Targeted therapy drugs for nasopharyngeal carcinoma

With the continuous development of society, there are more and more methods to treat tumors. Among them, targeted therapy is a better method to treat tumors in recent years, especially targeted therapy for nasopharyngeal carcinoma. Although targeted therapy for nasopharyngeal carcinoma is no longer news, few people know about it. So, what are the targeted drugs for nasopharyngeal carcinoma?

Clinical research on targeted therapy for nasopharyngeal carcinoma

We probably don't know much about targeted therapy. Targeted therapy is a type of therapy that can inhibit the occurrence and development of tumors or eliminate tumors through various mechanisms. So what is the effect of targeted therapy for nasopharyngeal carcinoma? With the continuous improvement of medical standards, there are more and more ways to treat nasopharyngeal carcinoma, including: radiotherapy, surgical treatment, chemotherapy, immunotherapy and traditional Chinese medicine treatment. Radiotherapy is the first choice in clinical practice. Taixinsheng (Nimotuzumab) is a targeted drug for the treatment of nasopharyngeal carcinoma, and it is also the only targeted drug for the treatment of nasopharyngeal carcinoma in the world. It is the first autologous monoclonal antibody officially launched in China. Taixinsheng can significantly inhibit tumor cell proliferation, induce decomposition, promote cell apoptosis, inhibit tumor angiogenesis, and enhance the effect of radiotherapy and chemotherapy. The drug has strong targeting and low toxicity and side effects, representing the latest development direction in the field of tumor molecular targeted therapy.

Clinical research results show that Taixinsheng is a targeted drug for the treatment of nasopharyngeal carcinoma with good tolerance and can increase the radiotherapy sensitivity of tumors. The biggest feature is that while killing tumor cells, it has very little effect on normal cells, and the patient's tolerance and quality of life are improved. Taixinsheng combined with radiotherapy further improves the patient's effect and survival rate without significantly increasing toxicity. Clinically, it is used in combination with radiotherapy to achieve better results than radiotherapy alone and prolong the median survival. Data from a clinical study on targeted treatment of nasopharyngeal carcinoma conducted in China showed that the effectiveness of Taixinsheng combined with radiotherapy was 100%, and the complete remission rate of tumors was 90.63%. The results of the 3-year survival period follow-up showed that compared with radiotherapy alone, the 3-year survival rate of the Taixinsheng combined with radiotherapy group was 84.29%, which was 7 percentage points higher than that of the control group, significantly prolonging the patient's survival time, and the toxic and side effects were not significantly different from those of radiotherapy alone, providing a new treatment method for patients with advanced nasopharyngeal carcinoma, which is worthy of clinical promotion and application.

Clinical application of targeted therapy for nasopharyngeal carcinoma

China is a high-incidence area for nasopharyngeal carcinoma. In recent years, comprehensive and individualized treatment for patients with advanced stage has become an important means to improve local control and survival rate. Molecular biological modification therapy has important clinical effects, which works by regulating cell biological activities and host immune response, including cytokines, monoclonal antibodies, immune effector cells, immunostimulants, gene drugs and non-cytotoxic small molecule target drugs.

In recent years, more and more molecular targeted drugs have been used in the combined radiotherapy of nasopharyngeal carcinoma, which can specifically block the signal transduction pathways that play a key role in the growth of tumor cells. While killing tumor cells, it reduces the impact on normal cells and improves the patient's radiotherapy survival rate and quality of life. Epidermal growth factor receptor (EGFR) is overexpressed in 95-100% of head and neck tumors and has become an important target for targeted treatment of head and neck tumors. The EGFR monoclonal antibody inhibitor cetuximab (Erbitux) has been approved by the FDA as a drug that can be combined with radiotherapy and chemotherapy for the treatment of head and neck tumors for the first time. The results of domestic phase III clinical trials show that cetuximab combined with concurrent radiotherapy and chemotherapy for targeted treatment of nasopharyngeal carcinoma improves the local control rate of nasopharyngeal carcinoma patients without increasing toxic and side effects. The results of domestic phase II clinical trials of nimotuzumab (Taixinsheng) combined with radiotherapy and chemotherapy show that nimotuzumab combined with radiotherapy and chemotherapy can improve the 3-year survival rate of nasopharyngeal carcinoma to 84.29%. The phase I clinical trial of panitumumab also proved that it is safe and feasible to combine with radiotherapy and chemotherapy. As small molecule tyrosine kinase inhibitors, gefitinib (Iressa) and erlotinib (Tarceva) have also been tested in Phase II clinical trials for head and neck squamous cell carcinoma, and have begun to show anti-tumor activity. The results of Phase II trials of vascular endothelial growth factor receptor (VEGFR) inhibitor bevacizumab combined with radiotherapy and chemotherapy for nasopharyngeal carcinoma showed an improvement in the local control rate, and the effect is encouraging.

The combined dual targeted therapy of Chinese and Western medicine solves several outstanding problems, so it is becoming more and more popular in clinical practice. In addition, combined with targeted therapy of traditional Chinese medicine, it can enhance the targeted effect, make the effect of targeted therapy more lasting and effective, and even achieve clinical recovery. Therefore, Chinese medicine treatment can be used throughout the entire process of cancer treatment.

Targeted therapy targets certain marker molecules overexpressed by tumor cells, selects specific blockers, and effectively interferes with the signal transduction pathways that are regulated by the marker molecules and are closely related to tumor occurrence, thereby inhibiting tumor growth, development and metastasis. Targeted therapy has achieved good results for some cancers such as breast cancer, but it is not suitable for all cancers. Targeted therapy for nasopharyngeal carcinoma is not commonly used, and radiotherapy is still the most commonly used, but there are also some targeted treatment plans for nasopharyngeal carcinoma in clinical practice.

Combining Chinese and Western medicine to treat nasopharyngeal carcinoma

Nasopharyngeal carcinoma is one of the common malignant tumors in China, and ranks first among head and neck malignant tumors. Due to various reasons, the incidence of nasopharyngeal carcinoma has shown an upward trend, with higher incidence in southern China, such as Guangdong, Guangxi, Hunan and other provinces, especially in the central and western parts of Guangdong, such as Zhaoqing, Foshan and Guangzhou. This is not a good thing for everyone. Because if nasopharyngeal carcinoma is not treated well, it will threaten life. When treating it, comprehensive treatment is usually the best. So how to carry out comprehensive treatment of nasopharyngeal carcinoma? Combining traditional Chinese and Western medicine to treat nasopharyngeal carcinoma is the right choice.

From the current status of nasopharyngeal carcinoma treatment research, combined chemotherapy is the main method at present, including adjuvant chemotherapy, neoadjuvant chemotherapy, synchronous chemoradiotherapy, molecular targeted therapy, etc. The indications of targeted treatment of nasopharyngeal carcinoma mainly include:

Some patients with advanced nasopharyngeal carcinoma (T3~4N0~1M0) and regionally advanced nasopharyngeal carcinoma (T1~2N2~3M0) should receive appropriate chemotherapy in addition to radiotherapy.

For patients with local advanced nasopharyngeal carcinoma (T3~4N2~3M0), their local recurrence rate and distant metastasis rate are quite high. Therefore, nasopharyngeal carcinoma must be combined with systemic treatment. The combination of Chinese and Western medicine has a certain effect in the treatment of nasopharyngeal carcinoma. Blood-activating and blood-stasis-removing drugs can improve microcirculation, increase blood flow, accelerate blood flow rate, and destroy the aggregation of fibrin around and inside tumor tissues, thereby improving the hypoxic tissue state.

Inhibitors for targeted therapy

Treatments for nasopharyngeal carcinoma include radiotherapy, chemotherapy, immunotherapy, and traditional Chinese medicine. Due to the particularity of the anatomical structure of the nasopharynx and the sensitivity of nasopharyngeal carcinoma tissue to radiation, radiotherapy is recognized as one of the primary treatments for nasopharyngeal carcinoma. In recent years, with the development of clinical high technology and the deepening of head and neck cancer cell and molecular biology research, biological treatments for nasopharyngeal carcinoma have also made great progress, as summarized below. In recent years, many anti-tumor targeted drugs for the treatment of nasopharyngeal carcinoma have been approved for marketing in the United States and Europe. These targeted drugs avoid the lack of specificity of traditional chemotherapy and radiotherapy, which brings about greater toxic and side effects, and have created a new era of connection between oncology diagnosis and treatment.

Epidermal growth factor receptor inhibitors: The expression of epidermal growth factor receptor (EGFR) in head and neck squamous cell carcinoma is as high as 88%. It is now known that EGFR plays an extremely important role in the growth, modification and survival of tumor cells. Its overexpression often indicates poor prognosis, rapid metastasis, resistance to chemotherapy drugs, hormone resistance, and short survival period. A study by A et al. on 155 patients with head and neck squamous cell carcinoma reported that head and neck squamous cell carcinoma had great variability in the expression of EGFR, which was unrelated to the primary lesion, lymph node stage and known prognostic factors of the patient. At the same time, it was found that low expression of EGFR was associated with high survival rate, high local control rate, and long disease-free survival time, but not with distant metastasis. Chua et al. studied 54 patients with nasopharyngeal carcinoma and found that low expression of EGFR was associated with high local control rate, long disease-free survival time and low distant metastasis rate. Eriksen et al. analyzed 336 patients with head and neck squamous cell carcinoma and concluded that the local control rate of EGFR low-expressing tumors was high after 9.5 weeks of segmented radiotherapy, while the local control rate of conventional radiotherapy and accelerated radiotherapy was not related to low EGFR expression. Bentxen et al.141 studied 344 patients with head and neck squamous cell carcinoma and concluded that high EGFR expression reduced the control rate of conventional radiotherapy.

What are the targeted drugs for the treatment of nasopharyngeal carcinoma? After the above introduction, I believe everyone has a relevant understanding of nasopharyngeal carcinoma. For nasopharyngeal carcinoma patients, it is very important to stay away from the harm of nasopharyngeal carcinoma. In addition, it is also necessary to develop good living habits and eating habits, actively exercise, enhance the body's resistance, and live a healthy life.