Abstract
IntroductionPlatinum-based chemotherapy is important for the treatment for recurrent or metastatic nasopharyngeal carcinomas (RM-NPCs), as recommended by current clinical guidelines. However, the prognosis of RM-NPC patients remains poor. This study aimed to evaluate the efficacy and safety of vascular-targeting agents apatinib or anlotinib plus chemotherapy for RM-NPC treatment.MethodsThis retrospective multicenter study, conducted at 4 hospitals in Guangxi Province, China, between January 2017 and December 2021, included 198 patients. Propensity score matching (PSM) was used to minimize potential selection bias between groups. After PSM, a total of 150 patients were included in the study. Chemotherapy was administered with and without vascular-targeting agents in 58 and 92 patients, respectively. The primary endpoint was progression-free survival (PFS), assessed by a blinded independent review committee according to RECIST v.1.1. The secondary end points were overall survival (OS) and safety.ResultsAfter PSM, median PFS was significantly higher in the combination group (8.0 months [95% CI, 5.7-8.3 months]) than in the chemotherapy alone group (5.0 months [95% CI, 4.1-5.9 months], P = 0.014), with a hazard ratio of 0.65 (95% CI, 0.46-0.92). The combination group exhibited a higher median OS compared to the chemotherapy alone group (45 months [95% CI, 21.3-52.7] vs 18 months [95% CI, 13.0-27.0 months], P = 0.019), representing a hazard ratio of 0.58 (95% CI, 0.37-0.92). In the combination therapy group, the most common adverse event was hand-foot syndrome (n = 16/58 [27.6%]).ConclusionThe addition of vascular-targeting agents to chemotherapy for RM-NPC patients provided superior efficacy compared to chemotherapy alone, along with a manageable safety profile.