Nasopharyngeal carcinoma (NPC) is common in South China and parts of Southeast Asia. Despite treatment, 20-30% of patients relapse within five years and ultimately become resistant to standard platinum-based chemotherapy; these patients have a poor prognosis with a median survival of 4- 6 months.
A randomised clinical trial in Singapore, led by N2CR member Prof Goh Boon Cher and Dr Chong Wan Qin, compared the efficacy of pembrolizumab (a PD-1 inhibitor) alone versus in combination with bevacizumab (a VEGF inhibitor) in patients with platinum-resistant recurrent or metastatic nasopharyngeal carcinoma (NPC). The study involved 48 patients and found that the combination therapy significantly improved the objective response rate (58.3% vs. 12.5%). Although the combination also resulted in a higher incidence of vascular side effects (29% vs. 8%), these side effects were generally manageable. There were no severe or life-threatening side effects or treatment-related deaths in either group.
These findings, published in The Lancet Oncology, suggest that pembrolizumab combined with bevacizumab could be more effective than pembrolizumab alone, improving tumour response and potentially setting a new standard of care if validated in a phase 3 trial.
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