PD-1 inhibitor combined with TPF induction chemotherapy in locally advanced nasopharyngeal carcinoma: a retrospective study of efficacy and safety.

IF 5.9 2区医学 Q1 IMMUNOLOGY

Frontiers in Immunology Pub Date : 2025-09-16 eCollection Date: 2025-01-01 DOI:10.3389/fimmu.2025.1654616

Weiwei Zhang, Yousheng Meng, Ping Zhang, Dujuan Tian, Xianghua Zeng, Mingqing Dong, Lang He

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引用次数: 0

Abstract

Background: The efficacy of PD-1 inhibitors in the induction therapy of locally advanced nasopharyngeal carcinoma (LA-NPC) remains unclear. The aim of this study was to retrospectively investigate the efficacy and safety of PD-1 inhibitor combined with induction chemotherapy in patients with LA-NPC.

Patients and methods: A retrospective study was conducted on 158 LA-NPC patients, 80 patients received TPF (nab-paclitaxel, cisplatin and 5-fuorouracil) induction chemotherapy, and 78 patients received TPF-ICB (TPF plus PD-1 inhibitor) chemoimmunotherapy. Treatment response was evaluated immediately following completion of induction therapy using RECIST v1.1 criteria, including cervical lymph nodes and primary nasopharynx lesions. Responses were categorized as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD), with objective response rate (ORR) calculated as the combined CR+PR rate. Secondary endpoints included progression-free survival (PFS), overall survival (OS), and toxicity assessment. Acute treatment-related toxicities during induction therapy were graded according to CTCAE v5.0 criteria and compared between treatment groups.

Results: After induction therapy, the ORR in the TPF group was significantly lower than that in the TPF-ICB group (71.2% vs. 88.5%, p = 0.007). The complete response (CR) rate in the TPF-ICB group was significantly higher than in the TPF group (29.5% vs. 11.3%, p = 0.004). The 3 and 5 years PFS rates in TPF-ICB group were 99% and 95%, which were significantly higher than the TPF group (89% and 87%, both p < 0.05). The 3-year (99% vs. 89%, p <0.001) and 5-years OS rates (95% vs. 87%, p < 0.0001) were superior in the TPF-ICB group. Grade ≥3 TRAEs occurred in 7 (8.6%) and 12 (15.5%) patients in the TPF and TPF-ICB groups, respectively (p = 0.596).

Conclusions: The induction therapy of PD-1 inhibitor combined with TPF showed high CR and ORR rates in LA-NPC, and the safety was acceptable.

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PD-1抑制剂联合TPF诱导化疗治疗局部晚期鼻咽癌的疗效和安全性回顾性研究

背景：PD-1抑制剂在局部晚期鼻咽癌（LA-NPC）诱导治疗中的疗效尚不清楚。本研究旨在回顾性探讨PD-1抑制剂联合诱导化疗治疗LA-NPC患者的疗效和安全性。患者与方法：对158例LA-NPC患者进行回顾性研究，80例患者接受TPF （nab-紫杉醇+顺铂+ 5-氟尿嘧啶）诱导化疗，78例患者接受TPF- icb （TPF + PD-1抑制剂）化疗免疫治疗。在诱导治疗完成后立即使用RECIST v1.1标准评估治疗效果，包括颈部淋巴结和原发性鼻咽部病变。反应分为完全缓解（CR）、部分缓解（PR）、疾病稳定（SD）或疾病进展（PD），客观缓解率（ORR）计算为CR+PR的综合缓解率。次要终点包括无进展生存期（PFS）、总生存期（OS）和毒性评估。根据CTCAE v5.0标准对诱导治疗期间急性治疗相关毒性进行分级，并在治疗组间进行比较。结果：诱导治疗后，TPF组的ORR显著低于TPF- icb组（71.2% vs. 88.5%, p = 0.007）。TPF- icb组的完全缓解率（CR）显著高于TPF组（29.5% vs 11.3%, p = 0.004）。TPF- icb组3、5年PFS分别为99%、95%，显著高于TPF组（89%、87%,p < 0.05）。TPF-ICB组3年生存率（99% vs 89%, p < 0.0001）优于对照组。TPF组7例（8.6%）、TPF- icb组12例（15.5%）发生≥3级trae （p = 0.596）。结论：PD-1抑制剂联合TPF诱导治疗LA-NPC的CR和ORR率较高，安全性可接受。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Immunology IMMUNOLOGY-

CiteScore

9.80

自引率

11.00%

发文量

7153

审稿时长

14 weeks

期刊介绍： Frontiers in Immunology is a leading journal in its field, publishing rigorously peer-reviewed research across basic, translational and clinical immunology. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Immunology is the official Journal of the International Union of Immunological Societies (IUIS). Encompassing the entire field of Immunology, this journal welcomes papers that investigate basic mechanisms of immune system development and function, with a particular emphasis given to the description of the clinical and immunological phenotype of human immune disorders, and on the definition of their molecular basis.