Capecitabine monotherapy for recurrent and metastatic nasopharyngeal cancer

Background: Capecitabine monotherapy had activity in recurrent/metastaticnasopharyngeal carcinoma (NPC) as demonstrated previously ina small pilot study. We conducted a retrospective review ofpatients who received capecitabine for recurrent and metastaticNPC to further evaluate its clinical benefits. Methods: Forty-nine patients with recurrent and metastatic NPC receivedcapecitabine at a dose of 1–1.25 G/m² twice daily for14 days in 3-week cycles. Disease sites were locoregional in29%, distant in 45% and locoregional plus distant in 26%. Allexcept one had prior platinum-based chemotherapy for relapseor as adjunctive treatment. Median follow-up was 10 months (range:3–41). Results: Treatment was generally well tolerated. Hand-foot syndrome wascommon and occurred in 86% (25% Grade 3). Grade 3 hematologicaltoxicity occurred in 6%. Partial response rate was 31% (95%CI: 18%, 44%) and complete response rate was 6% (95% CI: 0%,13%), for an overall response rate of 37% (95% CI: 23%, 50%).Median time-to-progression was 5 months and median survivalwas 14 months. One- and two-year survival rates were 54 and26%, respectively. Significantly better survival was observedin patients treated for locoregional recurrence and those withsevere hand-foot syndrome. Conclusions: Capecitabine has single agent activity in NPC and severe hand-footsyndrome predicts favorable outcome. Based on our experience,capecitabine monotherapy should be considered in patients withrecurrent/metastatic NPC.