Induction chemotherapy plus nimotuzumab followed by concurrent chemoradiotherapy for advanced nasopharyngeal carcinoma

Introduction: This study investigated the best mode for the application of nimotuzumab (Nimo) in combination with chemoradiotherapy to treat nasopharyngeal carcinoma (NPC). Material and methods: Data were prospectively collected from 168 patients with NPC from September 2009 to February 2014. One hundred twelve patients received 2-3 cycles of induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT), and 56 patients with well-matched propensity scores received IC + CCRT + Nimo. Patients were divided into 3 subgroups according to the application schedule of Nimo: group A, IC + CCRT; group B: IC (combined with Nimo) + CCRT; and group C: IC + CCRT (combined with Nimo). The 5-year overall survival (OS) and progression-free survival (PFS) and adverse events were investigated. Results: With a median follow-up of 61.4 months (range: 1.7-96.5 months), the 5-year OS and PFS for group A vs. groups B + C were 74.8 +/- 4.1% versus 87.0 +/- 4.6% (p = 0.043) and 72.7 +/- 4.3% vs. 83.1 +/- 5.1% (p = 0.243), respectively. The 5-year OS of group B was significantly improved over that of group A (93.0 +/- 4.8% vs. 74.8 +/- 4.1%, p = 0.038); however, there was no benefit to the 5-year PFS (89.3 +/- 5.9% vs. 72.7 +/- 4.3%, p = 0.144). The 5-year OS and PFS for group C were 80.4 +/- 7.9% and 76.4 +/- 8.5%, respectively, and there was no statistically significant difference from group A (p = 0.257 and p = 0.611, respectively). No significant increase in toxicities was observed with the addition of Nimo. Conclusions: Nimo administered with chemoradiotherapy is effective for NPC. Nimo concurrent with IC followed by CCRT could be the optimal mode of sequential treatment.