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!
_version_ 1849312140586909696
author 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
author_facet 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
author_sort Qihua Zou
collection DOAJ
description 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.
format Article
id doaj-art-a24b2cb9d791477fa520cca605d49f7b
institution Kabale University
issn 1741-7015
language English
publishDate 2025-05-01
publisher BMC
record_format Article
series BMC Medicine
spelling doaj-art-a24b2cb9d791477fa520cca605d49f7b2025-08-20T03:53:12ZengBMCBMC Medicine1741-70152025-05-0123111110.1186/s12916-025-04103-0Nimotuzumab combined with docetaxel and cisplatin as first-line treatment for patients with recurrent or metastatic nasopharyngeal carcinoma: a multicenter, phase 2 trialQihua Zou0Yi Cao1Yulin Lai2Yu Fang3Yuchen Zhang4Panpan Liu5Lixia Lu6Hao Wu7Tianying Huang8Ning Su9Zhihua Li10Xicheng Wang11Xiaopeng Tian12Lirong Li13Yingxian Liu14Qingqing Cai15Yi Xia16State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterDepartment of Medical Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityState Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterZhongshan School of Medicine, Sun Yat-Sen UniversityDepartment of Medical Oncology, Huizhou Municipal Central HospitalDepartment of Oncology, Guangzhou Chest HospitalDepartment of Medical Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen UniversityDepartment of Oncology, The First Affiliated Hospital/The First Clinical Medicine School of Guangdong Pharmaceutical UniversityState Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterAbstract 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.https://doi.org/10.1186/s12916-025-04103-0NimotuzumabDocetaxelCisplatinFirst-line therapyRecurrent or metastatic nasopharyngeal carcinoma
spellingShingle 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
Nimotuzumab combined with docetaxel and cisplatin as first-line treatment for patients with recurrent or metastatic nasopharyngeal carcinoma: a multicenter, phase 2 trial
BMC Medicine
Nimotuzumab
Docetaxel
Cisplatin
First-line therapy
Recurrent or metastatic nasopharyngeal carcinoma
title Nimotuzumab combined with docetaxel and cisplatin as first-line treatment for patients with recurrent or metastatic nasopharyngeal carcinoma: a multicenter, phase 2 trial
title_full Nimotuzumab combined with docetaxel and cisplatin as first-line treatment for patients with recurrent or metastatic nasopharyngeal carcinoma: a multicenter, phase 2 trial
title_fullStr Nimotuzumab combined with docetaxel and cisplatin as first-line treatment for patients with recurrent or metastatic nasopharyngeal carcinoma: a multicenter, phase 2 trial
title_full_unstemmed Nimotuzumab combined with docetaxel and cisplatin as first-line treatment for patients with recurrent or metastatic nasopharyngeal carcinoma: a multicenter, phase 2 trial
title_short Nimotuzumab combined with docetaxel and cisplatin as first-line treatment for patients with recurrent or metastatic nasopharyngeal carcinoma: a multicenter, phase 2 trial
title_sort nimotuzumab combined with docetaxel and cisplatin as first line treatment for patients with recurrent or metastatic nasopharyngeal carcinoma a multicenter phase 2 trial
topic Nimotuzumab
Docetaxel
Cisplatin
First-line therapy
Recurrent or metastatic nasopharyngeal carcinoma
url https://doi.org/10.1186/s12916-025-04103-0
work_keys_str_mv AT qihuazou nimotuzumabcombinedwithdocetaxelandcisplatinasfirstlinetreatmentforpatientswithrecurrentormetastaticnasopharyngealcarcinomaamulticenterphase2trial
AT yicao nimotuzumabcombinedwithdocetaxelandcisplatinasfirstlinetreatmentforpatientswithrecurrentormetastaticnasopharyngealcarcinomaamulticenterphase2trial
AT yulinlai nimotuzumabcombinedwithdocetaxelandcisplatinasfirstlinetreatmentforpatientswithrecurrentormetastaticnasopharyngealcarcinomaamulticenterphase2trial
AT yufang nimotuzumabcombinedwithdocetaxelandcisplatinasfirstlinetreatmentforpatientswithrecurrentormetastaticnasopharyngealcarcinomaamulticenterphase2trial
AT yuchenzhang nimotuzumabcombinedwithdocetaxelandcisplatinasfirstlinetreatmentforpatientswithrecurrentormetastaticnasopharyngealcarcinomaamulticenterphase2trial
AT panpanliu nimotuzumabcombinedwithdocetaxelandcisplatinasfirstlinetreatmentforpatientswithrecurrentormetastaticnasopharyngealcarcinomaamulticenterphase2trial
AT lixialu nimotuzumabcombinedwithdocetaxelandcisplatinasfirstlinetreatmentforpatientswithrecurrentormetastaticnasopharyngealcarcinomaamulticenterphase2trial
AT haowu nimotuzumabcombinedwithdocetaxelandcisplatinasfirstlinetreatmentforpatientswithrecurrentormetastaticnasopharyngealcarcinomaamulticenterphase2trial
AT tianyinghuang nimotuzumabcombinedwithdocetaxelandcisplatinasfirstlinetreatmentforpatientswithrecurrentormetastaticnasopharyngealcarcinomaamulticenterphase2trial
AT ningsu nimotuzumabcombinedwithdocetaxelandcisplatinasfirstlinetreatmentforpatientswithrecurrentormetastaticnasopharyngealcarcinomaamulticenterphase2trial
AT zhihuali nimotuzumabcombinedwithdocetaxelandcisplatinasfirstlinetreatmentforpatientswithrecurrentormetastaticnasopharyngealcarcinomaamulticenterphase2trial
AT xichengwang nimotuzumabcombinedwithdocetaxelandcisplatinasfirstlinetreatmentforpatientswithrecurrentormetastaticnasopharyngealcarcinomaamulticenterphase2trial
AT xiaopengtian nimotuzumabcombinedwithdocetaxelandcisplatinasfirstlinetreatmentforpatientswithrecurrentormetastaticnasopharyngealcarcinomaamulticenterphase2trial
AT lirongli nimotuzumabcombinedwithdocetaxelandcisplatinasfirstlinetreatmentforpatientswithrecurrentormetastaticnasopharyngealcarcinomaamulticenterphase2trial
AT yingxianliu nimotuzumabcombinedwithdocetaxelandcisplatinasfirstlinetreatmentforpatientswithrecurrentormetastaticnasopharyngealcarcinomaamulticenterphase2trial
AT qingqingcai nimotuzumabcombinedwithdocetaxelandcisplatinasfirstlinetreatmentforpatientswithrecurrentormetastaticnasopharyngealcarcinomaamulticenterphase2trial
AT yixia nimotuzumabcombinedwithdocetaxelandcisplatinasfirstlinetreatmentforpatientswithrecurrentormetastaticnasopharyngealcarcinomaamulticenterphase2trial