or detectable post-treatment EBV DNA. The primary toxicity was hand-foot syndrome, with a higher incidence in the Immu/Cape group (53.7% vs. 9.8%; p < 0.001), including 12.2% grade 3–4 events; other severe adverse events were comparable.
Conclusion: This study provides hypothesis-generating evidence that Immu/Cape maintenance may improve survival in R/M NPC, especially for high-risk patients. Prospective, randomized trials are required to validate this strategy before it can be considered practice-changing.
British Journal of Cancer , résumé, 2025