They are infrequent and are often diagnosed late, when they are more difficult to treat. Furthermore, nasopharyngeal tumors already arise in an area that is difficult to reach because they originate in the posterior part of the nasal passages, in the upper part of the soft palate and throat. And although for several years there have been no relevant therapeutic innovations for these rather rare neoplasms, from the annual congress of the American Society of Clinical Oncology (Asco) comes good news for patients already in the metastatic phase: the results of a study presented during the plenary session of the conference, the main one, in fact indicate that with immunotherapy the evolution of the disease can be slowed down.
Often late diagnosis
There are about 570 new cases of nasopharyngeal carcinoma annually registered every year in Italy. The discovery is often late – he explains Lisa Licitra, director of Medical Oncology 3 Head and Neck Tumors of the IRCCS Foundation National Cancer Institute of Milan – and we frequently see locally advanced stages already at the time of diagnosis. Due to the position in which they are located, an area difficult to reach with a scalpel, surgical excision is almost always excluded, so the therapeutic strategy is mainly based on drugs and radiotherapy. Generally we proceed only with radiation in the very early stages (which are for a few) and with a combination of chemo and radiotherapy in the more advanced forms. With these solutions, on average, almost 60% of patients reach the fateful threshold of five years from diagnosis, but it can reach 70-80% if the sick are treated in the best possible way, with optimal doses of radiotherapy and with optimal integration with chemo – specifies Licitra -. Now, the results of the study presented to Asco open a new perspective: the introduction of immunotherapy in association with chemotherapy drugs when the disease spreads or relapses without the possibility of operating or re-radiating.
Immunotherapy in addition to chemo
The phase three JUPITER-02 trial enrolled 289 patients with recurrent or metastatic nasopharyngeal cancer who had not yet been treated with chemotherapy. Participants received an investigational immunotherapy drug (toripalimab) or a placebo, along with standard chemotherapy for first-line treatment. The results indicate that progression-free survival (i.e. the time between the end of treatment and the tumor reappearance) averaged one year with the chemo-immunotherapy mix and 8 months in the other group. A year later, 49% of patients treated with toripalimab and in 28% of those who underwent only chemo had not yet recovered from the disease. On the other hand, the serious side effects and the interruption of treatment were practically the same in the two groups. a significant step forward, especially since most sufferers receive the diagnosis when they already have metastases and current late-stage care options are limited, said Julie R. Gradow, Asco’s vice president. A persistent nasal obstruction, a feeling of pressure or pain in the ear, and a headache that does not go away they should not be ignored – concludes Licitra -, as well as the swelling of the lymph nodes in the neck. Better to talk to the doctor who will decide whether to make a visit to the specialist and possibly proceed with an endoscopic examination.
June 8, 2021 (change June 8, 2021 | 17:47)
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