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Predictive progression outcomes and risk stratification in patients with recurrent or metastatic nasopharyngeal carcinoma who received first-line immunochemotherapy

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A Correction to this article was published on 28 February 2024

This article has been updated

Abstract

Purpose

Progression after first-line immunochemotherapy (ICT) for recurrent or metastatic nasopharyngeal carcinoma (R/M NPC) is a clinical concern due to subsequent limited treatment options. This study firstly predicted the progress outcome.

Methods

A cohort of 186 R/M NPC cases that received first-line ICT was included for developing a Cox regression model for progression-free survival (PFS) and risk stratification, which was verified by cross-validation. Discrimination and calibration were evaluated. Progression sites in risk groups was shown with a Sankey diagram.

Results

Baseline predictors including liver metastasis, trend of plasma Epstein–Barr virus DNA copies, lymphocyte-to-monocyte ratio, and level of platelet and lactate dehydrogenase were identified for model construction, which stratify the cohort into low, middle, and high-risk groups. The overall concordance index (C-index) was 0.67 (95% CI 0.62–0.73). The area under the curve (AUC) was 0.68 (95% CI 0.60–0.76), 0.74 (95% CI 0.66–0.82), 0.75 (95% CI 0.65–0.84) at predicting 12, 18, and 24 months PFS, indicating a moderate accuracy. Cross-validation showed the model performance was robust. Compared with the low-risk group (median PFS: 24.4 months, 95% CI 18.4 months to not reached), the high-risk group (median PFS: 7.1 months, 95% CI 6.4–10.1 months; hazard risk: 7.4, 95% CI 4.4–12.4, p < 0.001) progressed with more liver metastasis after ICT resistance.

Conclusion

It was the first study that described the risk factors and progression characteristics in R/M NPC patients who received first-line ICT, investigating the progression patterns, which was helpful to identify patients with different risks and help guide personalized interventions.

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Data availability

The dataset used and analysed during the current study is available from the corresponding author on reasonable request.

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Acknowledgements

We sincerely thank Dr. Jialin Wu for providing technical assistance.

Author information

Author notes

  1. Danjie He, Yudong Zhang and Shuiqing He authors have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People’s Republic of China

    Danjie He, Shuiqing He, Cheng Xu & Ying Huang

  2. Department of Thoracic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510062, People’s Republic of China

    Yudong Zhang

  3. Guangzhou Medical University, Guangzhou, Guangdong, 511436, People’s Republic of China

    Yuzhuo Zhang & Keyao Dai

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  1. Danjie He
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Correspondence to Cheng Xu or Ying Huang.

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The authors have no competing interests to declare.

Ethics approval

This retrospective study was approved by Sun Yat-sen University Cancer Center (IRB-approved number, B2022-797).

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All clinical information was anonymous, and the requirement for informed consent was waived.

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He, D., Zhang, Y., He, S. et al. Predictive progression outcomes and risk stratification in patients with recurrent or metastatic nasopharyngeal carcinoma who received first-line immunochemotherapy. Clin Transl Oncol 26, 1209–1219 (2024). https://doi.org/10.1007/s12094-023-03344-w

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