What are the targeted drugs for nasopharyngeal carcinoma

What are the targeted drugs for nasopharyngeal carcinoma ? Since the publication of The Intergroup Study 0099 in the United States , the concurrent chemoradiotherapy plus adjuvant chemotherapy used in the study has become the standard treatment model for stage III and IV nasopharyngeal carcinoma in North America. Although the chemotherapy drugs currently used for nasopharyngeal carcinoma have achieved a high efficacy, the long-term effect is still not ideal, and there are more serious side effects, so it is necessary to further find highly effective and low-toxic drugs. In the 1990s , new drugs such as taxanes, oxaliplatin, gemcitabine, and CPT-11 showed good efficacy.

(1) Taxanes

Carboplatin combined with paclitaxel induction chemotherapy and concurrent chemoradiotherapy with cisplatin were used to treat patients with Ⅲ and Ⅳ nasopharyngeal carcinoma. The efficacy of induction chemotherapy was 16% for primary lesions and 58% for regional lymph nodes . The 2- year overall survival rate and progression-free survival rate were 91.8 % and 78.5 % , respectively. Patients had good tolerance. Three cycles of docetaxel (75mg/m2) and cisplatin (75mg/m2) chemotherapy were performed before radiotherapy, with an efficacy of 89% ( 37% complete remission )

The results of a phase I dose-escalation clinical trial of using weekly Taxol chemotherapy to treat locally advanced nasopharyngeal carcinoma during radiotherapy were reported . The recommended dose of Taxol is 30 mg/m2 , and the main reactions are mucositis and skin reactions. In addition, Taxol alone or in combination with platinum chemotherapy is effective as a first-line or second-line treatment for metastatic nasopharyngeal carcinoma. When used alone for 3 weeks, the dose is 135 mg/m2~175 mg/m2 , the effective rate is 22% , and the effective duration is 7.5 months. When Taxol is combined with carboplatin, the effective rate is 60 ~72% , and the median progression time as a first-line treatment is 7 months. In another study, it was reported that carboplatin ( AUC7 mg/ml per minute ) and Taxol 200 mg/m2 were used with the support of growth factors, and the effective rate reached 57% , and the disease progression time was 4.3 months. When the dose was further increased, the toxicity was significantly increased, but the efficacy was similar.

(2) Capecitabine

17 patients with metastatic or recurrent head and neck squamous cell carcinoma who were refractory to platinum-based treatment were treated with capecitabine. The median follow-up time was 7.5 months, 3 cases had partial remission, 1 case had complete remission, the total effective rate was 23.5 % , the median survival time was 7.6 months, the main reaction was grade I to II hand-foot syndrome, and the blood toxicity was mild. Therefore, capecitabine can be used as an effective salvage treatment for patients with advanced metastatic or recurrent nasopharyngeal carcinoma. The researchers said that the results of a phase I trial of the simultaneous use of capecitabine and radiotherapy in early nasopharyngeal carcinoma showed that the regimen was tolerable and effective, and the recommended dose was 1700 mg/m2 per day .

(3) GEM