The Chinese Society of Clinical Oncology (CSCO) clinical guidelines for the diagnosis and treatment of nasopharyngeal carcinoma

Cancer Communications, Год журнала: 2021, Номер 41(11), С. 1195 - 1227

Опубликована: Окт. 26, 2021

Abstract Nasopharyngeal carcinoma (NPC) is a malignant epithelial tumor originating in the nasopharynx and has high incidence Southeast Asia North Africa. To develop these comprehensive guidelines for diagnosis management of NPC, Chinese Society Clinical Oncology (CSCO) arranged multi‐disciplinary team comprising experts from all sub‐specialties NPC to write, discuss, revise guidelines. Based on findings evidence‐based medicine China abroad, domestic have iteratively developed provide proper NPC. Overall, describe screening, clinical pathological diagnosis, staging risk assessment, therapies, follow‐up which aim improve

Язык: Английский

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Effect of Radiotherapy Alone vs Radiotherapy With Concurrent Chemoradiotherapy on Survival Without Disease Relapse in Patients With Low-risk Nasopharyngeal Carcinoma

JAMA, Год журнала: 2022, Номер 328(8), С. 728 - 728

Опубликована: Авг. 23, 2022

Importance

Concurrent chemoradiotherapy has been the standard treatment for stage II nasopharyngeal carcinoma (NPC) based on data using 2-dimensional conventional radiotherapy. There is limited evidence role of chemotherapy with use intensity-modulated radiation therapy (IMRT).

Objective

To assess whether concurrent can be safely omitted patients low-risk II/T3N0 NPC treated IMRT.

Design, Setting, and Participants

This multicenter, open-label, randomized, phase 3, noninferiority clinical trial was conducted at 5 Chinese hospitals, including 341 adult NPC, defined as II/T3N0M0 without adverse features (all nodes <3 cm, no level IV/Vb nodes; extranodal extension; Epstein-Barr virus DNA <4000 copies/mL), enrollment between November 2015 August 2020. The final date follow-up March 15, 2022.

Interventions

Patients were randomly assigned to receive IMRT alone (n = 172) or (IMRT cisplatin, 100 mg/m²every 3 weeks cycles [n 169]).

Main Outcomes Measures

primary end point 3-year failure-free survival (time from randomization any disease relapse death), a margin 10%. Secondary points comprised overall survival, locoregional relapse-free distant metastasis-free events, health-related quality life (QOL) measured by European Organisation Research Treatment Cancer Quality Life Questionnaire (QLQ-C30; range, 0-100 points; minimum clinically important difference ≥10 physical function, symptom control, QOL; higher score indicates better functioning global health status worse symptoms).

Results

Among randomized (mean [SD] age, 48 [10] years; 30% women), 334 (98.0%) completed trial. Median 46 months (IQR, 34-58). Three-year 90.5% IMRT-alone group vs 91.9% (difference, −1.4%; 1-sided 95% CI, −7.4% ∞;Pvalue noninferiority, <.001). No significant differences observed groups in relapse, metastasis. experienced significantly lower incidence grade 4 events (17% 46%; difference, −29% [95% −39% −20%]), hematologic toxicities (leukopenia, neutropenia) nonhematologic (nausea, vomiting, anorexia, weight loss, mucositis). had QOL scores during radiotherapy domains status, social functioning, fatigue, nausea pain, insomnia, appetite constipation.

Conclusions Relevance

resulted that not inferior chemoradiotherapy.

Trial Registration

ClinicalTrials.gov Identifier:NCT02633202

Язык: Английский

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Association of Intratumoral Microbiota With Prognosis in Patients With Nasopharyngeal Carcinoma From 2 Hospitals in China

JAMA Oncology, Год журнала: 2022, Номер 8(9), С. 1301 - 1301

Опубликована: Июль 14, 2022

Microbiota-tumor interactions have qualified microbiota as a promising prognostic biomarker in various types of cancers. Although the nasopharynx acts crucial niche upper respiratory tract microbiome, whether intratumoral exists and its clinical significance nasopharyngeal carcinoma (NPC) remain uncertain.To evaluate for individual prognostication patients with NPC.This retrospective cohort study included NPC biopsy samples from 2 hospitals: Sun Yat-sen University Cancer Center (Guangzhou, China) Zhejiang Hospital (Hangzhou, between January 2004 November 2016, follow-up through 2020. A total 802 were according to following criteria: histologically proven NPC, without distant metastasis at initial diagnosis, had not received antitumor treatment before sampling, aged 18 70 years, complete medical records regular follow-up, history cancer, successfully extracted enough DNA experiments.The primary end point was disease-free survival, secondary points metastasis-free survival overall survival. To assess existence load 96 or tumor relapse, 16S rRNA sequencing quantitative polymerase chain reaction used. The associations bacterial outcome evaluated 241 fresh-frozen (training cohort) validated paraffin-embedded internal (n = 233) external 232) validation cohorts. Metagenomic transcriptome analyses performed ascertain origin underlying mechanism bacteria.A (mean [SD] age, 46.2 [10.6] years; 594 [74.1%] male) enrolled. Microbiota presented within tissues, among which Corynebacterium Staphylococcus predominated. Patients high training inferior rates (hazard ratio [HR], 2.90; 95% CI, 1.72-4.90; P < .001), (HR, 3.18; 1.58-6.39; 3.41; 1.90-6.11, .001) than those low load, finding that by Single-nucleotide variant analysis revealed main bacteria. Transcriptome digital pathology demonstrated higher negatively associated T-lymphocyte infiltration.Intratumoral robust tool this study, indicating potential guidance decisions different levels risk malignant progression.

Язык: Английский

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TRIM21 inhibits irradiation-induced mitochondrial DNA release and impairs antitumour immunity in nasopharyngeal carcinoma tumour models

Nature Communications, Год журнала: 2023, Номер 14(1)

Опубликована: Фев. 16, 2023

Abstract Although radiotherapy can promote antitumour immunity, the mechanisms underlying this phenomenon remain unclear. Here, we demonstrate that expression of E3 ubiquitin ligase, tumour cell-intrinsic tripartite motif-containing 21 (TRIM21) in tumours, is inversely associated with response to radiation and CD8 + T cell-mediated immunity nasopharyngeal carcinoma (NPC). Knockout TRIM21 modulates cGAS/STING cytosolic DNA sensing pathway, potentiates antigen-presenting capacity NPC cells, activates cytotoxic radiation. Mechanistically, promotes degradation mitochondrial voltage-dependent anion-selective channel protein 2 (VDAC2) via K48-linked ubiquitination, which inhibits pore formation by VDAC2 oligomers for (mtDNA) release, thereby inhibiting type-I interferon responses following exposure. In patients NPC, high was poor prognosis early relapse after radiotherapy. Our findings reveal a critical role radiation-induced providing potential targets improving efficacy NPC.

Язык: Английский

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Anti–Epstein–Barr Virus BNLF2b for Mass Screening for Nasopharyngeal Cancer

New England Journal of Medicine, Год журнала: 2023, Номер 389(9), С. 808 - 819

Опубликована: Авг. 30, 2023

Population screening of asymptomatic persons with Epstein–Barr virus (EBV) DNA or antibodies has improved the diagnosis nasopharyngeal carcinoma and survival among affected persons. However, positive predictive value current strategies is unsatisfactory even in areas where endemic. We designed a peptide library representing highly ranked B-cell epitopes EBV coding sequences to identify novel serologic biomarkers for carcinoma. After retrospective case–control study, performance biomarker anti–BNLF2b total antibody (P85-Ab) was validated through large-scale prospective program compared that standard two-antibody–based method (EBV nuclear antigen 1 [EBNA1]–IgA EBV-specific viral capsid [VCA]–IgA). P85-Ab most promising screening, high sensitivity (94.4%; 95% confidence interval [CI], 86.4 97.8) specificity (99.6%; CI, 97.8 99.9) study. Among 24,852 eligible participants cohort, 47 cases (38 at an early stage) were identified. showed higher than two-antibody (97.9% vs. 72.3%; ratio, 1.4 [95% 1.1 1.6]), (98.3% 97.0%; 1.01 1.02]), (10.0% 4.3%; 2.3 1.8 2.8]). The combination markedly increased 44.6% (95% 33.8 55.9), 70.2% 56.0 81.4). Our results suggest sensitivity, specificity, method. (Funded by National Key Research Development Program China others; ClinicalTrials.gov number, NCT04085900.)

Язык: Английский

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LINC-PINT plays an anti-tumor role in nasopharyngeal carcinoma by binding to XRCC6 and affecting its function

Pathology - Research and Practice, Год журнала: 2024, Номер 260, С. 155460 - 155460

Опубликована: Июль 18, 2024

Язык: Английский

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Camrelizumab combined with apatinib in patients with first-line platinum-resistant or PD-1 inhibitor resistant recurrent/metastatic nasopharyngeal carcinoma: a single-arm, phase 2 trial

Nature Communications, Год журнала: 2023, Номер 14(1)

Опубликована: Авг. 14, 2023

Immunotherapy combined with antiangiogenic targeted therapy has improved the treatment of certain solid tumors, but effective regimens remain elusive for refractory recurrent/metastatic nasopharyngeal carcinoma (RM-NPC). We conducted a phase 2 trial to evaluate safety and activity camrelizumab plus apatinib in platinum-resistant (cohort 1, NCT04547088) PD-1 inhibitor resistant NPC 2, NCT04548271). Here we report on primary outcome objective response rate (ORR) secondary endpoints safety, duration response, disease control rate, progression-free survival, overall survival. The endpoint ORR was met cohort 1 (65%, 95% CI, 49.6-80.4, n = 40) (34.3%; 17.0-51.8, 32). Grade ≥ 3 treatment-related adverse events (TRAE) were reported 47 (65.3%) 72 patients. Results our predefined exploratory investigation predictive biomarkers show: B cell markers are most differentially expressed genes tumors responders versus non-responders that tertiary lymphoid structure is associated higher ORR; Angiogenesis gene expression signatures strongly 2. Camrelizumab combination effectiveness high PD-L1, VEGF Receptor B-cell-related signatures. shows promising efficacy measurable profile RM-NPC

Язык: Английский

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Chemotherapy‐Induced Senescence Reprogramming Promotes Nasopharyngeal Carcinoma Metastasis by circRNA‐Mediated PKR Activation

Advanced Science, Год журнала: 2023, Номер 10(8)

Опубликована: Янв. 22, 2023

Senescence is associated with tumor metastasis and chemotherapy resistance, yet the mechanisms remain elusive. Here, it identified that nasopharyngeal carcinoma (NPC) patients who developed distant are characterized by senescence phenotypes, in which circWDR37 a key regulator. CircWDR37 deficiency limits cisplatin or gemcitabine-induced senescent NPC cells from proliferation, migration, invasion. Mechanistically, binds to dimerizes double-stranded RNA-activated protein kinase R (PKR) initiate PKR autophosphorylation activation. Independent of its activity, phosphorylated induces I-kappaB beta (IKKβ) phosphorylation, releases RELA NF-κB inhibitor alpha (IκBα) trigger nuclear factor kappa B (NF-κB) activation, thereby stimulating cyclin D1 (CCND1) senescence-associated secretory phenotype component gene transcription circWDR37-dependent manner. Low levels correlate response favorable survival treated gemcitabine induction chemotherapy. This study uncovers new mechanism activated senescence-driven provides appealing therapeutic targets NPC.

Язык: Английский

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Global burdens of nasopharyngeal carcinoma in children and young adults and predictions to 2040

Oral Oncology, Год журнала: 2024, Номер 155, С. 106891 - 106891

Опубликована: Июнь 14, 2024

Язык: Английский

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Tumor habitat-based MRI features assessing early response in locally advanced nasopharyngeal carcinoma

Oral Oncology, Год журнала: 2024, Номер 158, С. 106980 - 106980

Опубликована: Авг. 15, 2024

The early response to concurrent chemoradiotherapy in patients with locally advanced nasopharyngeal carcinoma (LA-NPC) is closely correlated prognosis. In this study, we aimed predict using a combined model that combines sub-regional radiomics features from multi-sequence MRI clinically relevant factors.

Язык: Английский

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