Real-World Overall Survival (OS) in Recurrent/Metastatic Nasopharyngeal Carcinoma (R/M NPC) in Asia:
A Literature Review
Darren W.T. Lim,1 Melvin L.K. Chua,1 Brigette B.Y. Ma,2 Jennifer S. Evans,3 Yan Ran Wee,3 Min Hee Choi,3 Natsumi Fujita,3 Shikha Dhawan,4 Junice Ng413• This literature review (LR) found limited real-world (RW) immuno-oncology (IO) use in recurrent/metastatic nasopharyngeal carcinoma

Conclusions

Poster No: 898P Presented at the European Society for
Medical Oncology (ESMO) Congress; September 13–17, 2024;Barcelona, Spain

National Cancer Centre Singapore, Singapore; Department of Clinical Oncology, Charlie Lee Precision Immuno-Oncology, Phase 1 Clinical Trial Center, The Chinese University of Hong Kong, Hong Kong SAR; Costello Medical, Singapore;
4
BeiGene Singapore Pte. Ltd, Singapore
2• The heterogenous evidence base made overarching conclusions challenging, and highlights a need for long-term RW research in R/M NPC(R/M NPC), likely reflecting access to recently introduced/approved IO compounds• In most cases, only 1 or 2 studies were available to provide data on IO as a point of comparison against chemotherapy (CT)-based
modalities, which may not be representative of all patients receiving IO in the RW• Comparisons of overall survival (OS) between modalities must be interpreted with caution due to differences in study design and patient
selection characteristics between modalities (eg, type of metastasis) which could have confounded OS outcomesBackgroundpatients, particularly in parts of Asia outside mainland China, to better understand the benefits of novel treatments such as IO• Nevertheless, the RW OS results complement randomized clinical trial (RCT) data to provide an initial indication of a potential role for IO inR/M NPC treatment

Results

Platinum-based CT ± radiotherapy (RT) was the standard of care for R/MNPC until the recent introduction of IO therapy• Meta-analyses (MAs) of RCTs report mixed results for IOs;1,2 adding
toripalimab/tislelizumab/camrelizumab to CT improved efficacy of first-line(LOT 1) treatment, while pembrolizumab was non-superior to CT in thelater-line (LOT 2+) setting3,4• An evidence gap was identified regarding data on current RW
usage and effectiveness of standard-of-care treatments and IO therapies
in R/M NPC• This targeted LR thus aimed to summarize RW treatments and OS for
patients with R/M NPC in Asia•

Of 5210 abstracts retrieved and 486 full texts reviewed, 24 articles were eligible.
Of these, 20 prioritized studies were extracted• Most studies (18/20, 90%) were from mainland China. Patient characteristics(eg, performance status, Epstein-Barr virus [EBV] status, age, sex) were similar
between studies, where reported• CT-based modalities were most common, and only mainland China reported studies
with IO (n=3)••

Figure 1 presents OS values at 1, 3, and 5 years, which show a general trend of reduced
OS over time. In CT-only patients, OS decreased sharply after 1 year, compared withpatients who received CT followed by RT (CT+RT) or IO±CT. IO studies showed a similar
range of OS to CT+RT studies at 1, 3, and 5 years, which was higher than CT-only studies
across LOTs

Figure 1. OS in R/M NPC by Treatment Modality and LOT•

Figure 2 reports median OS by treatment type. Currently, a single study is available for
IO+CT, which limits meaningful comparison with other treatment modalities

Figure 2. Median OS in R/M NPC by Treatment Modality and LOT

5-year OS
31.6

46.2

IO±CT*
36.2

CT+RT

39.0

Metastatic NPC

3.4

CT only

3-year OS
47.8

16.2

61.2

32.5

25.9

CT+RTCT only

14.0*

CT+RT

IO±CT*

11.7

0

20.3

24.3

28.0 31.8

40.3

50

55.8 58.0

60405060CT only

85.6

75

30

69.5

57
42.1

18.5

16.0

65.4

20

17.6

61.8

1-year OS1035.1 37.0
33.0

24.8

0

40.1

32.0

36.7

CT only

91.7

15.2

7075

89.8

77.5
80

Each bubble represents an included study; bubbles are sized to scale according to individual study sample sizes. Median duration of follow-up ranged from 7‒71.5 months, where reported.
*Studies in LOT1 used IO+CT; studies in LOT2 used IO-only; studies where LOT was NR used IO±CT±targeted/local therapy.
CT, chemotherapy; IO, immuno-oncology; LOT, line of therapy; NR, not reported; OS, overall survival; R/M NPC, recurrent/metastatic nasopharyngeal carcinoma; RT, radiotherapy.

Acknowledgments
This study was sponsored by BeiGene Ltd. Literature review and writing support was provided by Costello Medical Singapore; editorial and submission support was provided byEnvision Pharma Inc. and funded by BeiGene.

23.0

13.2

1671.1
70.4

23.0

25.6

29.4

18.0

85.5

OS (%)

BGNE-25704-1 ESMO24 NPC SLR in Asia poster CG12.indd 1

Metastatic NPC

Recurrent NPC

CT+RT

Yan L et al. Front Pharmacol. 2023;13:1095734.
Mai H-Q et al. JAMA. 2023;330(20):1961-1970.
Guven DC; et al. Laryngoscope. 2024;134(1):7-17.
Luo J et al. BMC Cancer. 2023;23(1):1172.

19.9

24.5

IO±CT*

1.
2.
3.
4.

IO+CT

n=402

Mix of R/M NPC

Locally recurrent NPC•References

n=1401

Mix of R/M NPC
43.7

n=28

LOT1 or LOT NR

LOT1 or LOT NR

Methods
MEDLINE and Embase (2020–April 25, 2023) were searched simultaneously
via the Ovid SP platform. Recent proceedings (2021–2023) of the American
Society of Clinical Oncology (ASCO) and European Society for MedicalOncology (ESMO) congresses were also searched, in addition to thebibliographies of systematic LRs/MAs• Observational studies were eligible if they reported treatment patterns(CT±RT or IO) and OS of patients with R/M NPC in Asia
• Records were screened by a single reviewer and eligible studies fromeach identified institution were prioritized for extraction based on outcomes
reported per treatment modality, sample size, and recency. Information on
the study and patient characteristics, treatments, and associated OS wasextracted• The study focused specifically on OS to provide a point of comparison across
RW data where reporting and definitions of outcomes (eg, progression-freesurvival) could vary substantially• OS was descriptively analyzed, stratified by line of and types of treatment,
as well as recurrent or metastatic disease

LOT 2+n=28

LOT 2+

090

1017.8

2220

30

40

50

60

70

Median OS (months)

Each bubble represents an included study; bubbles are sized to scale according to individual study sample sizes.
Median duration of follow-up ranged from 17.7‒112 months, where reported.
*9.4% of patients received CT+RT; 90.6% of patients received concurrent chemoradiotherapy.
CT, chemotherapy; IO, immuno-oncology; LOT, line of therapy; NPC, nasopharyngeal carcinoma; NR, not reported; OS, overall survival; R/M, recurrent/metastatic; RT, radiotherapy.

Disclosures
Darren W.T. Lim received research funding from Bristol-Myers Squibb through institution,and honoraria/travel support from Merck, Roche, Boehringer-Ingelheim, Taiho Pharmaceuticals,Pfizer, Novartis, and Eisai.

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05/09/2024 18:37