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Published in: International Journal of Clinical Oncology 6/2017

01-12-2017 | Original Article

Gemcitabine monotherapy in patients with heavily treated nasopharyngeal cancer: a case series

Authors: Tomohiro Enokida, Shinya Uozumi, Takao Fujisawa, Yuri Ueda, Susumu Okano, Makoto Tahara

Published in: International Journal of Clinical Oncology | Issue 6/2017

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Abstract

Background

Although gemcitabine is thought to play a critical role in the treatment of nasopharyngeal cancer, no research to evaluate the efficacy and toxicity of gemcitabine monotherapy has been conducted in Japan.

Methods

We retrospectively reviewed eight nasopharyngeal carcinoma patients treated with gemcitabine monotherapy at National Cancer Center Hospital East between May 2015 and August 2016. The main eligibility criteria were (1) histopathologically proven NPC; (2) tumor recurrence or an initial M1 TNM stage diagnosis; (3) at least two other types of systemic chemotherapy prior to gemcitabine; (4) no other active malignant tumor during treatment.

Results

All patients were administered gemcitabine 800–1000 mg/m2 on days 1, 8, and 15, repeated every 4 weeks. Gemcitabine was given as third-line systemic chemotherapy in six (74%) patients, as fourth-line in one (13%) and as fifth-line in one (13%). One patient had a complete response and one had a partial response, giving an overall response rate of 25%; four patients (50%) had stable disease and two (25%) experienced disease progression. The main toxicity was myelosuppression, with grade 3 leukopenia in three (38%) patients and neutropenia in four (50%). There were no treatment-related deaths. Median dose intensity and relative dose intensity of gemcitabine were 620 mg/m2/week and 97.5%, respectively.

Conclusion

Our findings suggest that GEM monotherapy is well tolerated and has potential as an active agent in Japanese patients with recurrent/metastatic NPC who have been heavily pretreated.
Literature
1.
go back to reference Ferlay J, Soerjomataram I, Dikshit R et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–E386CrossRefPubMed Ferlay J, Soerjomataram I, Dikshit R et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–E386CrossRefPubMed
2.
go back to reference Jin Y, Shi YX, Cai XY et al (2012) Comparison of five cisplatin-based regimens frequently used as the first-line protocols in metastatic nasopharyngeal carcinoma. J Cancer Res Clin 138:1717–1725CrossRef Jin Y, Shi YX, Cai XY et al (2012) Comparison of five cisplatin-based regimens frequently used as the first-line protocols in metastatic nasopharyngeal carcinoma. J Cancer Res Clin 138:1717–1725CrossRef
3.
go back to reference Chua DTT, Yiu HHY, Seetalarom K et al (2012) Phase II trial of capecitabine plus cisplatin as first-line therapy in patients with metastatic nasopharyngeal cancer. Head Neck 34:1225–1230CrossRefPubMed Chua DTT, Yiu HHY, Seetalarom K et al (2012) Phase II trial of capecitabine plus cisplatin as first-line therapy in patients with metastatic nasopharyngeal cancer. Head Neck 34:1225–1230CrossRefPubMed
4.
go back to reference Tan EH, Khoo KS, Wee J et al (1990) Phase II trial of a paclitaxel and carboplatin combination in Asian patients with metastatic nasopharyngeal carcinoma. Ann Oncol 10:235–237CrossRef Tan EH, Khoo KS, Wee J et al (1990) Phase II trial of a paclitaxel and carboplatin combination in Asian patients with metastatic nasopharyngeal carcinoma. Ann Oncol 10:235–237CrossRef
5.
go back to reference Ngeow J, Lim WT, Leong SS et al (2011) Docetaxel is effective in heavily pretreated patients with disseminated nasopharyngeal carcinoma. Ann Oncol 22:718–722CrossRefPubMed Ngeow J, Lim WT, Leong SS et al (2011) Docetaxel is effective in heavily pretreated patients with disseminated nasopharyngeal carcinoma. Ann Oncol 22:718–722CrossRefPubMed
6.
go back to reference Poon D, Chowbay B, Cheung YB et al (2005) Phase II study of irinotecan (CPT-11) as salvage therapy for advanced nasopharyngeal carcinoma. Cancer 103:576–581 Poon D, Chowbay B, Cheung YB et al (2005) Phase II study of irinotecan (CPT-11) as salvage therapy for advanced nasopharyngeal carcinoma. Cancer 103:576–581
7.
go back to reference Chua DTT, Sham JST, Au GKH et al (2003) A phase II study of capecitabine in patients with recurrent and metastatic nasopharyngeal carcinoma pretreated with platinum-based chemotherapy. Oral Oncol 39:361–366CrossRefPubMed Chua DTT, Sham JST, Au GKH et al (2003) A phase II study of capecitabine in patients with recurrent and metastatic nasopharyngeal carcinoma pretreated with platinum-based chemotherapy. Oral Oncol 39:361–366CrossRefPubMed
8.
go back to reference Catimel G, Vermorken JB, Clavel M et al (1994) A phase II study of gemcitabine (LY 188011) in patients with advanced squamous cell carcinoma of the head and neck. EORTC Early Clinical Trials Group. Ann Oncol 5:543–547 Catimel G, Vermorken JB, Clavel M et al (1994) A phase II study of gemcitabine (LY 188011) in patients with advanced squamous cell carcinoma of the head and neck. EORTC Early Clinical Trials Group. Ann Oncol 5:543–547
9.
go back to reference Zhang L, Huang Y, Hong S et al (2016) Gemcitabine plus cisplatin versus fluorouracil plus cisplatin in recurrent or metastatic nasopharyngeal carcinoma: a multicentre, randomised, open-label, phase 3 trial. Lancet 388:1883-1892 Zhang L, Huang Y, Hong S et al (2016) Gemcitabine plus cisplatin versus fluorouracil plus cisplatin in recurrent or metastatic nasopharyngeal carcinoma: a multicentre, randomised, open-label, phase 3 trial. Lancet 388:1883-1892
10.
go back to reference Foo KF, Tan EH, Leong SS et al (2002) Gemcitabine in metastatic nasopharyngeal carcinoma of the undifferentiated type. Ann Oncol 13:150–156CrossRefPubMed Foo KF, Tan EH, Leong SS et al (2002) Gemcitabine in metastatic nasopharyngeal carcinoma of the undifferentiated type. Ann Oncol 13:150–156CrossRefPubMed
11.
go back to reference Zhang L, Zhang Y, Huang PY et al (2008) Phase II clinical study of gemcitabine in the treatment of patients with advanced nasopharyngeal carcinoma after the failure of platinum-based chemotherapy. Cancer Chemoth Pharm 61:33–38CrossRef Zhang L, Zhang Y, Huang PY et al (2008) Phase II clinical study of gemcitabine in the treatment of patients with advanced nasopharyngeal carcinoma after the failure of platinum-based chemotherapy. Cancer Chemoth Pharm 61:33–38CrossRef
12.
go back to reference Sobin LH, Gospodarowicz MK, Wittekind CH (2009) UICC TNM classification of malignant tumours, 7th edn. Wiley, New York Sobin LH, Gospodarowicz MK, Wittekind CH (2009) UICC TNM classification of malignant tumours, 7th edn. Wiley, New York
13.
go back to reference Kaidar-Person O, Kuten J, Atrash F et al (2012) Brain metastasis of nasopharyngeal carcinoma: a case report and literature review. Case Rep Med 2012:405917CrossRefPubMedPubMedCentral Kaidar-Person O, Kuten J, Atrash F et al (2012) Brain metastasis of nasopharyngeal carcinoma: a case report and literature review. Case Rep Med 2012:405917CrossRefPubMedPubMedCentral
14.
go back to reference Sarmiento JM, Wi MS, Piao Z et al (2012) Solitary cerebral metastasis from transitional cell carcinoma after a 14-year remission of urinary bladder cancer treated with gemcitabine: case report and literature review. Surg Neurol Int 3:82CrossRefPubMedPubMedCentral Sarmiento JM, Wi MS, Piao Z et al (2012) Solitary cerebral metastasis from transitional cell carcinoma after a 14-year remission of urinary bladder cancer treated with gemcitabine: case report and literature review. Surg Neurol Int 3:82CrossRefPubMedPubMedCentral
15.
go back to reference Crino L, Mosconi AM, Scagliotti G et al (1999) Gemcitabine as second-line treatment for advanced non-small-cell lung cancer: a phase II trial. J Clin Oncol 17:2081–2085CrossRefPubMed Crino L, Mosconi AM, Scagliotti G et al (1999) Gemcitabine as second-line treatment for advanced non-small-cell lung cancer: a phase II trial. J Clin Oncol 17:2081–2085CrossRefPubMed
16.
go back to reference Lee HW, Hwang YH, Han JH et al (2010) High expression of excision repair cross-complementation group1 protein predicts poor outcome in patients with nasopharyngeal cancer. Oral Oncol 46:209–213CrossRefPubMed Lee HW, Hwang YH, Han JH et al (2010) High expression of excision repair cross-complementation group1 protein predicts poor outcome in patients with nasopharyngeal cancer. Oral Oncol 46:209–213CrossRefPubMed
Metadata
Title
Gemcitabine monotherapy in patients with heavily treated nasopharyngeal cancer: a case series
Authors
Tomohiro Enokida
Shinya Uozumi
Takao Fujisawa
Yuri Ueda
Susumu Okano
Makoto Tahara
Publication date
01-12-2017
Publisher
Springer Japan
Published in
International Journal of Clinical Oncology / Issue 6/2017
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-017-1152-8

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