title: Induction chemotherapy followed by concurrent chemoradiation and nimotuzumab for locoregionally advanced nasopharyngeal carcinoma: preliminary results from a phase II clinical trial.
abstract: Overexpression of epidermal growth factor receptor can be found in more than 80% of patients with locoregionally advanced nasopharyngeal carcinoma and is associated with shorter survival. In this work, we evaluated the feasibility of adding nimotuzumab to chemoradiation in locoregionally advanced nasopharyngeal carcinoma. Twenty-three patients with clinically staged T3-4 or any node-positive disease were enrolled. They were scheduled to receive one cycle of induction chemotherapy followed by intensity-modulated radiotherapy, weekly administration of nimotuzumab and concurrent chemotherapy. Results showed that all patients received a full course of radiotherapy, 19(82.6%)patients completed the scheduled neoadjuvant and concurrent chemotherapy, and 22(95.7%) patients received ≥6 weeks of nimotuzumab. During the period of concurrent chemoradiation and nimotuzumab, grade 3-4 toxicities occurred in 14(60.9%) patients: 8 (34.8%) had grade 3-4 oral mucositis, 6(26.1%) had grade 3 neutropenia, and 1(4.3%) had grade 3 dermatitis. No acne-like rash was observed. With a median follow-up of 24.1 months, the 2-year progression-free survival and overall survival were 83.5% and 95.0%, respectively. In conclusion, concurrent administration of chemoradiation and nimotuzumab was well-tolerated with good compliance. Preliminary clinical outcome data appear encouraging with favorable normal tissue toxicity results comparing with historical data of concurrent chemoradiation plus cetuximab.
authors.affiliation: Department of Radiobiology, School of Radiation Medicine and Protection and Jiangsu Provincial Key Laboratory of Radiation Medicine and Protection, Medical College of Soochow University, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions and School for Radiological and Interdisciplinary Sciences (RAD-X), Soochow University, Suzhou, China.|Department of Radiation Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China.
authors.forename: Jian-Feng
authors.initials: JF
authors.lastname: Huang
authors.affiliation: Department of Radiation Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China.
authors.forename: Fu-Zheng
authors.initials: FZ
authors.lastname: Zhang
authors.affiliation: Department of Radiation Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China.
authors.forename: Qin-Zhou
authors.initials: QZ
authors.lastname: Zou
authors.affiliation: Department of Radiation Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China.
authors.forename: Le-Yuan
authors.initials: LY
authors.lastname: Zhou
authors.affiliation: Department of Radiation Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Yang
authors.affiliation: Department of Radiation Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China.
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Chu
authors.affiliation: Department of Radiobiology, School of Radiation Medicine and Protection and Jiangsu Provincial Key Laboratory of Radiation Medicine and Protection, Medical College of Soochow University, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions and School for Radiological and Interdisciplinary Sciences (RAD-X), Soochow University, Suzhou, China.
authors.forename: Jia-Hua
authors.initials: JH
authors.lastname: Yu
authors.affiliation: Department of Radiobiology, School of Radiation Medicine and Protection and Jiangsu Provincial Key Laboratory of Radiation Medicine and Protection, Medical College of Soochow University, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions and School for Radiological and Interdisciplinary Sciences (RAD-X), Soochow University, Suzhou, China.
authors.forename: Hao-Wen
authors.initials: HW
authors.lastname: Zhang
authors.affiliation: Department of Radiation Oncology, Nantong Tumor Hospital, Affiliated Tumor Hospital of Nantong University, Nantong, China.
authors.forename: Xiao-Peng
authors.initials: XP
authors.lastname: Yuan
authors.affiliation: Department of Radiation Oncology, Nantong Tumor Hospital, Affiliated Tumor Hospital of Nantong University, Nantong, China.
authors.forename: Guo-Mei
authors.initials: GM
authors.lastname: Tai
authors.affiliation: Department of Radiobiology, School of Radiation Medicine and Protection and Jiangsu Provincial Key Laboratory of Radiation Medicine and Protection, Medical College of Soochow University, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions and School for Radiological and Interdisciplinary Sciences (RAD-X), Soochow University, Suzhou, China.
authors.forename: Fen-Ju
authors.initials: FJ
authors.lastname: Liu
authors.affiliation: Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA.
authors.forename: C-M Charlie
authors.initials: CC
authors.lastname: Ma
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000627:therapeutic use; D000074322:Antineoplastic Agents, Immunological / Q000008:administration & dosage* / Q000627:therapeutic use; D002277:Carcinoma / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000074322:Antineoplastic Agents, Immunological; C501466:nimotuzumab
keywords: chemoradiotherapy; induction chemotherapy; nasopharyngeal carcinoma; nimotuzumab