Abstract 898P
Background
Platinum-based chemotherapy (CT)±radiotherapy (RT) was the standard of care (SoC) for R/M NPC until the recent introduction of immuno-oncology (IO) therapy, but meta-analyses (MAs) of randomised clinical trials (RCTs) report mixed results for IOs. This targeted literature review (LR) aimed to summarise real-world (RW) treatments (tx) and OS for patients (pts) with R/M NPC in Asia.
Methods
MEDLINE and Embase (2020–25 April 2023), recent oncology congresses (2021–2023) and systematic LRs/MAs were searched. Observational studies were eligible if they reported tx patterns (CT±RT or IO) and OS of pts with R/M NPC in Asia.
Results
Of 5,210 abstracts retrieved and 486 full-texts reviewed, 20 unique studies were extracted from 24 eligible articles. Most (18/20) were from mainland China and patient characteristics (eg, performance status, Epstein-Barr viral status, age, sex) were similar between studies, where reported. CT-based modalities were most common, and only mainland China reported studies with IO (n=3). The Table reports OS by line of tx (LOT). In LOT1, OS decreased sharply in CT only pts after 1 year compared with CT followed by RT (CT+RT). IO studies showed higher 1-year OS than CT only studies, both in LOT2+ and where LOT was unspecified. Median OS for LOT1 pts was similar between IO+CT, CT only, and the lower range of CT+RT, but CT+RT pts had the longest median OS at the higher range. For unspecified LOTs, median OS was shorter in CT only, compared with CT+RT. Table: 898P
Real-world OS in R/M NPC
Treatment | 1-year OS, % | 2-year OS, % | 3-year OS, % | 5-year OS, % | Median OS, Months |
LOT1 (n=11 studies) | |||||
IO+CT | NR | NR | NR | NR | 19.9 (n=1) |
CT followed by RT (CT+RT) | 75.0–89.8 (n=3) | 63.9–69.8 (n=3) | 25.9–61.8 (n=6) | 36.2–43.7 (n=2) | 16.2–69.5 (n=7) |
CT only | 71.1–77.5 (n=2) | 32.6–49.4 (n=3) | 11.7–31.8 (n=3) | 3.4 (n=1) | 17.8–23.0 (n=3) |
LOT2+ (n=3 studies) | |||||
IO only | 65.4 (n=1) | NR | NR | NR | NR |
CT+RT | NR | NR | NR | NR | NR |
CT only | 60.0 (n=1) | 30.0 (n=1) | 28.0 (n=1) | NR | 16.0–29.4 (n=2) |
Unspecified LOT (n=7 studies) | |||||
IO± targeted/local therapy | 85.6–91.7 (n=1) | NR | 47.8–61.2 (n=1) | 31.6–46.2 (n=1) | NR |
CT+RT | NR | NR | 50.0 (n=1) | NR | 35.1–37.0 (n=2) |
CT only | 70.4–75.0 (n=2) | 28.7–32.1 (n=2) | 0.0–36.7 (n=4) | 24.5 (n=1) | 13.2–25.6 (n=7) |
Conclusions
While this LR found limited RW IO use in R/M NPC, likely reflecting access to recently introduced/approved IO compounds, the results complement RCT data to support a potential place for IO in R/M NPC tx. However, the heterogeneous evidence base (eg, differences in study design) made overarching conclusions challenging. This highlights a need for more long-term RW research for R/M NPC pts, particularly in parts of Asia outside mainland China, to better understand the role and benefits of novel tx such as IO.
Clinical trial identification
Editorial acknowledgement
This study was sponsored by BeiGene, Ltd. Literature review/editorial support was provided by Costello Medical Singapore, and submission support was provided by Envision Pharma Inc, funded by BeiGene.
Legal entity responsible for the study
BeiGene, Ltd.
Funding
BeiGene, Ltd.
Disclosure
D.W. Lim: Financial Interests, Institutional, Advisory Board: MSD, Roche, Beigene, Daiichi-Sankyo, Janssen; Financial Interests, Institutional, Trial Chair, Grant funding for investigator-sponsored study: Bristol Myers Squibb, Taiho Pharmaceuticals. M.L.K. Chua: Financial Interests, Personal, Invited Speaker: Varian, AstraZeneca, Janssen, BeiGene, MSD, Bayer; Financial Interests, Personal, Member of Board of Directors: Digital Life Line; Financial Interests, Personal, Stocks/Shares: Digital Life Line; Financial Interests, Institutional, Advisory Board: Digital Life Line; Financial Interests, Institutional, Other, Research agreement: Decipher Biosciences; Financial Interests, Institutional, Research Grant, Grant for an IIT: BeiGene; Non-Financial Interests, Leadership Role: Head and Neck Cancer International Group; Non-Financial Interests, Principal Investigator, PI of an IIT partly sponsored by BeiGene: BeiGene; Non-Financial Interests, Member of Board of Directors, Board of Trustees and Chair of Scientific Committee: Alice's Arc; Non-Financial Interests, Leadership Role, Chair of ASCO Asia Pacific Regional Council: ASCO; Non-Financial Interests, Leadership Role, Chair of the ASCO Breakthrough Meeting 2024: ASCO. B.B.Y. Ma: Financial Interests, Personal, Advisory Board, Advisory Board/Consultancy: MSD; Financial Interests, Personal, Advisory Board, Consultancy: Y-biologics; Financial Interests, Personal, Advisory Board, Ad board and consultancy: Viracta Therapeutics; Financial Interests, Personal, Invited Speaker: Taiho, Merck Serono, Daiichi Sankyo; Financial Interests, Personal, Advisory Board: AstraZeneca, Pierre Fabre, Beigene; Financial Interests, Institutional, Research Grant: Merck Serono, MSD; Non-Financial Interests, Principal Investigator, NRG oncology study PI: NRG oncology. J.S. Evans, Y.R. Wee, M.H. Choi, N. Fujita: Financial Interests, Personal, Full or part-time Employment: Costello Medical Singapore. S. Dhawan: Financial Interests, Personal, Full or part-time Employment: BeiGene; Financial Interests, Personal, Stocks/Shares: BeiGene. J. Ng: Financial Interests, Personal, Full or part-time Employment: BeiGene; Financial Interests, Personal, Stocks/Shares: BeiGene.
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Abstract