Recurrence and metastasis are the main causes of treatment failure of NPC. Immunotherapy is an emerging cancer treatment method, which has less adverse reactions and longer duration compared with chemotherapy. At present, there are a large number of PATIENTS with anti-PD-1 resistance in clinical practice, who are faced with a significant decline in the efficacy of anti-PD-1 after treatment. However, without the synergistic effect of anti-PD-1, survival after chemotherapy alone will be significantly shortened. how to improve the efficacy of immunotherapy rechallenge so that a large number of potential patients can benefit from immunotherapy is an urgent problem to be solved at present. Studies have shown that G-CSF can significantly increase the proportion of effector cells dominated by CD4+ T cells, improve the diversity of peripheral blood TCR, thus regulate the immune status of tumor patients. Therefore, G-CSF may have a synergistic effect on anti-PD-1. This study intends to explore whether the addition of G-CSF can restore the efficacy of anti-PD-1 in drug-resistant NPC patients through a prospective clinical trial.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
25
PEG-rhG-CSF, 3mg, D1, Q3W, subcutaneous injection, until stop using PD-(L)1 inhibitor, progressive disease (PD) or unacceptable toxicity. Meanwhile, the original maintenance regimen--PD-(L)1 inhibitor ± VEGFR/EGFR TKI/Ab--continues.
PEG-rhG-CSF, 6mg, D1, Q3W, subcutaneous injection, until stop using PD-(L)1 inhibitor, progressive disease (PD) or unacceptable toxicity. Meanwhile, the original maintenance regimen--PD-(L)1 inhibitor ± VEGFR/EGFR TKI/Ab--continues.
Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center
Guangzhou, Guangdong, China
RECRUITINGORR
Defined as the proportion of patients whose tumors shrink to complete response (CR) or partial response (PR) and remain for a certain period of time according to RECIST 1.1
Time frame: 1 year
The proportion of patients who achieved disease control
Defined as the proportion of subjects who achieve CR+PR+stable disease (SD) for at least 4 weeks according to RECIST 1.1.
Time frame: 1 year
The proportion of patients who achieved clinical benefit
Defined as maintaining the efficacy of CR+PR+SD for at least 6 months according to RECIST 1.1.
Time frame: 1 year
Duration of response
Defined as the time from the first assessment of CR and PR to the first assessment of PD or death caused by any cause according to RECIST 1.1.
Time frame: 1 year
median progression-free survival
Defined as the period from the start of enrollment until disease progression or death from any cause.
Time frame: 1 year
Adverse events
assessed by NCI-CTC5.0 standard
Time frame: 1 year
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