title: Graft-vs-tumor effect in patients with advanced nasopharyngeal cancer treated with nonmyeloablative allogeneic PBSC transplantation.
abstract: While nonmyeloablative peripheral blood stem cell transplantation (NST) has shown efficacy against several solid tumors, it is untested in nasopharyngeal cancer (NPC). In a phase II clinical trial, 21 patients with pretreated metastatic NPC underwent NST with sibling PBSC allografts, using CY conditioning, thymic irradiation and in vivo T-cell depletion with thymoglobulin. Stable lymphohematopoietic chimerism was achieved in most patients and prophylactic CYA was tapered at a median of day +30. Seven patients (33%) showed partial response and three (14%) achieved stable disease. Four patients were alive at 2 years and three showed prolonged disease control of 344, 525 and 550 days. With a median follow-up of 209 (4-1147) days, the median PFS was 100 days (95% confidence interval (CI), 66-128 days), and median OS was 209 days (95% CI, 128-236 days). Patients with chronic GVHD had better survival-median OS 426 days (95% CI, 194-NE days) vs 143 days (95% CI, 114-226 days) (P=0.010). Thus, NST may induce meaningful clinical responses in patients with advanced NPC.
authors.affiliation: Department of Medical Oncology, National Cancer Centre, Singapore, Singapore. hanchongtoh@gmail.com
authors.forename: H C
authors.initials: HC
authors.lastname: Toh
authors.forename: W K
authors.initials: WK
authors.lastname: Chia
authors.forename: L
authors.initials: L
authors.lastname: Sun
authors.forename: C H
authors.initials: CH
authors.lastname: Thng
authors.forename: Y
authors.initials: Y
authors.lastname: Soe
authors.forename: Y P
authors.initials: YP
authors.lastname: Phoon
authors.forename: S P
authors.initials: SP
authors.lastname: Yap
authors.forename: W T
authors.initials: WT
authors.lastname: Lim
authors.forename: W M
authors.initials: WM
authors.lastname: Tai
authors.forename: S W
authors.initials: SW
authors.lastname: Hee
authors.forename: S H
authors.initials: SH
authors.lastname: Tan
authors.forename: S S
authors.initials: SS
authors.lastname: Leong
authors.forename: E H
authors.initials: EH
authors.lastname: Tan
mesh_terms: D000328:Adult; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D020350:Graft vs Tumor Effect; D006801:Humans; D008212:Lymphocyte Depletion; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D009362:Neoplasm Metastasis; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods* / Q000401:mortality; D016019:Survival Analysis; D018183:Transplantation Chimera; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous
chemical_list: D003520:Cyclophosphamide