Short-term outcomes of induction chemotherapy with docetaxel, cisplatin, and fluorouracil (TPF) in locally advanced nasopharyngeal carcinoma

• Published in: Investigational new drugs Vol. 39; no. 2; pp. 564 - 570
• Main Authors: Takamizawa, Shigemasa, Honma, Yoshitaka, Murakami, Naoya, Mori, Taisuke, Oka, Hiroki, Yamamoto, Shun, Kashihara, Tairo, Ito, Kimiteru, Kubo, Yuko, Ikeda, Atsuo, Matsumoto, Fumihiko, Omura, Go, Kobayashi, Kenya, Itami, Jun, Kato, Ken, Yoshimoto, Seiichi
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.04.2021; Springer Nature B.V
• Subjects: 5-Fluorouracil; Adolescent; Adult; Adverse events; Aged; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer; Chemoradiotherapy; Chemoradiotherapy - methods; Chemotherapy; Cisplatin; Cisplatin - therapeutic use; Docetaxel - therapeutic use; Female; Fluorouracil - therapeutic use; Hematology; Humans; Induction Chemotherapy - methods; Leukopenia; Male; Medicine; Medicine & Public Health; Middle Aged; Nasopharyngeal carcinoma; Nasopharyngeal Carcinoma - drug therapy; Nasopharyngeal Carcinoma - mortality; Nasopharyngeal Carcinoma - pathology; Nasopharyngeal Carcinoma - therapy; Nasopharyngeal Neoplasms - drug therapy; Nasopharyngeal Neoplasms - mortality; Nasopharyngeal Neoplasms - pathology; Nasopharyngeal Neoplasms - therapy; Neoplasm Staging; Neutropenia; Oncology; Pharmacology/Toxicology; Pilot Projects; Progression-Free Survival; Response rates; Retrospective Studies; Short Report; Survival; Throat cancer; Toxicity; Young Adult; Nasopharyngeal carcinoma; Induction chemotherapy; Chemoradiotherapy; Cisplatin; Docetaxel; Fluorouracil
• ISSN: 0167-6997; 1573-0646
• DOI: 10.1007/s10637-020-00999-y

Summary There is an unmet need for improving survival outcomes of locally advanced nasopharyngeal carcinoma, for example, T4/ N3 stage disease. To this end, we administered induction chemotherapy (IC) with TPF (docetaxel, cisplatin, and fluorouracil) because this stage of disease is associated with a high risk of recurrence and is difficult to control with standard treatments, such as chemoradiotherapy (CRT) alone or CRT followed by adjuvant chemotherapy. The aim of this retrospective single-center study was to clarify the short-term outcomes of locally far-advanced nasopharyngeal carcinoma patients treated with IC-TPF, followed by CRT with cisplatin. Data from 11 patients were extracted from our database, indicating that the overall response rate to IC-TPF, clinical complete response rate after CRT, 1-year progression-free survival, and 1-year overall survival were 73%, 91%, 68%, and 89%, respectively. Hematological toxicity was the most common adverse event reported during IC-TPF with 64% of patients suffering grade 3 or 4 neutropenia, 55% grade 3 or 4 leucopenia and 9% febrile neutropenia. Despite the small number of patients, these data are important because there is a limited number of studies investigating IC-TPF followed by CRT in Japanese patients. This pilot study provides some indication of the short-term effectiveness and toxicity of this therapeutic approach, which may be superior to standard treatments. Long-term follow-up is warranted to assess the effectiveness of IC-TPF in terms of clinical outcome and late-phase toxicity.