Nimotuzumab combined with docetaxel and cisplatin as first-line treatment for patients with recurrent or metastatic nasopharyngeal carcinoma: a multicenter, phase 2 trial

Abstract Background To evaluate the efficacy and safety of nimotuzumab combined with docetaxel and cisplatin (TPN) as the first-line therapy in patients with recurrent or metastatic nasopharyngeal carcinoma (RM-NPC). Methods In this multicenter, open-label, phase 2 trial (ClinicalTrials.gov identifi...

Full description

Saved in:
Bibliographic Details
Main Authors: Qihua Zou, Yi Cao, Yulin Lai, Yu Fang, Yuchen Zhang, Panpan Liu, Lixia Lu, Hao Wu, Tianying Huang, Ning Su, Zhihua Li, Xicheng Wang, Xiaopeng Tian, Lirong Li, Yingxian Liu, Qingqing Cai, Yi Xia
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12916-025-04103-0
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background To evaluate the efficacy and safety of nimotuzumab combined with docetaxel and cisplatin (TPN) as the first-line therapy in patients with recurrent or metastatic nasopharyngeal carcinoma (RM-NPC). Methods In this multicenter, open-label, phase 2 trial (ClinicalTrials.gov identifier: NCT03708822), patients with RM-NPC received intravenous nimotuzumab (200 mg on days 1, 8, and 15), docetaxel (75 mg/m2 on day 1), and cisplatin (75 mg/m2 on day 1) every 3 weeks for 6 cycles. The primary endpoint was the objective response rate (ORR), and the secondary endpoints included the disease control rate (DCR), duration of response (DOR), time to response (TTR), progression-free survival (PFS), overall survival (OS), and safety. Results Between October 15, 2018, and July 20, 2022, 52 patients were enrolled. The ORR and DCR in the intention-to-treat population were 65.4% and 90.4%, respectively. With a median follow-up of 38.1 months, the median PFS and OS were 7.4 and 40.4 months, respectively. The majority of adverse events were grades 1–2. Grade 3/4 adverse events were neutropenia (42.3%), leukopenia (32.7%), febrile neutropenia (11.5%), nausea (7.7%), fatigue (5.8%), infection (5.8%), thrombocytopenia (1.9%), and anorexia (1.9%). There was no treatment-related death. Low baseline plasma Epstein-Barr virus (EBV) DNA level and the clearance of plasma EBV DNA after 2 cycles of treatment were associated with longer PFS. Additionally, patients who received ≥ 2400 mg of nimotuzumab and ≥ 4 cycles of docetaxel plus cisplatin had superior ORR and survival. Conclusions First-line therapy with the TPN regimen showed promising efficacy with a well-tolerated safety profile in RM-NPC patients. Trial registration ClinicalTrials.gov: NCT03708822.
ISSN:1741-7015