Source: Office of Medical Science
Written by: Office of Medical Science
Translated by: Professor Chen Lei

On December 18th, the award of the 2012 “Top 10 Scientific and Technological Progress of Chinese Universities” was announced in Beijing by the Science and Technology Commission of Ministry of Education. The research on combined chemo-radiotherapy and basis of individualized treatment of nasopharyngeal carcinoma, charged by Professor Ma Jun in Sun Yat-sen University Cancer Center has been selected. The project is also the only one selected in Guangdong Province this year. The whole project has lasted 6 years, and got full funding by Sun Yat-sen University "5010 plans".
The research on combined chemo-radiotherapy and basis of individualized treatment of nasopharyngeal carcinoma

Every year, 40% of new cases of nasopharyngeal carcinoma appear in China. The site of nasopharyngeal carcinoma is too concealed to notice by the patients themselves, therefore, 70% of the patients in the hospital are locoregionally advanced, and metastasis and local recurrence rate is very high. The international guideline recommends that standard treatment for locoregionally advanced nasopharyngeal carcinoma is not only concurrent chemoradiotherapy, but also 3 courses of adjuvant chemotherapy after chemo-radiotherapy. However, what confused clinicians is whether Chinese patients can benefit from these 3 courses of adjuvant chemotherapy. Are there any specific biomarkers that can predict the effect of chemotherapy and guide individualized therapy?

The team led by Professor Ma Jun, together with other 6 cancer centers including Fudan University Shanghai Cancer Center and Beijing Cancer Hospital, completed the biggest prospective randomized controlled clinical trial (508 cases) of locoregionally advanced nasopharyngeal carcinoma in the world. They found that the standard concurrent chemoradiotherapy plus adjuvant chemotherapy (3 courses of “cisplatin and fluorouracil”) is unable to improve survival after concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma. Meanwhile, the toxic effects are much heavier and patients are unable to suffer once the treatment extends three months more. On this basis, Professor Ma’s team combined with West China School of Medicine Sichuan University, analyzed 465 specimens of nasopharyngeal carcinoma by microRNA signatures and found out that a five-miRNA signature could help to predict treatment effect better.

The above research results have been published in the international authoritative journal The Lancet Oncology, (Lancet Oncol. 2012, 13:163-71 and 2012, 13:633-41). At the same time, the international counterparts commented that the study of optimal treatment for nasopharyngeal carcinoma provides the most reliable evidence. The results are also recommended and highlighted on the Nature China website. International assessment of the biomedical website “Faculty of Top 1000” confirmed that the study is within the top 2% medical literatures. After being published, the study was adopted as the clinical guideline by the European Association of Head and Neck Cancer, Radiotherapy Association and Chemical Therapy Association (Annals of Oncology 23 (Supplement 7): vii83–vii85, 2012 doi:10.1093/annonc/mds266).

The significance of the research lies in the avoidance of overtreatment on patients and effective use of medical resources. Also, it has laid the foundation for nasopharyngeal carcinoma individualized treatment and opened up a new thought on targeted drug development.