Novel systemic therapeutic for nasopharyngeal carcinoma.
BACKGROUND
Systemic therapy is crucial to the management of locally advanced or metastatic nasopharyngeal cancer (NPC). Despite initial responses, the benefits of conventional chemotherapy are seldom durable and the toxicities are intolerable to most patients. Therefore, novel therapies based on molecular targets of NPC have become the focus of development.


METHODS
Three novel therapeutics, targeting EGFR, angiogenic processes and epigenetic dysregulation, are discussed in this review. The scientific basis and latest published results of clinical trials are also highlighted.


CONCLUSIONS
In summary, cetuximab, an anti-EGFR monoclonal antibody shows promising results in both locally advanced and metastatic disease. Anti-angiogenic therapy such as sunitinib is efficacious but hemorrhagic complications are of concern in selected patients. Finally, translational studies demonstrate that epigenetic therapeutics could restore the immunogenicity of Epstein-Barr virus in NPC cells. For anti-EGFR therapy, the promising results in early clinical trials should be validated in Phase III clinical trials. Better selection of patients and safer therapy is necessary in future development of anti-angiogenic therapy for NPC. Early clinical trials on epigenetic therapeutics are in process and results are eagerly awaited.
The Chinese University of Hong Kong, Hong Kong Cancer Institute and Prince of Wales Hospital, Sir YK Pao Center for Cancer, Department of Clinical Oncology, State Key Laboratory in Oncology in South China, Shatin, Hong Kong.
Stephen L
SL
Chan
Brigette B
BB
Ma
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D044127:Epigenesis, Genetic; D066246:ErbB Receptors / Q000037:antagonists & inhibitors / Q000235:genetics; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy* / Q000821:virology
D020533:Angiogenesis Inhibitors; D066246:ErbB Receptors