Intensity-modulated radiotherapy plus nimotuzumab with or without concurrent chemotherapy for patients with locally advanced nasopharyngeal carcinoma

Jianfeng Huang,1,* Qinzhou Zou,1,* Danqi Qian,1 Leyuan Zhou,1 Bo Yang,1 Jianjun Chu,1 Qingfeng Pang,2 Kewei Wang,2 Fuzheng Zhang1 1Department of Radiation Oncology, Affiliated Hospital of Jiangnan University, 2Department of Epidemiology, Wuxi Medical School of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China *These authors contributed equally to this work Objective: This study aimed to evaluate the safety and efficacy of intensity-modulated radiotherapy (IMRT) plus nimotuzumab with or without concurrent chemotherapy (CCT) for patients with locally advanced nasopharyngeal carcinoma (LA-NPC). Patients and methods: A total of 50 newly diagnosed patients with LA-NPC treated at the Affiliated Hospital of Jiangnan University between November 2011 and January 2017 were retrospectively analyzed. All patients received the combined treatment modality of nimotuzumab plus IMRT. Nimotuzumab was administered concurrently with IMRT at a weekly dose of 200 mg. Neoadjuvant, concurrent or adjuvant chemotherapy with the doublet regimen of taxanes (docetaxel or paclitaxel) plus platinum (cisplatin or nedaplatin) were administered. Among the 50 patients, 43 (86.0%) received ≥6 cycles of nimotuzumab (median 7 cycles, range 2–14 cycles) and 29 (58.0%) received two cycles of CCT with docetaxel plus nedaplatin. Results: With a median follow-up of 28.0 months, the 2-year progression-free survival (PFS) and overall survival were 83.29% (95% confidence interval [CI]: 67.93%–91.72%) and 97.67% (95% CI: 84.62%–99.67%), respectively. Both univariate and multivariate analyses revealed that cycles of nimotuzumab were significantly associated with PFS. Patients who received ≥6 cycles of nimotuzumab showed a better PFS than those receiving <6 cycles (P=0.006), whereas the addition of CCT failed to improve PFS. Oral mucositis was the most common adverse event, which was recorded as grade 3–4 in 18 (36.0%) patients. Besides, two (4.0%) patients experienced nimotuzumab-related anaphylaxis, and no skin rash was found in any patient. Subgroup analysis revealed that the patients who received CCT had more grade 3–4 adverse events as compared to those who did not receive CCT (62.1% vs 33.3%, P=0.045). Conclusion: The regime of nimotuzumab plus IMRT for the treatment of LA-NPC was well tolerated, with encouraging survival data, and it could be an effective treatment alternative for patients with LA-NPC. Further clinical trials are needed to confirm these findings.Keywords: nasopharyngeal carcinoma, intensity-modulated radiotherapy, nimotuzumab, concurrent chemoradiotherapy, treatment outcome&nbsp

Radiosensitivity enhancement by combined treatment of nimotuzumab and celecoxib on nasopharyngeal carcinoma cells

Jianfeng Huang,1,* Xiaopeng Yuan,2,* Qingfeng Pang,3 Haowen Zhang,4 Jiahua Yu,4 Bo Yang,1 Leyuan Zhou,1 Fuzheng Zhang,1 Fenju Liu4 1Department of Radiation Oncology, Affiliated Hospital of Jiangnan University, Wuxi, People’s Republic of China; 2Department of Radiation Oncology, Nantong Tumor Hospital, Affiliated Tumor Hospital of Nantong University, Nantong, People’s Republic of China; 3Department of Physiopathology, Wuxi School of Medicine, Jiangnan University, Wuxi, People’s Republic of China; 4State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Medical College of Soochow University, Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Jiangsu Provincial Key Laboratory of Radiation Medicine and Protection, Suzhou, People’s Republic of China *These authors contributed equally to this work Introduction: In this study, the radiation-enhancing effects of combined treatment with nimotuzumab, a humanized EGFR-blocking antibody, and celecoxib, a COX-2 selective inhibitor, in human nasopharyngeal carcinoma (NPC) cells were investigated. Materials and methods: 3-(4,5-Dimethylthiazol-2yl)-2,5-diphenyltetrazolium bromide and clonogenic survival assays were done to evaluate the combined cytotoxic and radiosensitizing effects of nimotuzumab or celecoxib or the combination on CNE1 and CNE2 cells. Western blot analysis was performed to identify the effect of nimotuzumab and/or celecoxib with or without irradiation on the cytoplasmic and nuclear EGFR signaling pathways in CNE2 cells. Results: Our results demonstrated that concurrent administration of nimotuzumab and celecoxib cooperatively enhanced the cytotoxicity and radiosensitivity of CNE2 cells but not CNE1 cells. The combination of both drugs with or without irradiation also cooperatively inhibited cytoplasmic and nuclear EGFR signaling pathways in CNE2 cells. Conclusion: Our results suggest a promising approach for the treatment of poorly differentiated NPC. Keywords: celecoxib, cyclooxygenase-2, epidermal growth factor receptor, nasopharyngeal carcinoma, nimotuzumab, radiosensitivit

Incidence of diarrhea caused by rotavirus infections in rural Zhengding, China: prospective, population-based surveillance.

Rotavirus is the pathogen most commonly associated with severe gastroenteritis in young children in the People's Republic of China, yet there are few population-based data on the incidence of rotavirus infection. The present study investigated the burden of rotavirus diarrhea and rotavirus infections in rural China, according to age. Population-based surveillance was used to study the incidence of rotavirus infection among children <5 years of age in 4 townships of Zhengding County, Hebei Province, China. The total population in the catchment area in 2002 was 75,630 individuals, including 2997 children aged <5 years. Stool samples were obtained and were tested for rotavirus antigen by use of an enzyme-linked immunosorbent assay. During 2002, a total of 2010 cases of diarrhea were detected among children <5 years of age. The incidence of treated cases of diarrhea was 671 cases/1000 children/year for children <5 years of age, and it was highest for children <12 months of age (1467 cases/1000 children/year). The estimated incidence of rotavirus infection was 151 cases/1000 children/year for children <5 years of age. The highest incidence of rotavirus infection was among children aged 1-2 years (340 cases/1000 children/year). Widespread immunization of children against rotavirus before 6 months of age should be considered for the control of rotavirus diarrhea