Annals of Oncology Advance Access published online on June 23, 2009
Annals of Oncology, doi:10.1093/annonc/mdp065
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Multicenter phase II study of gemcitabine and oxaliplatin in advanced nasopharyngeal carcinoma—correlation with excision repair cross-complementing-1 polymorphisms
1 Department of Clinical Oncology at the Sir Y K Pao Center for Cancer, Hong Kong Cancer Institute and Li Ka Shing Institute for Health Science, State Key Laboratory in Oncology in South China, Chinese University of Hong Kong, Hong Kong SAR
2 Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong SAR
3 Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong SAR
4 Center for Clinical Trials, School of Public Health, Chinese University of Hong Kong, Hong Kong SAR, China
* Correspondence to: Prof. A. T. C. Chan, Department of Clinical Oncology, Prince of Wales Hospital, Ngan Shing Street, Shatin, New Territories, Hong Kong SAR, China. Tel: +852-26322118; Fax: +852-26487097; E-mail: anthony{at}clo.cuhk.edu.hk
Background: Nasopharyngeal carcinoma (NPC) is a platinum-sensitive cancer and excision repair cross-complementing group 1 (ERCC1) polymorphisms have been shown to predict survival in several cancers following platinum therapy.
Patients and methods: This multicenter study evaluated the activity of oxaliplatin and prolonged infusion of gemcitabine (‘GEMOX’ regimen) in recurrent NPC. Baseline blood samples were genotyped for the presence of ERCC1-118 gene polymorphisms.
Results: Forty-two patients were recruited, of whom most (61%) had metastatic disease. Of the 40 patients evaluated for response, the respective overall response and disease control rates were 56.1% and 90.2%. At a median follow-up of 14.8 months, the respective median overall survival and time to progression were 19.6 months [95% confidence interval (CI) = 12.8–22 months] and 9 months (95% CI = 7.3–10 months). Grade 3–4 toxic effects were uncommon. The distribution of ERCC1-118 genotypes from 29 patients was C/C (n = 17, 40.5%), C/T (n = 10, 23.8%) and T/T (n = 2, 4.8%). No differences in survival or response rates were found between genotypes.
Conclusions: GEMOX is active in the treatment of recurrent NPC. Detection of single-nucleotide gene polymorphisms from genomic DNA in peripheral blood is feasible in NPC and further studies are warranted.
ERCC1 polymorphisms, gemcitabine, nasopharyngeal carcinoma, oxaliplatin
Received for publication November 4, 2008. Revision received February 21, 2009. Accepted for publication February 24, 2009.