Nasopharyngeal carcinoma (NPC) remains a significant public health concern in China, with epidemiological data indicating rising incidence and mortality rates across advancing age groups. While multimodal treatment—including surgery, radiotherapy, and systemic therapy—forms the backbone of NPC management, patients with recurrent or metastatic disease who progress after standard therapies face limited therapeutic options. In recent years, advances in targeted and immuno-oncology approaches have expanded the treatment landscape, offering renewed hope for improved survival and quality of life.
A notable development is the approval of veboketumab injection (brand name: Meiyouheng), a novel epidermal growth factor receptor (EGFR)-targeting antibody–drug conjugate (ADC) developed by Lepu Biopharma. Meiyouheng is indicated specifically for adult patients with recurrent or metastatic NPC who have failed at least two prior lines of systemic chemotherapy and PD-1/PD-L1 inhibitor therapy—a population historically characterized by poor prognosis and few effective salvage options.
Veboketumab consists of a humanized anti-EGFR monoclonal antibody (JMT101) linked via a cleavable valine-citrulline (VC) linker to the potent microtubule-disrupting cytotoxic agent monomethyl auristatin E (MMAE). This design enables selective internalization into EGFR-expressing tumor cells, followed by intracellular payload release—maximizing antitumor activity while minimizing off-target toxicity compared with conventional cytotoxic chemotherapy.
Efficacy was demonstrated in a pivotal phase III randomized clinical trial enrolling 173 patients with heavily pretreated recurrent or metastatic NPC. Participants were assigned to receive either veboketumab (n=86) or investigator-selected chemotherapy (n=87). Results showed a statistically significant improvement in objective response rate (ORR) with veboketumab (30.2% vs. 11.5%; p<0.001), median progression-free survival (PFS) of 5.82 months versus 2.83 months (hazard ratio for progression or death: 0.63; p<0.001), and median overall survival (OS) of 17.08 months versus 11.99 months as of December 30, 2024.
From a safety perspective, veboketumab demonstrated a favorable tolerability profile. The incidence of treatment-emergent adverse events was comparable to that of chemotherapy, but grade ≥3 neutropenia occurred significantly less frequently (9.3% vs. 35.6%). Common adverse reactions included mild rash, anemia, and peripheral sensory neuropathy—generally manageable and rarely leading to treatment discontinuation. This improved safety margin supports sustained dosing and contributes to better patient-reported outcomes and quality of life.
While multiple branded injectable agents—including EGFR inhibitors, immune checkpoint inhibitors, and platinum-based chemotherapies—are integrated across different lines of NPC therapy, no single agent is universally optimal for all postoperative or relapsed patients. Treatment selection must be individualized based on prior regimens, biomarker status, performance status, and toxicity profiles. For patients exhausted of immunotherapy and chemotherapy options, veboketumab represents a clinically meaningful advancement—offering a biologically rational, evidence-based strategy to address the unmet need in late-line NPC management.