Nasopharyngeal Carcinoma In Phase II Trial - Bevacizumab Reduced Spread

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Academic Journal
Main Category: Ear, Nose and Throat
Also Included In: Cancer / Oncology
Article Date: 16 Dec 2011 - 8:00 PST


A new phase II trial published Online First in The Lancet Oncology, reveals that the combination of standard chemoradiation therapy with the popular cancer drug bevacizumab is safe and may lengthen survival in individuals with advanced nasopharyngeal carcinoma. According to the results, bevacizumab may be more efficient at preventing nasopharyngeal carcinoma spreading to other areas of the body, the most prevalent cause of death in individuals with advanced disease.

For individuals with nasopharyngeal carcinoma, introducing intensity-modulated radiotherapy (IMRT) caused local tumor control rates of more than 90%. Although among head and neck cancers, nasopharyngeal carcinoma has the highest rate of metastases. In approximately 30% of individuals with the disease, it spreads to distant organs within four to five years.

Bevacizumab is a monoclonal antibody that prevents vascular endothelial growth factor (VEGF-A). VEGF-A is linked to poor prognosis in individuals suffering with head and neck cancers. In approximately two-thirds of individuals with nasopharyngeal carcinoma VEGF-A is overexpressed. It has been shown that bevacizumab enhances disease-free response rates, progression-free, as well as overall survival in several forms of advanced cancer including non-small cell lung cancer, renal cell cancer and colorectal cancer.

Nancy Lee from Memorial Sloan-Kettering Cancer Center, New York, USA, and her team from the Radiation Therapy Oncology Group (RTOG), reveal results from a phase II trial examining the combination of bevacizumab to chemoradiation. Chemoradiation is the typical treatment individuals with nasopharyneal carcinoma receive.

46 previously untreated individuals with locoregionally advanced nasopharyneal carcinoma were enrolled from 19 centers in Hong Kong and North America to participate in the investigation. Bevacizumab was combined with the concurrent and adjuvant phases of chemotherapy with cisplatin and fluorouracil. Results demonstrated that this combination resulted in more than 90% of participants surviving two years with no distant metastases. In addition, the combination prevented worsening of the disease in 75% of participants.

According to the researchers, the combination did not seem to considerably increase toxicity or affect compliance with treatment, compared to standard chemoradiotherapy alone.

In the study, 9 (20%) participants experienced treatment-related grade 1 to 2 bleeding, no grade 3 to 4 bleeding or deaths were reported. The most prevalent grade 3 or higher side effects were acute mucositis (painful inflammation of mucous membranes in mouth) and blood or bone marrow related complications.

The researchers explain:

"The addition of bevacizumab to chemoradiation for nasopharyneal carcinoma is feasible and it causes no major compromise in the delivery of standard chemoradiation and might delay the progression of subclinical distant disease.

Although the addition of bevacizumab did not seem to result in any unusual grade 3-4 events, toxicity was still substantial overall and compliance to protocol treatment was not ideal so further research is needed to identify those at risk of distant metastasis and hence those who might benefit most from additional bevacizumab."

Written by Grace Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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