On August 2 2021, president of Sun Yat-sen University Cancer Center Prof. Xu Ruihua published his latest research on NPC treatment in Nature Medicine, one of the top medical journals in the world. The study was a phase 3 clinical trial on toripalimab plus chemotherapy as the first-line treatment in advanced nasopharyngeal carcinoma (NPC). It was a multicenter study conducted with colleagues Prof. Mai Haiqiang and Prof. Chen Qiuyan from Sun Yat-sen University Cancer Center and NPC researchers form different institutes around the world.
NPC is a rare cancer disease in most parts of the world but is endemic in South China and Southeast Asia. The age-standardized incidence rate is 20-30 people per 100,000 in South China. Gemcitabine-cisplatin (GP) chemotherapy is the standard first-line treatment for recurrent and metastatic nasopharyngeal carcinoma (RM-NPC). However, the treatment effect is not promising. The average progression-free survival (PFS) for RM-NPC is about seven months, and new treatments are needed to improve the survival of NPC patients.
Authors Prof. Mai Haiqiang, Prof. Xu Ruihua and Prof. Chen Qiuyan
The phase 3 JUPITER-02 study carried out by Prof. Xu’s team tested the effectiveness and safety by adding toripalimab to the GP regimen. The study is the first cross-national, multicenter, randomized, double-blind phase 3 trial for RM-NPC patients.
From November 2018 to October 2019, the study enrolled 289 patients in mainland China, Taiwan, and Singapore. Patients with RM-NPC were randomized (1/1) to receive either toripalimab, or a placebo in combination with GP every three weeks for up to six cycles, followed by monotherapy with toripalimab, or placebo. Researchers detected a significant improvement in PFS in the chemotherapy with toripalimab group, with a median PFS of 11.7 months, which is 3.7 months longer than the median PFS of the placebo group. Nearly half of the patients in the toripalimab group had no disease progression for more than one year, which was 21.5% higher than in the placebo combined chemotherapy group. Improvement in PFS was also observed across other relevant subgroups, including gender, ECOG performance score, EBV baseline copy number and disease stage. As of 18 February 2021, a 40% reduction in risk of death was observed in the toripalimab group and with a manageable safety profile.
In recent years, immunotherapy has made significant breakthroughs in cancer treatment, and immunotherapy for NPC has become an important research focus. Prof. Xu’s achievement is expected to change the clinical practice of NPC in the future.
In June of this year, Prof. Xu was also invited to give a speech at the plenary session of the American Society of Clinical Oncology’s global event. It is hoped that through the unremitting efforts of generations of researchers, precise treatment will be developed to benefit more and more NPC patients.
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