Becotatug vedotin delivers promising outcomes in patients with metastatic NAP

Treatment with the anti-epidermal growth factor receptor antibody-drug conjugate becotatug vedotin, compared with chemotherapy, results in significant improvements in objective response rate (ORR) and progression-free survival (PFS) among patients with heavily pretreated and immunotherapy-exposed recurrent or metastatic nasopharyngeal carcinoma (NPC), according to a study.

Researchers conducted this multicentre, open-label, randomized trial in patients with recurrent or metastatic NPC after failure to at least two lines of systemic therapies, including chemotherapy and PD-1/PD-L1 inhibitors. They randomly allocated 173 participants to receive becotatug vedotin 2.3 mg/kg every 3 weeks (n= 86) or chemotherapy (n=87; capecitabine or docetaxel).

The ORR was significantly higher in the becotatug vedotin group than the chemotherapy group (30.2 percent vs 11.5 percent; p=0.003).

Over a median follow-up of 7.39 months, becotatug vedotin correlated with a significant decrease in the risk of disease progression or death compared with chemotherapy (median PFS: 5.82 vs 2.83 months; hazard ratio [HR], 0.63, 95 percent confidence interval [CI], 0.43‒0.91; log-rank p=0.01).

The interim overall survival (OS) analysis revealed a median OS of 17.08 months with becotatug vedotin compared with 11.99 months with chemotherapy (HR, 0.73, 95 percent CI, 0.48‒1.12; log-rank p=0.015), with a median follow-up of 13.47 months. Both treatment regimens were safe and well tolerated.

“Among patients with heavily pretreated and immunotherapy-exposed recurrent or metastatic NPC, becotatug vedotin significantly improved ORR and PFS compared with chemotherapy, with comparable toxicity and encouraging but immature OS results,” the researchers said.

The coprimary endpoints were the independent review committee-confirmed objective response rate (ORR), progression-free survival (PFS), and overall survival (OS).