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Background Given a lack of standard of care treatment for patients with recurrent/metastatic nasopharyngeal carcinoma (R/M NPC), the objectives were to assess treatment utilization and overall survival (OS) outcomes for R/M NPC in the real-world setting. Methods A retrospective chart review was conducted in South Korea (SK) and Taiwan (TW) to identify patients who initiated first-line systemic therapy for R/M NPC between January 1, 2012 and June 30, 2013. Patients were followed through December 31, 2015. Stratification of study outcomes was performed per location of metastases for patients with distant metastatic disease vs. metastatic disease in distant lymph nodes only. Results Among 154 R/M NPC patients enrolled across 12 sites, median age was 52 years (interquartile range 45-59), 78% were male, and 87% had ECOG 0-1. In TW (N = 104), all patients had distant metastatic disease either as newly diagnosed metastatic (stage IVc) disease (32%) or disease recurrence with distant metastases (68%). In SK (N = 50), 42% of patients had distant metastatic disease, and 58% presented with distant lymph nodes only. Among patients with distant metastatic disease, patients mainly received systemic therapy only as first-line treatment in both TW (72%) and SK (67%), among which platinum + 5-FU was most common (34%). Remaining patients with distant metastatic disease received systemic therapy + radiation (28% TW; 33% SK). In contrast, patients with distant lymph nodes only in SK primarily received systemic therapy + radiation (83%). Median OS for patients with distant metastatic disease who received systemic therapy only was 23 months (95% confidence interval [CI] 18-32), compared with 32 months (95% CI: 22-Not Determined) for patients who received systemic therapy + radiation. Median OS was not reached for patients with distant lymph nodes only who received systemic therapy + radiation. Conclusions Differences in the location of metastases for patients with R/M NPC led to variation in treatment approaches across TW and SK. Prognosis in patients with distant metastatic disease remains poor with limited therapeutic options, underscoring the need for newer, more efficacious treatments. Legal entity responsible for the study Merck and Co., Inc. Funding Merck and Co., Inc. Disclosure M-J. Ahn: Honoraria (self): Merck Sharpe and Dohme; Honoraria (self): Astra-Zeneca; Honoraria (self): Bristol Myers Squibb; Honoraria (self): Merck ; Honoraria (self): Roche; Honoraria (self): Alphas Pharmaceutical. D.R. Chirovsky: Shareholder / Stockholder / Stock options, Full / Part-time employment: Merck and Co. Inc. H. Kuyas: Research grant / Funding (institution), Full / Part-time employment: Kantar Health Division. V. Auclair: Research grant / Funding (institution), Full / Part-time employment: Kantar Health Division. S. Abounit: Research grant / Funding (institution), Full / Part-time employment: Kantar Health Division. S. Joo: Shareholder / Stockholder / Stock options, Full / Part-time employment: Merck and Co, Inc. R. Shah: Full / Part-time employment: Merck and Co, Inc. All other authors have declared no conflicts of interest. |
