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DOI: 10.1055/a-2148-2429
Nasopharyngeal Carcinoma: Case Presentation and Literature Review of Treatment Innovation with Immunotherapy
Abstract
Nasopharyngeal carcinoma (NPC), a rare head and neck malignancy, arises from the epithelial lining of nasopharyngeal mucosa. The confluence of various risk factors, such as latent Epstein–Barr virus infection, genetic susceptibility, smoking, alcohol consumption, and high nitrosamine diet, is thought to contribute to NPC pathogenesis. Radiation therapy serves as the mainstay of treatment for early stage while concurrent chemotherapy and radiation are the basis of treatment for locoregional advanced disease with overall 80% five-year survival rate. Recurrent or metastatic disease pose treatment challenges as reirradiation, repeat cycles of chemotherapy, and surgery follow with high likelihood of treatment toxicity or postoperative morbidities. Typically reserved for nonresectable recurrent or metastatic disease, immunotherapy serves as novel treatment for NPC. NPC tumor microenvironment predominated by a dense infiltrate of immune cells hosts an ideal target for immunotherapy. Several clinical trials have investigated the efficacy of anti-programmed cell death protein 1 antibodies such as pembrolizumab, nivolumab, and camrelizumab with promising results. Treatment of recurrent and metastatic NPC remains a challenge; however, the advent of immunotherapy has provided additional options and potential for preventative and therapeutic measures.
Keywords
nasopharyngeal carcinoma - immunotherapy - nasopharynx - head and neck cancer - EBV - immune checkpoint inhibitors - recurrent disease - adoptive cell therapyPublikationsverlauf
Eingereicht: 12. Juli 2023
Angenommen: 01. August 2023
Accepted Manuscript online:
03. August 2023
Artikel online veröffentlicht:
03. Oktober 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Georg Thieme Verlag KG
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References
- 1 Chen YP, Chan ATC, Le QT, Blanchard P, Sun Y, Ma J. Nasopharyngeal carcinoma. Lancet 2019; 394 (10192): 64-80
- 2 Chen L, Hu CS, Chen XZ. et al. Adjuvant chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma: long-term results of a phase 3 multicentre randomised controlled trial. Eur J Cancer 2017; 75: 150-158
- 3 Kong L, Zhang Y, Hu C, Guo Y, Lu JJ. Effects of induction docetaxel, platinum, and fluorouracil chemotherapy in patients with stage III or IVA/B nasopharyngeal cancer treated with concurrent chemoradiation therapy: final results of 2 parallel phase 2 clinical trials. Cancer 2017; 123 (12) 2258-2267
- 4 Li W-F, Chen N-Y, Zhang N. et al. Concurrent chemoradiotherapy with/without induction chemotherapy in locoregionally advanced nasopharyngeal carcinoma: long-term results of phase 3 randomized controlled trial. Int J Cancer 2019; 145 (01) 295-305
- 5 Yang Q, Cao S-M, Guo L. et al. Induction chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: long-term results of a phase III multicentre randomised controlled trial. Eur J Cancer 2019; 119: 87-96
- 6 Hong RL, Hsiao CF, Ting LL. et al. Final results of a randomized phase III trial of induction chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in patients with stage IVA and IVB nasopharyngeal carcinoma-Taiwan Cooperative Oncology Group (TCOG) 1303 Study. Ann Oncol 2018; 29 (09) 1972-1979
- 7 Zou X, Han F, Ma WJ. et al. Salvage endoscopic nasopharyngectomy and intensity-modulated radiotherapy versus conventional radiotherapy in treating locally recurrent nasopharyngeal carcinoma. Head Neck 2015; 37 (08) 1108-1115
- 8 Chen MY, Wang SL, Zhu YL. et al. Use of a posterior pedicle nasal septum and floor mucoperiosteum flap to resurface the nasopharynx after endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma. Head Neck 2012; 34 (10) 1383-1388
- 9 Lee AWM, Ng WT, Chan JYW. et al. Management of locally recurrent nasopharyngeal carcinoma. Cancer Treat Rev 2019; 79: 101890
- 10 Wong KCW, Hui EP, Lo KW. et al. Nasopharyngeal carcinoma: an evolving paradigm. Nat Rev Clin Oncol 2021; 18 (11) 679-695
- 11 Hsu C, Lee SH, Ejadi S. et al. Safety and antitumor activity of pembrolizumab in patients with programmed death-ligand 1-positive nasopharyngeal carcinoma: results of the KEYNOTE-028 study. J Clin Oncol 2017; 35 (36) 4050-4056
- 12 Ma BBY, Lim WT, Goh BC. et al. Antitumor activity of nivolumab in recurrent and metastatic nasopharyngeal carcinoma: an international, multicenter study of the Mayo Clinic Phase 2 Consortium (NCI-9742). J Clin Oncol 2018; 36 (14) 1412-1418
- 13 Fang W, Yang Y, Ma Y. et al. Camrelizumab (SHR-1210) alone or in combination with gemcitabine plus cisplatin for nasopharyngeal carcinoma: results from two single-arm, phase 1 trials. Lancet Oncol 2018; 19 (10) 1338-1350
- 14 Chan ATC, Lee VHF, Hong RL. et al. Pembrolizumab monotherapy versus chemotherapy in platinum-pretreated, recurrent or metastatic nasopharyngeal cancer (KEYNOTE-122): an open-label, randomized, phase III trial. Ann Oncol 2023; 34 (03) 251-261
- 15 Tan LLY, Le QT, Lee NYY, Chua MLK. JUPITER-02 trial: advancing survival for recurrent metastatic nasopharyngeal carcinoma and next steps. Cancer Commun (Lond) 2022; 42 (01) 56-59
- 16 Mai HQ, Chen QY, Chen D. et al. Toripalimab or placebo plus chemotherapy as first-line treatment in advanced nasopharyngeal carcinoma: a multicenter randomized phase 3 trial. Nat Med 2021; 27 (09) 1536-1543
- 17 Wang B-C, Cao R-B, Fu C. et al. The efficacy and safety of PD-1/PD-L1 inhibitors in patients with recurrent or metastatic nasopharyngeal carcinoma: a systematic review and meta-analysis. Oral Oncol 2020; 104: 104640
- 18 Li W, Duan X, Chen X. et al. Immunotherapeutic approaches in EBV-associated nasopharyngeal carcinoma. Front Immunol 2023; 13: 1079515
- 19 Lin CL, Lo WF, Lee TH. et al. Immunization with Epstein-Barr virus (EBV) peptide-pulsed dendritic cells induces functional CD8+ T-cell immunity and may lead to tumor regression in patients with EBV-positive nasopharyngeal carcinoma. Cancer Res 2002; 62 (23) 6952-6958