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Tislelizumab plus chemotherapy as first-line treatment for recurrent or metastatic nasopharyngeal cancer: A multicenter phase 3 trial (RATIONALE-309)

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机构: [1]Department of Medical Oncology of Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, 16th Floor, No. 2 Building, Dongfeng East Road, Yuexiu District, Guangzhou, Guangdong 510060, China [2]Department of Head & Neck Radiation Oncology, Fujian Cancer Hospital, No. 420, Fuma Road, Jinan District, Fuzhou, Fujian 350014 China [3]Thoracic Radiotherapy Department I, Hunan Cancer Hospital, No. 283, Tongzipo Road, Yuelu District, Changsha, Hunan 410013 China [4]Otolaryngology Department of the People’s Hospital of Guangxi Zhuang Autonomous Region, Cancer Research Institute of Guangxi Academy of Medical Sciences, No.6 Tao Yuan Road, Nan Ning, Guangxi 530021, China [5]Department of Head and Neck Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 37 Guoxuexiang, Wuhou District, Chengdu, Sichuan 610041, China [6]Department of Head and Neck Radiotherapy, Zhejiang Cancer Hospital, 38 Guangji Road, Gongshu District, Hangzhou, Zhejiang 310022, China [7]Radiotherapy Department, Beijing Cancer Hospital, No. 52 Fucheng Road, Haidian District, Beijing 100142, China [8]Department of Medical Oncology, Cancer Hospital Chinese Academy of Medical Sciences, No. 17 Panjiayuannanli, Chaoyang District, Beijing 100021, China [9]Department of Radiation, Fudan University Shanghai Cancer Centre, No. 270, Dong’an Road, Xuhui District, Shanghai 200032, China [10]Department of Oncology, the First Affiliated Hospital of Guangzhou Traditional Chinese Medicine University, No. 16 Airport Road, Baiyun District, Guangzhou, Guangdong 510405, China [11]Department of Medical Oncology of Respiratory, the Affiliated Cancer Hospital of Guangxi Medical University, No. 71 Hedi Road, Nanning, Guangxi 530021, China [12]Head and Neck Oncology Section One of The Fifth Affiliated Hospital Sun Yat-sen University, No. 52 Meihua East Road, Xiangzhou District, Zhuhai, Guangzhou Province 519000, China [13]Department of Oncology, Changsha Central Hospital, No. 161, Shaoshan South Road, Changsha, Hunan 410004, China [14]Head and Neck Radiotherapy Department, The People’s Hospital of Zhongshan City, No. 2 Sunwen East Road, Zhongshan, Guangdong 528403, China [15]Cancer Center, Nasopharyngeal Cancer Disease Center, Affiliated Hospital of Guangdong Medical University, No. 57 South Renmin Road, Zhanjiang, Guangdong 524000, China [16]Cancer Centre, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan, Hubei 430022, China [17]Department of Radiation, Cancer Hospital of Shantou University Medical College, No. 7 Raoping Road, Shantou, Guangdong 515031, China [18]Department of Oncology, Shanghai East Hospital, School of Medicine, Tongji University, No. 1800, Yuntai Road, Shanghai 200123, China [19]Department of Oncology, the First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Street, Nanchang, Jiangxi 330006, China [20]Department of Otolaryngology Head and Neck Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yan Jiang West Road, Guangzhou, Guangdong 510120, China [21]Clinical Development, BeiGene (Shanghai) Co., Ltd., Jing An Kerry Centre, 20/F, Tower 3, 1228 Middle Yan’an Road, Shanghai 200040, China [22]Clinical Biomarker Science and CDx Development, BeiGene (Beijing) Co., Ltd., 6 Jianguomenwai Avenue, SK Tower, 36th Floor, Chaoyang District, Beijing 100022, China [23]Bioinformatics, BeiGene (Beijing) Co., Ltd. 30 Science Park Road, Zhongguancun Life Science Park, Changping District, Beijing 102206, China
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Checkpoint inhibitors are effective in recurrent/metastatic nasopharyngeal cancer (R/M NPC). RATIONALE-309 (NCT03924986) randomized 263 treatment-naive R/M NPC patients to tislelizumab or placebo every 3 weeks (Q3W), plus chemotherapy (Q3W for 4-6 cycles). At interim analysis, progression-free survival (PFS) was significantly longer with tislelizumab-chemotherapy versus placebo-chemotherapy (hazard ratio: 0.52; 95% confidence interval: 0.38, 0.73; p < 0.0001). PFS benefit for tislelizumab-chemotherapy versus placebo-chemotherapy was observed regardless of programmed death-ligand 1 expression. PFS after next line of treatment and overall survival showed favorable trends for tislelizumab-chemotherapy versus placebo-chemotherapy. The safety profile was similar between arms. Gene expression profiling (GEP) identified immunologically "hot" tumors, and showed an activated dendritic cell (DC) signature was associated with tislelizumab-chemotherapy PFS benefit. Our results support that tislelizumab-chemotherapy should be considered as first-line treatment for R/M NPC, and GEP and activated DC signature results may help identify patients who might benefit most from immunochemotherapy treatment. VIDEO ABSTRACT.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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大类 | 1 区 医学
小类 | 1 区 细胞生物学 1 区 肿瘤学
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大类 | 1 区 医学
小类 | 1 区 细胞生物学 1 区 肿瘤学
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Q1 CELL BIOLOGY Q1 ONCOLOGY
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Q1 CELL BIOLOGY Q1 ONCOLOGY

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第一作者机构: [1]Department of Medical Oncology of Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, 16th Floor, No. 2 Building, Dongfeng East Road, Yuexiu District, Guangzhou, Guangdong 510060, China
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