Capecitabine as salvage treatment in relapsed nasopharyngeal carcinoma: a phase II study

• Published in: Journal of B.U. ON. Vol. 13; no. 1; p. 37
• Main Authors: Ciuleanu, E, Irimie, A, Ciuleanu, T E, Popita, V, Todor, N, Ghilezan, N
• Format: Journal Article
• Language: English
• Published: Greece 01.01.2008
• Subjects: Adolescent; Adult; Antimetabolites, Antineoplastic - therapeutic use; Capecitabine; Deoxycytidine - analogs & derivatives; Deoxycytidine - therapeutic use; Female; Fluorouracil - analogs & derivatives; Fluorouracil - therapeutic use; Humans; Male; Middle Aged; Nasopharyngeal Neoplasms - drug therapy; Nasopharyngeal Neoplasms - mortality; Neoplasm Recurrence, Local - drug therapy; Patient Compliance; Salvage Therapy
• ISSN: 1107-0625

To evaluate the efficacy of capecitabine (Xeloda) as rescue treatment (2nd, 3rd and 4th line) in patients with relapsed nasopharyngeal carcinoma (NPC) in a phase II study. Between 5/2002-11/2005, 23 relapsed NPC patients (17 locoregional relapse, 3 metastatic, 3 locoregional + metastatic) received capecitabine 2500 mg/m(2)/d, days 1-14 every 3 weeks, until progression or for a maximum of 6 cycles. 23 patients (14 men, 9 women) with median age 46 years (range 15-59); ECOG performance status 1 n=21, 2 n=2; histology: undifferentiated carcinoma (WHO type III) n=21, non-keratinizing epidermoid carcinoma (WHO type II), n=2. Capecitabine was given as 2nd--(13 patients), 3rd--(7 patients), and 4th--(3 patients) line chemotherapy. Previous chemotherapy regimes were epirubicin + cisplatin, paclitaxel + carboplatin, paclitaxel + 5-fluorouracil and leucovorin (5-FU/LV) or methotrexate. 104 cycles were given (median 5, range 2-6). Two (9%) patients achieved complete response (CR); 9 (39%) partial response (PR); 9 (39%) stable disease (SD) and 3 (13%) progressed (PD). Toxicity was mild without toxic deaths or grade 4 toxicities. The most frequent toxicities (grades 1-3) were anemia (38%), hand-foot syndrome (23%), leukopenia (13%) and diarrhea (7%). Median follow-up was 10 months (range 2-44). Median overall survival was not reached at 18 months and actuarial one-year survival was 62% (95% confidence interval/CI: 41-80). Median progression-free survival was 14 months. Capecitabine is active in relapsed NPC patients, achieving 48% objective responses, with mild toxicity. It is an attractive therapy to be administered in an outpatient setting.