Clinical Trial Data of Anti-PD-1/PD-L1 Therapy for Recurrent or Metastatic Nasopharyngeal Carcinoma: A Review
Cette étude passe en revue les données des essais cliniques évaluant l'efficacité des traitements par anti-PD-1/PD-L1 chez les patients atteints d'un carcinome du rhinopharynx de stade métastatique ou récidivant
Importance : Anti–programmed cell death receptor-1 (PD-1) therapy is standard of care for incurablerecurrent or metastatic non-nasopharyngeal head and neck cancer. In contrast, thereare no regulatory agency–approved anti–PD-1 agents indicated for the treatment ofrecurrent or metastatic nasopharyngeal carcinomas (RM-NPC) in the Western hemisphere,and no standard treatment option exists beyond first-line chemotherapy for RM-NPC.The pace of development of novel systemic therapy regimens for RM-NPC has been slowcompared to many other advanced tumor types, leaving an unmet clinical need for thesepatients with a poor prognosis. Observations : Recent clinical trials have documented the clinical activity of anti–PD-1 therapyin RM-NPC. In particular, randomized clinical trials in the first-line setting have demonstrated significant improvements in progression-free survival (PFS) with theaddition of anti–PD-1 therapy to standard chemotherapy. Whether the observed PFS benefitsrequire combination chemoimmunotherapy or can be achieved with chemotherapy followedby crossover to immunotherapy upon progression remains unknown. Ongoing clinical trialsare exploring novel anti–PD-1 therapy–based combinations, which may further solidifya role for these agents in RM-NPC. Conclusions and Relevance : Among patients with RM-NPC, anti–PD-1 therapy added to first-line standard-of-caregemcitabine plus cisplatin provides significantly better efficacy outcomes comparedto chemotherapy alone, and anti–PD-1 monotherapy appears to have comparable clinicalactivity and better tolerability than chemotherapy in previously treated disease.Thus, anti–PD-1 therapy is poised to advance standard of care for the treatment ofRM-NPC.