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Objectives <p>The decision on trade-off between the chance of salvage and the risk of serious toxicity in locally recurrent nasopharyngeal carcinoma (lrNPC) is a dilemma both to the clinician and patients. This study aimed to evaluate the efficacy of our watch-and-wait (W-W) strategy by receiving low-intensity maintenance treatment (LIMT) in lrNPC patients who achieved objective response after immune checkpoint inhibitors plus chemotherapy (ICI-chemotherapy), and explore the possibility of sparing or delaying local treatment.</p> Methods <p>LrNPC patients who were treated in our institution from January 2022 to May 2023 were candidates for this study. All enrolled patients would receive protocolized ICI-chemotherapy followed by LIMT alone (W-W approach) without immediate local treatment. The objective response rate (ORR), progression free survival (PFS), overall survival (OS) and safety profile were evaluated.</p> Results <p>Twenty-six lrNPC patients were included, 18 patients (69.2%) achieved objective response after ICI-chemotherapy, and continued with LIMT, 17 of them (17/18, 94.4%) maintained a state of disease remission without requiring local treatment, only one patient experienced PD during LIMT. Six patients remained in SD at the completion of ICI-chemotherapy, two patients experienced PD during ICI-chemotherapy. The 2-year OS and PFS were 87.8% and 64.0%, respectively. Reported adverse events were all manageable and no severe treatment-emergent adverse event were detected.</p> Conclusions <p>For patients achieving response after ICI-chemotherapy, a “W-W” approach by continuing with LIMT, eschewing immediate local therapy, may be a viable option. Well-designed, prospective trials with conventional approaches involving earlier local treatment in comparison are essential to confirm the benefit of this innovative approach.</p>

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Watch-and-wait strategy in patients with objective response after immuno-chemotherapy for locally recurrent nasopharyngeal carcinoma: a pilot study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月1日

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  • Quxia Zhang,
  • Wanfang Huang,
  • Xinlan Chen,
  • Zhiwei Yan,
  • Daqiang Huang,
  • Hanchuan Xu,
  • Yahan Zheng,
  • Lili Zhu,
  • Caizhu Pan,
  • Jianji Pan,
  • Shaojun Lin,
  • Chaobin Huang,
  • Qiaojuan Guo

摘要

Objectives

The decision on trade-off between the chance of salvage and the risk of serious toxicity in locally recurrent nasopharyngeal carcinoma (lrNPC) is a dilemma both to the clinician and patients. This study aimed to evaluate the efficacy of our watch-and-wait (W-W) strategy by receiving low-intensity maintenance treatment (LIMT) in lrNPC patients who achieved objective response after immune checkpoint inhibitors plus chemotherapy (ICI-chemotherapy), and explore the possibility of sparing or delaying local treatment.

Methods

LrNPC patients who were treated in our institution from January 2022 to May 2023 were candidates for this study. All enrolled patients would receive protocolized ICI-chemotherapy followed by LIMT alone (W-W approach) without immediate local treatment. The objective response rate (ORR), progression free survival (PFS), overall survival (OS) and safety profile were evaluated.

Results

Twenty-six lrNPC patients were included, 18 patients (69.2%) achieved objective response after ICI-chemotherapy, and continued with LIMT, 17 of them (17/18, 94.4%) maintained a state of disease remission without requiring local treatment, only one patient experienced PD during LIMT. Six patients remained in SD at the completion of ICI-chemotherapy, two patients experienced PD during ICI-chemotherapy. The 2-year OS and PFS were 87.8% and 64.0%, respectively. Reported adverse events were all manageable and no severe treatment-emergent adverse event were detected.

Conclusions

For patients achieving response after ICI-chemotherapy, a “W-W” approach by continuing with LIMT, eschewing immediate local therapy, may be a viable option. Well-designed, prospective trials with conventional approaches involving earlier local treatment in comparison are essential to confirm the benefit of this innovative approach.