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- Title
Adoptive T-cell Transfer and Chemotherapy in the First-line Treatment of Metastatic and/or Locally Recurrent Nasopharyngeal Carcinoma.
- Authors
Chia, Whay-Kuang; Teo, Marissa; Wang, Who-Whong; Lee, Bernett; Ang, Soo-Fan; Tai, Wai-Meng; Chee, Chit-Lai; Ng, Joanna; Kan, Rebecca; Lim, Wan-Teck; Tan, Sze-Huey; Ong, Whee-Sze; Cheung, Yin-Bun; Tan, Eng-Huat; Connolly, John E; Gottschalk, Stephen; Toh, Han-Chong
- Abstract
The outcomes for patients with metastatic or locally recurrent Epstein-Barr virus (EBV)-positive nasopharyngeal carcinoma (NPC) remain poor. Adoptive immunotherapy with EBV-specific cytotoxic T lymphocytes (EBV-CTLs) has proven clinical efficacy, but it has never been evaluated in the first-line treatment setting in combination with chemotherapy. To evaluate the safety and efficacy of a chemotherapy in combination with adoptive EBV-CTL transfer, we conducted a phase 2 clinical trial consisting of four cycles of gemcitabine and carboplatin (GC) followed by up to six doses of EBV-CTL. Thirty-eight patients were enrolled, and 35 received GC and EBV-CTL. GC-CTL therapy resulted in a response rate of 71.4% with 3 complete responses and 22 partial responses. With a median follow up of 29.9 months, the 2-year and 3-year overall survival (OS) rate was 62.9 and 37.1%, respectively. Five patients did not require further chemotherapy for more than 34 months since initiation of CTL. Infusion of CTL products containing T cells specific for LMP2 positively correlated with OS (hazard ratio: 0.35; 95% confidence interval: 0.14-0.84; P = 0.014). Our study achieved one of the best survival outcomes in patients with advanced NPC, setting the stage for a future randomized study of chemotherapy with and without EBV-CTL.
- Subjects
EPSTEIN-Barr virus diseases; CANCER chemotherapy; CARBOPLATIN; T cells; IMMUNOTHERAPY
- Publication
Molecular Therapy, 2014, Vol 22, Issue 1, p132
- ISSN
1525-0016
- Publication type
Article
- DOI
10.1038/mt.2013.242