Salvage gemcitabine-vinorelbine chemotherapy in patients with metastatic nasopharyngeal carcinoma pretreated with platinum-based chemotherapy.

Platinum-based chemotherapy is the recognized first-line treatment for metastatic nasopharyngeal carcinoma (NPC). However there is no standard second-line treatment. This study was designed to evaluate the efficacy and safety of a gemcitabine and vinorelbine combination (GV) in patients with metastatic NPC previously treated with platinum-based chemotherapy.A total of 61 patients with metastatic NPC after prior platinum-based chemotherapy were enrolled. Gemcitabine (1000 mg/m(2)) and vinorelbine (25mg/m(2)) were administered intravenously on Day 1 and Day 8 every 3 weeks.In this study, the overall response rate was 37.7% (95% CI, 25.5-49.9%) one complete response (1.6%) and 22 partial responses (36.1%). The median progression-free survival was 5.2 months (95% CI, 3.4-7.0 months) and the median overall survival was 14.1 months (95% CI, 11.1-17.1 months). Grade 3/4 toxicity including leucopenia (19.7%), neutropenia (18%), anemia (4.9%) and thrombocytopenia (6.5%) were tolerable. Univariate and multivariate analyses indicated age and salvage treatment after failure of GV treatment were independently significant prognostic factors.Our preliminary result shows gemcitabine and vinorelbine combination is effective and safe for the patients with advanced NPC pretreated with platinum-based chemotherapy. Further clinical study is warranted.