NPC New Drugs, 1. Taxane
Chan et al [13] used induction chemotherapy with carboplatin and paclitaxel and cisplatin plus radiotherapy and chemotherapy over the same period , nasopharyngeal carcinoma patients, the efficiency of induction chemotherapy with 16% of the primary tumor, regional lymph nodes 58%, 2-year overall survival and progression-free survival rates were 91.8%, 78.5%, and patients can still be tolerated. Yamouni [14] 3 cycles before radiotherapy docetaxel (75mg/m2) and cisplatin (75mg/m2) chemotherapy, 89% efficiency (37% complete remission). Chen et al [15] reported that radiation therapy over the same period of Taxol weekly chemotherapy for locally advanced nasopharyngeal carcinoma of the dose escalation phase clinical trial results, the recommended dose of paclitaxel 30mg/m2, the main reaction is mucositis, skin reactions. Also as a transfer line or second-line treatment of nasopharyngeal carcinoma, paclitaxel alone or combined with platinum chemotherapy were effective. 3 weeks, when the program of single-agent dose of 135mg/m2 ~ 175mg/m2, 22% efficient, effective duration of 7.5 months, paclitaxel plus carboplatin, there is 60% to 72%, as first-line treatment in the median time to progression 7 months. In another study reported that growth factor support in the use of carboplatin per minute (AUC 7mg/ml) and Taxol 200mg/m2, effective rate of 57%, time to progression of 4.3 months to further enhance the toxic dose was found increased significantly, while similar efficacy.
NPC New Drugs, 2. Oxaliplatin
Oxaliplatin is the second carboplatin, cisplatin after generation platinum compound, with no cross-resistance with cisplatin, renal toxicity and ototoxicity low, few reports of nasopharyngeal carcinoma. Zhang et al [22] conducted a phase clinical trial, 115 patients with locally advanced nasopharyngeal carcinoma were randomly divided into two groups, comparing radiotherapy plus oxaliplatin in the same period (weekly 70mg/m2) chemotherapy and radiotherapy alone efficacy of concurrent chemoradiotherapy group 97% of patients completed the treatment, the median follow-up time of 24 months, concurrent chemoradiotherapy group and the radiotherapy alone group 2-year overall survival rates were 100% and 77%. Compared with radiotherapy alone, chemoradiotherapy group overall survival, recurrence-free survival, metastasis-free survival has significantly improved, and no significant serious adverse events.
3. Irinotecan
Poon et al [23] evaluated irinotecan in advanced nasopharyngeal carcinoma patients the efficacy and safety, a total of 28 patients at 3 months had received platinum or paclitaxel-based chemotherapy in patients with ineffective, given Yi single-agent chemotherapy irinotecan (100mg/m2, d1, 8,15,28), used up to 6 courses, until disease progression or intolerable toxicity, an average of three cycles of chemotherapy, the toxicity greater than grade including neutropenia, anemia, diarrhea. Progression-free survival of 3.9 months, overall survival of 11.4 months, PR14%, SD4%. Or paclitaxel to platinum-based chemotherapy-resistant patients with advanced nasopharyngeal carcinoma, irinotecan as salvage therapy drugs.
4. Pui gemcitabine
Hong Kong Chua [16] reported 17 cases of transfer of platinum treatment fails or recurrent head and neck squamous cell carcinoma were treated with capecitabine, the median follow-up time was 7.5 months, 3 had partial remission, 1 case of complete remission, and the total efficiency of 23.5%, median survival time of 7.6 months, the main reaction is ~ grade hand-foot syndrome, blood toxicity of light, so that the transfer of advanced or recurrent NPC patients, capecitabine can be used as an effective salvage therapy means. Jiang et al [17] reported that in early stage nasopharyngeal carcinoma both capecitabine and radiotherapy in stage application test results, the program can be tolerated and effective, the recommended dose per day 1 700mg/m2.
NPC New Drugs, 5. Gemcitabine
Recently, Yau et al [18] evaluated gemcitabine plus cisplatin induction chemotherapy in the treatment of advanced nasopharyngeal cancer results in 37 patients with stage patients with nasopharyngeal carcinoma received 3 cycles of gemcitabine plus cisplatin induction chemotherapy, and radiotherapy over the same period (70Gy) and chemotherapy (DDP100mg/m2, d1, a course of treatment every three weeks), induction chemotherapy greater than 90% efficient, the treatment can be tolerated, all patients completed a radiotherapy, 3-year overall survival rate of 76%. In addition, several retrospective studies and clinical trial results that a single agent or in combination with gemcitabine and cisplatin in patients with metastatic or relapsed nasopharyngeal carcinoma effectively. Ma et al [19] with gemcitabine alone or combined with cisplatin treatment of 32 metastatic or recurrent nasopharyngeal carcinoma, gemcitabine alone group was 35%, 1-year survival 48%; combined treatment group was 64% , 1-year survival rate 69%, is well tolerated. Foo et al [20] Treatment of 52 with gemcitabine in patients with metastatic nasopharyngeal carcinoma in patients who previously received chemotherapy in 48% total efficiency, low toxicity, the median time to progression was 3 to 5 months. Leong et al [21] combined with carboplatin, paclitaxel, gemcitabine treatment of metastatic nasopharyngeal carcinoma, the total efficiency of 76%, gemcitabine and cisplatin was similar, 83% of patients had grade ~ neutropenia.