Materiały źródłowe

• #1 Nasopharyngeal Cancer Treatment – NCI

  https://www.cancer.gov/types/head-and-neck/patient/adult/nasopharyngeal-treatment-pdq

  Nasopharyngeal cancer is a type of head and neck cancer that starts in the tissues of the nasopharynx. […] There are different types of treatment for people with nasopharyngeal cancer. […] The following types of treatment are used: Radiation therapy, Chemotherapy, Surgery. […] Treatment for nasopharyngeal cancer may cause side effects. […] Treatment of stage I nasopharyngeal cancer is usually radiation therapy to the tumor and lymph nodes in the neck. […] Treatment of stage II, III, and IVA (nonmetastatic) nasopharyngeal cancer may include: radiation therapy to the tumor and lymph nodes in the neck, chemotherapy given with radiation therapy, followed by more chemotherapy, chemotherapy followed by more chemotherapy given with radiation therapy, chemotherapy followed by radiation therapy (under study), surgery to remove lymph nodes if they still contain cancer cells after initial treatment. […] Treatment of stage IVB (metastatic) or recurrent nasopharyngeal cancer may include: intensity-modulated radiation therapy, stereotactic radiation therapy, or internal radiation therapy, surgery, chemotherapy.

• #2 Nasopharyngeal carcinoma – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nasopharyngeal-carcinoma/diagnosis-treatment/drc-20375535

  Treatment for nasopharyngeal carcinoma most often begins with radiation therapy or a mix of radiation and chemotherapy. […] You and your healthcare team work together to make a treatment plan. Several factors go into making the plan. These may include the stage of your cancer, your treatment goals, your overall health and the side effects you’re willing to have. […] Radiation therapy treats cancer with powerful energy beams. The energy can come from X-rays, protons or other sources. […] Radiation therapy for nasopharyngeal carcinoma most often involves external beam radiation. During this procedure, you lie on a table. A large machine goes around you. It sends radiation to the precise spot where it can target your cancer. […] For small nasopharyngeal carcinomas, radiation therapy may be the only treatment needed. For cancers that are larger or have grown into nearby areas, radiation therapy is typically combined with chemotherapy.

• #3 Treatment options for nasopharyngeal cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/nasopharyngeal-cancer/treatment/decisions

  Your doctor and healthcare team will talk to you about your treatment and the options you have. They will explain its benefits and the possible side effects. […] The most common treatments for nasopharyngeal cancer are: radiotherapy, chemotherapy with radiotherapy (chemoradiotherapy), chemotherapy on its own, and surgery. […] The treatment you have depends on: where your cancer is, its size and whether it has spread (the stage), the type of cancer, your general health and level of fitness. […] Radiotherapy is the main treatment for early or locally advanced nasopharyngeal cancer. You might have radiotherapy alone or with chemotherapy. Radiotherapy with chemotherapy is called chemoradiotherapy. […] For advanced nasopharyngeal cancer, you usually have chemotherapy. […] Surgery is usually only used if the cancer comes back after the original treatment.

• #4 Nasopharyngeal cancer

  https://www.nhs.uk/conditions/nasopharyngeal-cancer/

  If you’re diagnosed with nasopharyngeal cancer, you’ll be cared for by a team of different specialists who work together in a multidisciplinary team (MDT). […] The 2 main treatments for nasopharyngeal cancer are: […] radiotherapy where radiation is used to kill cancer cells […] chemotherapy where medicine is used to kill cancer cells. […] A combination of radiotherapy and chemotherapy is often used. […] Surgery isn’t usually used to treat nasopharyngeal cancer because it’s difficult for surgeons to access the affected area. […] Radiotherapy is the most commonly used treatment for nasopharyngeal cancer. […] It can be used on its own to treat very early-stage cancers, or in combination with chemotherapy for more advanced cancers. […] Most of the time, external radiotherapy is used.

• #5 Nasopharyngeal Carcinoma Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/head-and-neck/hp/adult/nasopharyngeal-treatment-pdq

  Treatment options for stage I nasopharyngeal carcinoma include the following: […] Radiation therapy is the initial treatment of nasopharyngeal carcinoma. High-dose radiation therapy is given to the primary tumor site and prophylactic radiation therapy is given to the bilateral regional lymph nodes in the neck. […] Treatment options for stages II, III, and IV nonmetastatic nasopharyngeal carcinoma include the following: Radiation therapy, Concurrent chemoradiation, Neoadjuvant chemotherapy and concurrent chemoradiation, Concurrent chemoradiation and adjuvant chemotherapy, Neoadjuvant chemotherapy followed by radiation therapy alone, Surgery, Chemotherapy (for patients with stage IVC disease). […] High-dose radiation therapy with chemotherapy is the initial treatment of nasopharyngeal carcinoma.

• #6 Nasopharyngeal Cancer: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/21661-nasopharyngeal-cancer

  Specific treatment depends on the stage of cancer. […] Nasopharyngeal cancer treatment may include: […] Radiation therapy. […] Chemotherapy. […] Chemoradiation (combination of chemotherapy and radiation). […] Targeted therapy. […] Surgery. In some instances, the tumor can be surgically removed. But because the nasopharynx is a difficult area to operate on, surgery usually isn’t the main treatment option. However, surgery is sometimes used to remove lymph nodes in your neck that haven’t responded to other treatments. […] Healthcare providers typically treat nasopharyngeal with radiation therapy or chemotherapy. Radiation and chemotherapy side effects may vary. If you’re being treated for nasopharyngeal cancer, you may want to consider palliative care to help you manage treatment side effects. […] NPC can be cured if healthcare providers diagnose the condition before it spreads. […] What are my treatment options?

• #7 Diagnosis and Therapy of Nasopharyngeal Carcinoma | IntechOpen

  https://www.intechopen.com/chapters/78042

  Nasopharyngeal carcinoma (NPC) is a malignancy with unique biological and clinical characteristics. It has highly associated with EpsteinBarr virus (EBV) infection and is sensitive to radiotherapy. […] Radiotherapy has been recognized as the first choice for NPC treatment. With the improvement of intensity-modulated radiation therapy (IMRT), the 5-year disease-specific survival rate in NPC patients at an early stage has reached 95%. However, the efficacy brought by radiotherapy has reached the bottleneck in advanced patients. Recently, the 5-year overall survival rate was increased around 60-80% in locoregionally advanced NPC patients by introducing concurrent chemoradiotherapy. In addition, molecular targeted therapy and immunotherapy have been introduced to many clinical trials. […] Most undifferentiated NPC is moderately sensitive to radiation therapy, leading it the first choice for NPC treatment. Taking advantage of accurate staging systems, modern radiotherapy techniques, and concurrent chemotherapy, the locoregional control and overall survival of NPC patients have substantially improved along with the decline of treatment-induced toxicity in the past two decades.

• #8 Treatments for nasopharyngeal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/nasopharyngeal/treatment

  If you have nasopharyngeal cancer, your healthcare team will create a treatment plan just for you. It will be based on your health and specific information about the cancer. When deciding which treatments to offer for nasopharyngeal cancer, your healthcare team will consider: […] The main treatment for stage 1 nasopharyngeal cancer is radiation therapy. […] The main treatment for stage 2 nasopharyngeal cancer is chemoradiation. […] The main treatment for stage 3 nasopharyngeal cancer is chemoradiation. […] The main treatments for stage 4 nasopharyngeal cancer include chemoradiation and chemotherapy. Radiation therapy may be offered. […] Recurrent nasopharyngeal cancer means that the cancer has come back (recurred) after it has been treated. […] Radiation therapy uses high-energy rays or particles to destroy cancer cells.

• #8 Treatments for nasopharyngeal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/nasopharyngeal/treatment

  Chemotherapy is the use of anti-cancer (cytotoxic) drugs to treat cancer. It is a systemic therapy that circulates throughout the body and destroys cancer cells, including those that may have broken away from the primary tumour. […] Surgery is rarely used to treat primary nasopharyngeal cancer. The anatomy and location of the nasopharynx make it difficult for surgeons to easily reach and completely remove these tumours. […] People with nasopharyngeal cancer should talk to their healthcare team about a follow-up plan that suits their individual situation.

• #9 Nasopharyngeal cancer

  https://www.nhs.uk/conditions/nasopharyngeal-cancer/

  In nasopharyngeal cancer, an advanced form of external radiotherapy called intensity-modulated radiation therapy (IMRT) is used. […] Stereotactic radiotherapy is another way of giving radiotherapy externally and may be used to target a specific area where the cancer has returned. […] Sometimes, internal radiotherapy may be needed if nasopharyngeal cancer has returned after initial treatment. […] Chemotherapy may be used before or alongside radiotherapy for more advanced nasopharyngeal cancers. […] Like radiotherapy, chemotherapy can cause a number of significant side effects, such as: […] You should discuss any concerns you have about the potential side effects of treatment with your care team before treatment begins. […] After your course of treatment ends, you’ll need to have regular follow-up appointments and scans to monitor your recovery and check for any signs of the cancer returning. […] More advanced cancers are treated with a combination of chemotherapy and radiotherapy. They’re often curable if the cancer hasn’t spread beyond the head and neck region.

• #10 Nasopharyngeal Carcinoma Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/head-and-neck/hp/adult/nasopharyngeal-treatment-pdq

  Most tumors are exclusively treated with external-beam radiation therapy. For some patients, radiation therapy may be boosted with intracavitary or interstitial implants, or by the use of stereotactic radiosurgery when clinical expertise is available and the anatomy is suitable. […] High-dose radiation therapy with chemotherapy is the initial treatment of patients with nasopharyngeal carcinoma for the primary tumor site and the neck. […] Selected patients with local recurrence may be retreated with moderate-dose external-beam radiation therapy (EBRT) using intensity-modulated radiation therapy, stereotactic radiation therapy, or intracavitary or interstitial radiation to the site of recurrence. […] In highly selected patients, surgical resection of locally recurrent lesions may be considered.

• #11 Nasopharyngeal Cancer Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/988165-treatment

  Radiotherapy is administered to the gross tumor volume (GTV) or disease in the primary site and neck adenopathy. The initial clinical target volume (CTV) includes the GTV and all sites of potential subclinical disease to a dose of 45-50.4 Gy at 1.8-2 Gy/fraction. […] It is anticipated that in most patients, levels I to V neck nodes are included in the initial CTV. For the boost CTV, the GTV with a margin is treated to a dose of 15-25 Gy. The total dose to the GTV usually ranges from 65-70 Gy. […] A randomized controlled trial compared the clinical outcomes of upper versus whole-neck prophylactic irradiation in the treatment of patients with node-negative nasopharyngeal carcinoma (NPC). The study concluded that prophylactic upper neck irradiation is sufficient for patients with node-negative NPC.

• #12 Radiation therapy for nasopharyngeal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/nasopharyngeal/treatment/radiation-therapy

  There are different types of external radiation therapy that may be used to treat nasopharyngeal cancer. […] Brachytherapy may be used to treat a small, early stage nasopharyngeal tumour or for nasopharyngeal cancer that comes back after external radiation therapy. It may also be given as a boost along with external radiation. […] Side effects of radiation therapy will depend mainly on the size of the area being treated, the specific area or organs being treated, the total dose of radiation, whether chemotherapy is given at the same time (chemoradiation) and the treatment schedule. Chemotherapy makes the radiation more effective in killing cancer cells, but it also makes the side effects from radiation worse.

• #13 Treatments – Cancer Institute | Northwell Health

  https://cancer.northwell.edu/cancer-care/nasopharyngeal-cancer/treatments

  TREATING NASOPHARYNGEAL CANCER […] At Northwell Health, we use leading-edge therapies and sophisticated surgical options to treat nasopharyngeal cancer.[…] Our multidisciplinary team of acclaimed head and neck cancer specialists is dedicated to your care and will create a treatment plan tailored to your specific needs. Because nasopharyngeal cancer (sometimes called nasopharyngeal carcinoma or NPC) is typically treated with multiple approaches like radiation therapy, chemotherapy, immunotherapy and sometimes even surgery, youll work closely with specialists in these disciplines throughout your treatment. Theyll collaborate continuously to ensure seamless coordination of your care.[…] We offer many therapies for the treatment of nasopharyngeal cancer. These include:[…] Radiation therapy: This is used to kill cancerous cells and shrink tumors, using advanced external-beam techniques like intensity-modulated radiation therapy to precisely target the cancer and spare surrounding healthy tissue. Sometimes an internal radiation therapy called brachytherapy is used for recurrent NPC. This treatment puts seeds of radioactive material close to the tumor for a very precise, long-lasting dose of radiation.[…] Chemotherapy: Chemotherapy uses powerful medications to kill or slow the growth of rapidly multiplying cancer cells. These drugs are usually given intravenously or orally but can be administered in other ways too.[…] Immunotherapy: A new class of drugs called immunotherapies may be recommended for the treatment of advanced or recurrent NPC. Immunotherapy boosts the bodys immune system so it can more effectively fight and destroy cancer cells.[…] Surgery: In some cases, a nasopharyngeal tumor may be surgically removed. However, because its difficult to operate on the nasopharynx, surgery isnt usually a recommended treatment.[…] Our team is here to guide you through every step of your treatment, with dedicated navigators to help answer questions and seamlessly integrate your care and support services. When youre dealing with cancer its good to be close to home, so we make every effort to treat you in one convenient location. When youre with us, we ensure that your care is anything but one-size-fits-all.[…] You may have an opportunity to take part in clinical trials to study promising new drugs, radiation technologies and surgical approaches.

• #14 Current Management Strategy of Nasopharyngeal Carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2848311/

  Nasopharyngeal carcinoma is an unique head and neck cancer. […] Radiotherapy with or without chemotherapy has been the primary treatment modality. […] The application of intensity modulated radiotherapy and the use of concomitant chemoradiation have improved the control of nasopharyngeal carcinoma together with the reduction of long term side effects. […] The choice of the optimal surgical salvage, either for neck disease or primary tumor depends on the extent of the residual or recurrent disease. […] Unlike other head and neck cancers, radiotherapy instead of surgery is the mainstay of treatment of NPC. NPC is highly radiosensitive and radiotherapy is the backbone of treatment for all stages of NPC without distant metastases. […] The major limitations of conventional 2D radiotherapy for NPC can now be overcome with 3 dimensional (3D) conformal radiotherapy and IMRT.

• #15 Radiation Therapy for Nasopharyngeal Cancer | NYU Langone Health

  https://nyulangone.org/conditions/nasopharyngeal-cancer/treatments/radiation-therapy-for-nasopharyngeal-cancer

  Doctors at NYU Langone typically use intensity modulated radiation therapy to manage nasopharyngeal cancer. […] Tailored to the size, shape, and location of the cancer, these minibeams enable doctors to deliver high doses of radiation to specific areas while avoiding nearby healthy tissue. […] Radiation therapy is delivered in fractions typically once daily, five days a week, for seven weeks. […] Physicians at NYU Langone’s Center for Advanced Radiosurgery may use stereotactic radiosurgery, which is also called Gamma Knife surgery, to manage small nasopharyngeal cancers that extend into the skull base. […] Gamma Knife surgery is an outpatient procedure and usually takes only a few hours to complete. […] Common side effects of radiation therapy for nasopharyngeal cancer include inflammation of the lining the mouth and nasopharynx, a stuffy nose, a sunburn-like change to the skin, changes in taste, difficulty swallowing, dry mouth, and temporary hair loss. […] An experimental test given before and after radiation therapy may help doctors determine how well the cancer is responding to treatment and decide which additional therapies may be needed. […] By measuring EBV levels in blood, doctors can also monitor nasopharyngeal cancer recurrence.

• #16 Nasopharyngeal Cancer Treatment (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65972/

  Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing by damaging their DNA. The way radiation therapy is given depends on the type and stage of the cancer. External and internal radiation therapy are used to treat nasopharyngeal cancer. […] Chemotherapy (also called chemo) uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy for nasopharyngeal cancer is usually systemic, meaning it is taken by mouth or injected into a vein or muscle. When given this way, the drugs enter the bloodstream and can reach cancer cells throughout the body. […] Surgery to remove the tumor is sometimes used for nasopharyngeal cancer that does not respond to radiation therapy. If cancer has spread to the lymph nodes, the doctor may remove lymph nodes and other tissues in the neck.

• #16 Nasopharyngeal Cancer Treatment (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65972/

  Treatment for nasopharyngeal cancer may cause side effects. […] New types of treatment are being tested in clinical trials. […] Follow-up care may be needed. […] Treatment of stage I nasopharyngeal cancer is usually radiation therapy to the tumor and lymph nodes in the neck. […] Treatment of stage II, III, and IVA (nonmetastatic) nasopharyngeal cancer may include: radiation therapy to the tumor and lymph nodes in the neck, chemotherapy given with radiation therapy, followed by more chemotherapy, chemotherapy followed by more chemotherapy given with radiation therapy, chemotherapy followed by radiation therapy (under study), surgery to remove lymph nodes if they still contain cancer cells after initial treatment. […] Treatment of stage IVB (metastatic) or recurrent nasopharyngeal cancer may include: intensity-modulated radiation therapy, stereotactic radiation therapy, or internal radiation therapy, surgery, chemotherapy.

• #17 Advances in systemic treatment for nasopharyngeal carcinoma – Tan – Chinese Clinical Oncology

  https://cco.amegroups.org/article/view/9596/html

  The optimal treatment of NPC involves a multidisciplinary approach. NPC (especially the endemic subtype) is a radiosensitive tumor, and as its deep-seated anatomic location limits a surgical approach, radiotherapy (RT) has been the mainstay and primary curative treatment modality. […] The development of concurrent chemoradiation (CRT) strategies has been important in improving treatment outcomes in locally advanced NPC, with no fewer than nine randomized clinical trials demonstrating that addition of concurrent chemotherapy during radiation leads to improved progression-free survival and response, and with overall survival (OS) benefit being demonstrated in the majority of trials. […] While there is established benefit from concomitant chemotherapy with RT, the role of adjuvant chemotherapy after CRT is uncertain.

• #18 Nasopharyngeal Cancer Treatment Options | American Cancer Society

  https://www.cancer.org/cancer/types/nasopharyngeal-cancer/treating/by-stage.html

  Treatment of nasopharyngeal cancer (NPC) is based largely on the stage (extent) of the cancer, but other factors are also important, such as your overall health and your personal preferences. […] The usual treatment for these early-stage cancers is radiation therapy aimed at the tumor. […] Most people with stage II (2) NPC get chemoradiation (chemotherapy given along with radiation therapy) to the nasopharynx and neck lymph nodes. […] People with stage III NPC are usually treated with chemotherapy first (sometimes called induction chemo) followed by chemoradiation to the nasopharynx and neck lymph nodes OR chemoradiation to the nasopharynx and neck lymph nodes sometimes followed by chemotherapy alone OR chemoradiation to the nasopharynx and neck lymph nodes. […] The usual treatment for Stage IVA (4A) or IVB (4B) NPC is chemo, often with cisplatin and one other drug.

• #19 Nasopharyngeal Cancer Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/988165-treatment

  Radiation therapy is the mainstay of treatment, with chemotherapy used in advanced cases. Concurrent cisplatin, 5-fluorouracil, and radiotherapy have been shown to improve survival. […] Sequential chemoradiotherapy with gemcitabine and cisplatin has been shown to improve survival in locoregionally advanced nasopharyngeal carcinoma. […] Many pediatric studies have used neoadjuvant chemotherapy followed by radiation therapy with improvement in local control or progression-free survival rates over radiotherapy alone. […] Toripalimab (Loqtorzi) is a programmed death receptor 1blocking antibody indicated for nasopharyngeal carcinoma (NPC). It gained approval as first-line treatment of metastatic or recurrently locally advanced NPC in combination with cisplatin and gemcitabine. Additionally, it is approved as monotherapy for treatment of recurrent, unresectable, or metastatic NPC with disease progression on or after platinum-containing chemotherapy.

• #20

  https://link.springer.com/article/10.1007/s11864-023-01083-2

  Nasopharyngeal carcinoma (NPC) is a rare malignancy, endemic in China, that is commonly diagnosed in locally advanced scenarios. Its pathogenesis is strongly associated with Epstein-Barr virus (EBV), an infection for which measuring EBV plasma DNA levels has helped as a prognostic factor guiding treatment options, including a stronger treatment in those with high titers. […] The local disease is treated with radiotherapy alone, preferentially intensity modulated radiotherapy. For locally advanced disease, the backbone treatment is concurrent chemoradiotherapy with the ongoing research dilemma being adding adjuvant chemotherapy or induction chemotherapy. […] The ongoing research is focused not only on identifying patients that will benefit from adjuvant or induction chemotherapy, but also on identifying the best chemotherapeutic regimen, regimen alternatives to diminish toxicity, the role that immune checkpoint inhibitors play, and the use of molecularly guided treatment targeting patients with NPC whether driven by EBV or tobacco and alcohol.

• #20

• #21

  https://link.springer.com/article/10.1007/s11864-023-01083-2

  Concurrent CRT is recognized as the backbone for treating locally advanced NPC as established by the phase III United States Intergroup 0099 trial led by Al-Sarraf et al., where patients received chemoradiation with cisplatin followed by adjuvant chemotherapy (AC) with cisplatin plus fluorouracil or RT alone. […] While it is well established that the backbone treatment for locally advanced NPC is CRT, questions regarding the addition of induction chemotherapy (IC) or adjuvant chemotherapy (AC) are the main objective of the research, coupled with the role of targeted therapies, predictive biomarkers, and reducing toxicity. […] The question regarding AC vs IC is the most debatable and studied aspect of the treatment of locoregionally advanced NPC. […] EBV-DNA levels have been demonstrated to be a determining factor in both IC (favoring those with high viral loads) and identifying patients in need of AC (favoring those with persistently elevated levels).

• #22 Treatment option of advanced nasopharyngeal carcinoma | CMAR

  https://www.dovepress.com/advanced-nasopharyngeal-carcinoma-current-and-emerging-treatment-optio-peer-reviewed-fulltext-article-CMAR

  Trials are underway for various uses of ICIs, including induction chemotherapy, postoperative treatment, and use in combination with chemoradiotherapy. […] Immunotherapy for NPC, an EBV-associated cancer, has been reported to have some efficacy with immunotherapy used in other EBV-associated cancers. […] Future changes in the treatment of NPC are expected to include risk classification based on plasma EBV-DNA levels and the development of personalized treatment with individual selection of timing and type of therapy. […] In NPC with locally advanced disease and lymph node metastases, concurrent CRT (CCRT) is the standard treatment. […] The addition of chemotherapy to RT was found to be the most effective factor for OS. […] The NCCN guidelines recommend that induction chemotherapy (ICT) or adjuvant chemotherapy (ACT) should be considered in high-risk cases with N1 or higher or T3 or higher.

• #23

  https://link.springer.com/article/10.1007/s11864-023-01083-2

  The standard regimen for IC consists of gemcitabine plus cisplatin. […] Even though gemcitabine+cisplatin is considered the preferred regimen, TPC and lobaplatin are acceptable alternatives for this population. […] Current research and the latest treatment advances in locally advanced NPC include induction vs adjuvant chemotherapy, which chemotherapeutic regimen, and the role of de-escalation.

• #24 Nasopharyngeal Cancer Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/988165-treatment

  Approval for first-line treatment was supported by results of the phase 3 JUPITER-02 trial (n = 289). Patients were randomly assigned 1:1 to either toripalimab or placebo on a background of cisplatin and gemcitabine, followed by toripalimab or placebo continuation. Significantly longer progression-free survival (PFS) was observed with toripalimab (11.7 months) compared with placebo (8 months) (P = .0003). Additionally, at the time of analysis, a 40% reduction in risk of death was reported with toripalimab vs placebo. […] The POLARIS-02 trial (n = 190) demonstrated the efficacy of toripalimab as a single agent in patients with unresectable or metastatic NPC who had received prior platinum-based chemotherapy or had progressed within 6 months of neoadjuvant, adjuvant, or chemoradiation therapy. The overall response rate was 20.5%, with median duration of response 12.8 months, median PFS 1.9 months, and median overall survival 17.4 months.

• #25 Understanding Treatment Options in Nasopharyngeal Carcinoma

  https://www.targetedonc.com/view/understanding-treatment-options-in-nasopharyngeal-carcinoma

  Deborah Wong, MD, PhD, discusses therapeutic options for patients with nasopharyngeal carcinoma. […] Standard treatment involves induction chemotherapy with gemcitabine and cisplatin followed by chemotherapy with radiation, curing many patients, according to Wong. […] For those not recently exposed to platinum-based therapies, the standard of care includes gemcitabine, cisplatin, and the anti-PD-1 immunotherapy toripalimab-tpzi (Loqtorzi), to manage or potentially cure metastatic cases. […] In that setting, the standard treatment is usually to treat with induction chemotherapy with gemcitabine and cisplatin. Following induction chemotherapy, patients receive chemotherapy concurrence with radiation. […] A good number of patients will be cured with this approach. However, some patients will unfortunately relapse and develop a recurrent or metastatic disease.

• #26 Treatment strategy for de novo metastatic nasopharyngeal carcinoma: a literature review – Liu – Chinese Clinical Oncology

  https://cco.amegroups.org/article/view/116796/html

  Given the diversity of metastatic NPC, a multimodality approach incorporating chemotherapy, immunotherapy, locoregional radiation and ablative treatment to metastatic sites has been shown to improve overall control. Further research is needed to determine the efficacy and optimal duration of maintenance therapy. […] The preferred first-line chemotherapy regimen recommended by NCCN guideline, was based on a phase III randomized controlled trial demonstrated that GP was superior to the traditional regimen of PF in 2016. […] Two recent randomized phase III trials (JUPITER-02 and CAPTAIN-1st) further demonstrated an improvement in PFS when anti-PD-1 immune checkpoint inhibitors (toripalimab or camrelizumab) were added to first-line treatment with GP, followed by maintenance immunotherapy. […] We recommend adding a PD-1 inhibitor to chemotherapy every 3 weeks for up to six cycles, followed by maintenance therapy with a PD-1 inhibitor as first-line treatment for eligible patients with de novo metastatic NPC.

• #27 Nasopharyngeal carcinoma – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nasopharyngeal-carcinoma/diagnosis-treatment/drc-20375535

  Sometimes, surgery may be used to remove cancer from the nasopharynx. Or it might treat cancer that comes back after having radiation or chemotherapy. To get to the cancer, a surgeon may make a cut in the roof of the mouth or in the face near the nose. Sometimes the surgeon can remove the cancer using special surgical tools that go through the nose.

• #28 Surgical treatment of nasopharyngeal carcinoma

  https://www.oaepublish.com/articles/2574-1225.2023.124

  Surgery is preferred over re-irradiation in specific situations where it becomes the first-line treatment. This includes cases where patients experience severe radiation-induced complications, such as osteoradionecrosis, making additional radiation risky. Surgery is also favored for localized, resectable recurrences (e.g., rT1-rT2) without distant metastasis, as it can achieve better local control. When patients have reached the maximum safe radiation dose yet still experience recurrence, surgery can offer effective management with fewer severe side effects. Additionally, in tumors located near critical structures or those less responsive to radiation (e.g., nasopharyngeal adenocarcinoma), surgery allows for precise removal and minimizes damage to surrounding tissues. […] Surgical intervention remains instrumental in managing NPC. According to the guidelines set forth by the National Comprehensive Cancer Network (NCCN), surgical resection is the preferred treatment for locally recurrent NPC. The indications for surgery encompass a range of clinical scenarios: primary well-differentiated squamous cell carcinoma (stages T1-T3, and selectively, T4), nasopharyngeal adenocarcinoma, locally recurrent resectable NPC (rT1-rT3, and select rT4 cases), and recurrent neck lymph nodes. Notably, Liu et al. suggested that for early-stage primary NPC (T1), minimally invasive surgical resection alone can rival radiotherapy in terms of survival outcomes while inflicting fewer adverse effects. However, these findings should be interpreted with caution due to the lack of a prospective randomized control in the study. The applicability of surgical intervention in early undifferentiated squamous cell carcinoma remains a subject of ongoing research. For patients suffering from skull base osteonecrosis after nasopharyngeal radiotherapy, endoscopic debridement has been identified as an efficacious management strategy.

• #29 Treatment of Recurrent Nasopharyngeal Carcinoma: A Sequential Challenge

  https://www.mdpi.com/2072-6694/14/17/4111

  Treatment of Recurrent Nasopharyngeal Carcinoma: A Sequential Challenge […] Recurrent nasopharyngeal carcinoma is one of the major causes of death among NPC patients. However, there are no international guidelines for the treatment of patients with recurrent NPC now. In this article, we summarize past publications on clinical research and mechanistic studies related to recurrent NPC, combined with the experience and lessons learned by our institutional multidisciplinary team in the treatment of recurrent NPC. We propose an objective protocol for the treatment of recurrent NPC. […] For recurrent NPC, the main treatment options currently include surgical resection and re-irradiation with or without chemotherapy, while chemotherapy alone is generally recommended only for patients who are unable to undergo surgical resection or who cannot tolerate secondary radiation therapy. For resectable recurrent NPC, the 2- and 5-year OS rates for salvage nasopharyngectomy ranged from 48.6% to 100.0% and 38.3% to 88.9%, respectively. If re-radiation was performed, the 2- and 5-year survival rates were 44.3–77.7% and 27.5–57.2%, respectively. It is clear that the prognosis in recurrent patients is poor compared to that in primary cases, regardless of the treatment modality applied.

• #30 Nasopharyngeal Cancer – Head and Neck Cancer Australia

  https://www.headandneckcancer.org.au/types-of-head-neck-cancer/nasopharyngeal-cancer/

  Chemotherapy is usually given during radiation therapy for advanced stage cancers to help the radiation therapy work better. This is called concurrent chemoradiation. […] Surgery for Nasopharyngeal Cancer is not common because the area is difficult to get to and it is close to important nerves and blood vessels. […] Surgery may be needed, if the cancer returns after previous treatment with radiation therapy.

• #31 Surgical treatment of nasopharyngeal carcinoma

  https://www.oaepublish.com/articles/2574-1225.2023.124

  Endoscopic nasopharyngectomy has emerged as a primary technique for nasopharyngeal cancer treatment. This procedure focuses on the precise removal of tumors within the nasopharynx, behind the nasal septum, and within the sphenoid sinus, using the accuracy afforded by nasal endoscopy. […] Endoscopic nasopharyngectomy is particularly suitable for patients with early-stage recurrent NPC (rT1-rT2) and primary NPC (T1-T2) that are confined to the nasopharynx or parapharyngeal space without invasion of critical structures such as the skull base or internal carotid artery. It is also recommended for patients with nasopharyngeal adenocarcinoma who are not ideal candidates for radiotherapy due to contraindications or preference for a less invasive approach. […] Compared to traditional open surgical techniques, endoscopic nasopharyngectomy proffers an array of advantages, including reduced invasiveness, no facial cosmetic concerns, a lower risk of damage to critical vascular and neural structures, improved accuracy in identifying tumor margins, and better patient survival outcomes.

• #32 Treatment of Recurrent Nasopharyngeal Carcinoma: A Sequential Challenge

  https://www.mdpi.com/2072-6694/14/17/4111

  Re-irradiation is a very important treatment for recurrent NPC, but it is also accompanied by difficulties and challenges. The difficulty lies in the fact that the re-irradiation dose is difficult to control due to the toxic side effects after the initial treatment, and the dose must be tuned to achieve the effective dose value while minimizing the toxic effects after radiotherapy. […] With the development of surgical techniques and the increased understanding of the anatomy of the eustachian tube region by otolaryngologists, surgical resection of the tumor has become another important option for the treatment of recurrent NPC. Surgical approaches include open surgical approaches such as transoral and maxillary external rotation and endoscopic transnasal approaches. […] Chemotherapy is one of the most classical treatment modalities for malignant tumors, and depending on the type of tumor, chemotherapy can play a “leading” or “supporting” role in the treatment process. For primary NPC, radiotherapy with chemotherapy is almost the accepted treatment modality, but the “role” of chemotherapy in the treatment of recurrent NPC is still debatable.

• #33 Surgical treatment of nasopharyngeal carcinoma

  https://www.oaepublish.com/articles/2574-1225.2023.124

  Open surgery is indicated for patients with locally advanced or recurrent NPC where endoscopic approaches are not feasible, such as when the tumor involves the carotid artery, the cavernous sinus, or extensive soft tissue structures. […] The maxillary swing approach is a leading open surgical procedure for the resection of NPC. This procedure involves making an incision and performing osteotomies on the ipsilateral maxilla, which is then delicately swung outwards, providing access to the tumor. […] The hard palate approach is an operative technique used for resecting nasopharyngeal tumors. This procedure provides access to the nasopharynx through an incision in the hard palate of the oral cavity, facilitating excision of tumors localized in this area. […] The pterygopalatine fossa approach is a surgical strategy invoked for the excision of nasopharyngeal tumors. This approach accesses the nasopharynx via the maxillary sinus, obviating the necessity for external incisions and offering a direct conduit for tumor excision.

• #34 Surgical treatment of nasopharyngeal carcinoma

  https://www.oaepublish.com/articles/2574-1225.2023.124

  The infratemporal fossa approach is a surgical technique devised for the resection of nasopharyngeal tumors. This method provides access to the nasopharynx by navigating through the infratemporal fossa, a complex anatomical region located beneath the skull base, bordered by the maxilla and temporal bone. […] For patients with locally recurrent neck lymph node metastasis of NPC following radiotherapy, surgical intervention becomes a viable consideration. […] The evolution of head and neck surgery has been markedly influenced by robot-assisted resection, especially with the integration of transoral robotic surgery (TORS) for salvage nasopharyngectomies in recurrent NPC cases. […] Surgical treatment of locally recurrent NPC has shown promising outcomes, with 5-year survival rates generally ranging from 63% to 77.1%. For nasopharyngeal adenocarcinoma, the 5-year survival rate is around 57.1%.

• #35 Surgical treatment of nasopharyngeal carcinoma

  https://www.oaepublish.com/articles/2574-1225.2023.124

  In the management of recurrent nasopharyngeal neoplasms, surgical resection is increasingly favored when practicable. This preference is due to its potential for greater efficacy and reduced side effects compared to radiotherapy. Modern surgical paradigms are steadily gravitating towards minimally invasive techniques in nasopharyngectomy, emphasizing approaches such as TORS and 3D high-definition endoscopic nasopharyngectomy.

• #36 Treatment of Recurrent Nasopharyngeal Carcinoma: A Sequential Challenge

  https://www.mdpi.com/2072-6694/14/17/4111

  Regardless of the treatment modality, it is inevitable that patients with recurrent nasopharyngeal cancer will experience adverse symptoms after treatment, but oncologists and otolaryngologists should minimize the occurrence of fatal complications such as nasopharyngeal hemorrhage. The summary of the complications after treatment of recurrent NPC in the past 10 years made it clear that certain complications such as nasopharyngeal necrosis, osteonecrosis, and bleeding cannot be avoided regardless of IMRT or endoscopic surgical treatment. […] The diagnosis, treatment, and post-treatment management of recurrent NPC pose a current challenge for oncologists and otolaryngologists. Thus, clinicians need to weigh the benefits and drawbacks of various treatment approaches for patients. For the treatment of recurrent NPC, the best approach is to develop a relatively standard and industry-approved treatment plan through a joint evaluation of the patient by the oncologist and otolaryngologist.

• #37 Immunotherapy for recurrent or metastatic nasopharyngeal carcinoma | npj Precision Oncology

  https://www.nature.com/articles/s41698-024-00601-1

  Immunotherapy, particularly immune checkpoint inhibitors (ICIs), such as anti-programmed death 1/programmed death-ligand 1 (PD-1/PD-L1) therapy, has emerged as a pivotal treatment modality for solid tumors, including recurrent or metastatic nasopharyngeal carcinoma (R/M-NPC). […] This current review underscores the potential of immunotherapy as a valuable adjunct to the treatment paradigm for R/M-NPC patients. […] Further research is warranted to enhance the efficacy of immunotherapy through the implementation of strategies such as combination therapies and overcoming immune suppression. […] Additionally, the development of a biomarker-based scoring system is essential for identifying suitable candidates for precision immunotherapy. […] Patients with recurrent or metastatic NPC (R/M-NPC) are typically recommended to receive platinum-based chemotherapy as the first-line treatment. […] Immunotherapy has emerged as a transformative approach to cancer treatment, revolutionizing strategies for various types of cancer. […] In this review, we will focus on clinically approved immunotherapy regimens for R/M-NPC therapy and discuss novel immunotherapy strategies, challenges, and future directions for Immunotherapy combination strategies in R/M-NPC.

• #38 Treatment of recurrent and metastatic nasopharyngeal carcinoma – UpToDate

  https://www.uptodate.com/contents/treatment-of-recurrent-and-metastatic-nasopharyngeal-carcinoma

  Treatment of recurrent and metastatic nasopharyngeal carcinoma […] The treatment of recurrent and metastatic NPC is presented here. […] Prolonged survival is possible in patients who are carefully selected and appropriately treated. […] Initial therapy includes Gemcitabine plus cisplatin, with rationale for the addition of immunotherapy and alternative options for immunotherapy. […] Subsequent therapy involves choosing between immunotherapy and chemotherapy, including checkpoint inhibitor immunotherapy options like Pembrolizumab, Nivolumab, and Toripalimab. […] Is there a role for maintenance therapy? […] Consolidation with radiation therapy is also considered.

• #39 Immunotherapy for recurrent or metastatic nasopharyngeal carcinoma | npj Precision Oncology

  https://www.nature.com/articles/s41698-024-00601-1

  Several studies have suggested a close association between elevated PD-L1 on NPC tumor cells and poor prognosis among patients undergoing traditional radiotherapy and chemotherapy. […] This suggests that anti-PD-1/PD-L1 therapy could be a promising treatment approach and a means to improve patients prognosis. […] In recent years, the emergence of PD-1 antibodies has presented a promising avenue for immunotherapeutic intervention in the management of R/M-NPC. […] In conclusion, the progress in PD-1 monoclonal antibody development has provided further clinical benefits for R/M-NPC. […] However, due to the significant heterogeneity within the TIME, PD-1 blockade therapy may only benefit a limited proportion of R/M-NPC patients, and there is a lack of effective biomarkers to screen the most suitable candidates. […] This highlights the need for novel immunotherapeutic strategies to improve patient survival.

• #40 Nasopharyngeal Cancer Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/988165-treatment

  Nivolumab (Opdivo) was approved by the US Food and Drug Administration (FDA) for recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN) with disease progression on or after a platinum-based therapy. Nivolumab is a monoclonal antibody that inhibits PD-1 and blocks interaction between PD-1 and its ligands, PD-L1 and PD-L2. […] FDA approval for this indication was based on the phase 3 CheckMate-141 trial, in which nivolumab significantly improved overall survival compared with the comparator (investigator’s choice of methotrexate, docetaxel, or cetuximab). Median overall survival was 7.5 months for nivolumab compared with 5.1 months for investigator’s choice (hazard ratio, 0.70; P = .0101), and estimated 1-year survival rate were 36% with nivolumab vs 16.6% with investigator’s choice.

• #41 List of 7 Nasopharyngeal Carcinoma Medications Compared

  https://www.drugs.com/condition/nasopharyngeal-carcinoma.html

  Nasopharyngeal carcinoma is a type of squamous cell carcinoma of the epithelial tissue of the nasopharynx, which is a small, tubular structure above the soft palate that connects the nose to the oropharynx. […] Treatment for nasopharyngeal carcinoma is usually radiotherapy, with the addition of chemotherapy for advanced-stage disease. […] Loqtorzi (toripalimab-tpzi) is the first FDA-approved treatment for the treatment of nasopharyngeal carcinoma. It is a next-generation, programmed death receptor-1 (PD-1) monoclonal antibody that works by blocking the PD-1 ligands PD-L1 and PD-L2 with high potency at a unique site on the PD-1 receptor, enabling the immune system to activate and kill the tumor.

• #42 Is Nasopharyngeal Cancer Curable? Stages, Symptoms & Treatment

  https://www.medicinenet.com/is_nasopharyngeal_cancer_curable/article.htm

  Immunotherapy: Boosts your immune cells to fight cancer cells. Loqtorzi (toripalimab) with cisplatin and gemcitabine is the first and only immunotherapy drug approved by the Food and Drug Administration (FDA) for the initial treatment of NPC, for people with NPC that has come back (recurred) or spread to other parts of the body (metastatic). It is also approved for recurrent or metastatic NPC that has gotten worse on or after standard chemotherapy.

• #43 Advances in targeted therapy mainly based on signal pathways for nasopharyngeal carcinoma | Signal Transduction and Targeted Therapy

  https://www.nature.com/articles/s41392-020-00340-2

  Nasopharyngeal carcinoma (NPC) is a malignant epithelial carcinoma of the head and neck region which mainly distributes in southern China and Southeast Asia and has a crucial association with the EpsteinBarr virus. […] To tackle the challenges including local recurrence and distant metastasis in the current NPC treatment, we discussed the implication of using targeted therapy against critical molecules in various signal pathways, and how they synergize with chemoradiotherapy in the NPC treatment. […] Combination treatment including targeted therapy and IMRT or concurrent chemoradiotherapy is presumably to be future options, which may reduce radiation or chemotherapy toxicities and open new avenues for the improvement of the expected functional outcome for patients with advanced NPC. […] Targeted therapy involves the design of specific drugs that bind specifically to oncogenic targets within tumor cells to inhibit the development of tumors.

• #44 Advances in targeted therapy mainly based on signal pathways for nasopharyngeal carcinoma | Signal Transduction and Targeted Therapy

  https://www.nature.com/articles/s41392-020-00340-2

  In recent years, NPC patients receiving chemoradiotherapy have a poor quality of life, along with severe side effects such as bone suppression. […] However, targeted therapy can accurately identify and treat NPC cells with low toxic and side effects, suggesting a broad prospect of targeted therapy in the clinical treatment of NPC. […] In this article, we reviewed crucial molecules in signal pathways and miRNAs/lncRNAs in NPC cells studied in recent five years, regarding their roles in the promotion or suppression of NPC and functions as potential therapeutic targets of this disease. […] The order of descriptions below corresponds to the depth of the last five years of research. […] The activation of the PI3K/Akt pathway is also related to EBV-encoded latent membrane proteins 1, 2A, 2B.

• #45 Advances in targeted therapy mainly based on signal pathways for nasopharyngeal carcinoma | Signal Transduction and Targeted Therapy

  https://www.nature.com/articles/s41392-020-00340-2

  Recent studies provide a basis for the selection of potential targets for targeted therapy of NPC. […] In summary, in addition to directly targeted inhibition of PI3K, Akt, and mTOR, targeted inhibition of HIF-1, MK2, CCND1, lncRNA FAM225A, MYH9, MDK, miR-92a, miR-18a, EBV-miR-BART7-3p, FGF2, COL1A1, RBM3, PNUTS, Annexin A1, IL-8, CDKN3, c-Src, Flot-2, EpCAM, OCT4, BEX3, and targeted activation of LZTS2, UBQLN1, SMG1 may become potential therapeutic strategies that affecting the PI3K/Akt pathway in NPC. […] For the p53 pathway, targeted inhibition of MDM2, COX-2, MYH9, Bmi-1, miR-125a, and miR-125b may become potential therapeutic strategies in NPC. […] The NF-B pathway can also be combined with immunotherapy. […] To sum up, the targeted inhibition of p65, LMP1, IKK, CDH6, Pim1, BST2, NEAT1, and the targeted activation of SIRT6, DLC-1, TNFAIP3, RERG, NKG2DLs in the targeted therapy of NPC could be a potential therapeutic strategy through the NF-B pathway.

• #46 Nasopharyngeal Cancer Symptoms, Causes & Treatments

  https://www.cancercenter.com/cancer-types/head-and-neck-cancer/types/nasopharyngeal-cancer

  Nasopharyngeal cancer treatment depends on the stage at which it’s diagnosed. The earlier, the better, for both survival rates and treatment options. Early stages may be treated with radiation therapy, which uses high-energy waves to damage and destroy cancer cells. […] More advanced stages of nasopharyngeal cancers are treated with chemotherapy in addition to radiation. Chemotherapies are drugs that are specifically designed to attack and damage fast-growing cells in the body, including cancer cells. The most common chemotherapy used for nasopharyngeal cancers is cisplatin, which is sometimes given alongside fluorouracil (5FU). If the tumor has spread, two or more chemotherapy drugs may be given together. […] Other treatments that may be used include immunotherapies, which are drugs that turn the immune system against cancer cells. The immunotherapies Keytruda (pembrolizumab) and Opdivo (nivolumab) are used for NPCs that have returned or spread after treatment. […] Doctors may also recommend surgery to remove potentially cancerous lymph nodes if the cancer has spread. A targeted drug, Erbitux (cetuximab), which specifically attacks cells by targeting epidermal growth factor receptors, may be used as well.

• #47 Advances in targeted therapy mainly based on signal pathways for nasopharyngeal carcinoma | Signal Transduction and Targeted Therapy

  https://www.nature.com/articles/s41392-020-00340-2

  However, in the practical application, the clinical effect of conventional methods is limited as a result of the severe side effects. […] Li et al. studied the combination of bevacizumab and radiotherapy and chemotherapy and found that this combination treatment had a higher disease relief rate and a lower incidence of side effects, which can be used for further clinical experimental research. […] In clinical trials, the effect of targeted drugs alone is not good, whose PFS is generally less than one year, while targeted drugs combined with chemotherapy or radiotherapy can significantly delay the progress of the tumor, with a great improvement of PFS and OS.

• #48 Precision medicine in nasopharyngeal carcinoma: comprehensive review of past, present, and future prospect | Journal of Translational Medicine | Full Text

  https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-023-04673-8

  The clinical trials are ongoing to further investigate the potential of targeted therapies, both as standalone treatment and in combination with other therapies. […] Precision medicine is a logical approach when a more personalized treatment is desired. […] In this case, genome mapping and in-depth exploration of the molecular aberrations across the individual or subset of NPC patients are required to discover effective and reliable biomarker in order to develop suitable targeted therapy or to make informed decision of using different combinations and sequences of currently available therapies for subsets of patients. […] To achieve this goal, having efficient and reliable biomarkers for precise screening, and treatment targets is of paramount importance. […] The different stages of NPC are determined based on the tumor, node, and metastasis (TNM) system which is also a fundamental system for treatment decisions.

• #49 Immunotherapy for recurrent or metastatic nasopharyngeal carcinoma | npj Precision Oncology

  https://www.nature.com/articles/s41698-024-00601-1

  Adoptive immune cell therapy, mainly targeting DCs, is well-tolerated in patients with NPC and has shown promising immune responses and clinical benefits. […] The administration route for DC vaccines varies; however, intranodal injection of DCs has demonstrated the ability to induce a more potent T cell anti-tumor immunity compared to intravenous or subcutaneous injection. […] However, there are some uncertainties in the detection of vaccine-induced anti-tumor responses. […] In conclusion, immunotherapy, particularly ICIs, has proven its therapeutic efficacy in the treatment of R/M-NPC. […] Furthermore, adoptive immune cell therapy has exhibited promising therapeutic potential and merits continued investigation in clinical settings.

• #50 Nasopharyngeal Cancer Program | Stanford Cancer Institute

  https://med.stanford.edu/cancer/research/nasopharyngeal-cancer-program.html

  Dr. Beadle is a radiation oncologist who specializes in the treatment of patients with head and neck cancer. […] Her research is devoted to using advanced technologies to improve cancer outcomes and minimize side effects for patients diagnosed with NPC. […] Dr. Hwang specializes in endoscopic approaches to tumors of the nasopharynx, sinuses and skull base. His research includes outcomes of surgical treatment of recurrent NPC, and management of chronic sinusitis complications of NPC treatment. […] Dr. Weng’s basic research interest is immunotherapy for cancer, with two components: tumor specific targeting therapy and allogeneic transplant. […] He is currently working on new strategies to target patient-specific tumor using antibody along with effector cells. […] He is institutional principal investigator of a clinical trials for allogeneic T- cell immunotherapy for patients with EBV- related cancers, including NPC. […] Dr. West’s research includes identification of novel markers in tumors for diagnosis, prognosis and prediction of therapeutic response in cancer.

• #51 Treatment options for nasopharyngeal cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/nasopharyngeal-cancer/treatment/decisions

  Radiotherapy on its own can cure most early stage nasopharyngeal cancers. […] You might have chemotherapy if the nasopharyngeal cancer has spread to the lymph nodes in your neck, spread to other parts of your body, such as the lungs or bones, or come back after treatment (recurred). […] Having chemotherapy and radiotherapy at the same time is called chemoradiotherapy. […] Surgery is not a common treatment for nasopharyngeal cancer. […] You might have immunotherapy for some types of nasopharyngeal cancer that has come back or spread to other parts of the body. […] The stage shows the size of the cancer and whether it has spread. It helps your doctor decide on what treatment they offer you. […] Radiotherapy is the main choice of treatment for stage 1 nasopharyngeal cancers. […] For stage 2 nasopharyngeal cancers you might have: radiotherapy to the tumour and the lymph nodes in your neck, chemoradiotherapy.

• #52 Diagnosis and Therapy of Nasopharyngeal Carcinoma | IntechOpen

  https://www.intechopen.com/chapters/78042

  NPC is relatively sensitive to ionizing radiation, and radiation therapy (RT) is the mainstay modality of curative-intent treatment for patients with the non-disseminated disease. The 5-year disease-specific survival rate in stage I NPC is now expected to be around 95% with IMRT alone. By introducing concurrent chemoradiotherapy to patients with locoregionally advanced diseases, the 5-year overall survival rate was around 60-80% recently. Researchers are making exploratory effects on molecular-targeted medicine and immunotherapy in the treatment of NPC. […] The ideal modality of RT should fully cover the complex-shaped gross tumor with high doses needed for eradication while providing maximum sparing for adjacent organs. […] While stage I NPC is treated by IMRT alone with little doubt, locoregionally advanced disease (stage II to stage IVB) requires the combination of chemotherapy with comprehensive consideration.

• #53

  https://link.springer.com/article/10.1007/s11864-023-01083-2

  Much is yet to be done, but the prognosis and management of NPC patients have changed drastically, offering precise treatment methods and excellent control of the disease, even in locally advanced scenarios. […] Local disease, classified as early stage I disease, encompasses patients with a tumor limited to the nasopharynx, or adjacent oropharynx, nasal cavity, without parapharyngeal involvement (T1), and no lymph node (N0) or distant metastasis (M0). Treatment at this stage has had limited advances regarding management, as international consensus establishes treatment with radiation therapy (RT) alone, as they are radiosensitive, have a limited surgical approach, and RT achieves excellent local control. […] IMRT must be the preferred mode, as mentioned previously. However, for locally advanced diseases, RT alone is not an option, as treatment must include concurrent chemoradiotherapy (CCRT).

• #54 Treatment options for nasopharyngeal cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/nasopharyngeal-cancer/treatment/decisions

  For stage 3 and stage 4A nasopharyngeal cancers, you might have: chemotherapy before chemoradiotherapy, chemoradiotherapy on its own, radiotherapy to the tumour and the lymph nodes in your neck. […] Your doctor might suggest treatment with chemotherapy or radiotherapy or both for nasopharyngeal cancer that has spread to other parts of the body. […] The treatment you might have for nasopharyngeal cancer that has come back depends on where in your body the cancer is. […] You might have to make further choices as your situation changes. […] You may decide not to have cancer treatments, such as chemotherapy. But you can still have medicines to help control symptoms, such as sickness, breathlessness or pain. […] Your doctor might ask if you’d like to take part in a clinical trial. […] A second opinion means seeing another GP or specialist doctor.

• #55 Treatment strategy for de novo metastatic nasopharyngeal carcinoma: a literature review – Liu – Chinese Clinical Oncology

  https://cco.amegroups.org/article/view/116796/html

  Nasopharyngeal carcinoma (NPC) with de novo distant metastasis (M1) is classified as stage IVB in the 8th edition of the staging system jointly adopted by the American Joint Committee on Cancer and the International Union against Cancer Control. […] This review discusses the personalized and intensified treatment strategies for de novo metastatic NPC. […] Recent advancements have brought new hope for this otherwise incurable condition. In the era of immunotherapy, checkpoint inhibitors have become the first-line systemic treatment for metastatic NPC in JUPITER-02, CAPTAIN-1st, and RATIONALE-309. Additionally, the value of radical locoregional radiation therapy and ablative treatment to distant metastatic sites should not be overlooked in patients with de novo metastatic diseases. Locoregional radiation with concurrent chemotherapy, maintenance chemotherapy, and radical local treatment to metastatic sites are emerging as potential treatment options.

• #56 Understanding Treatment Options in Nasopharyngeal Carcinoma

  https://www.targetedonc.com/view/understanding-treatment-options-in-nasopharyngeal-carcinoma

  For those patients who have not received gemcitabine and cisplatin recently, within the past 6 months or so, those patients are considered platinum sensitive, and the standard of care would be to treat with a combination of gemcitabine and platinum [chemotherapy], along with toripalimab, which is an antiPD-1 immunotherapy.

• #57 Treatment strategy for de novo metastatic nasopharyngeal carcinoma: a literature review – Liu – Chinese Clinical Oncology

  https://cco.amegroups.org/article/view/116796/html

  The natural course of patients with metastatic NPC is commonly perceived as governed by distant disease, and the primary treatment has been palliative systemic therapy. Increasing evidence suggests that LRRT contributes to improved clinical outcomes in patients who responded well to chemotherapy. […] Therefore, we recommend the use of 46 cycles of induction systemic therapy followed by LRRT with a radical dose of 6670 Gy, preferably with concurrent chemotherapy if patients tolerance allowed, in those who responded well to induction chemotherapy (undetectable EBV DNA or CR/PR) or those with oligometastases. […] Treatment for de novo metastatic NPC should be individualized. […] For patients with widespread metastases, systemic therapy with chemotherapy and immunotherapy should be offered in eligible patients as first-line treatment. High dose locoregional RT with concurrent chemotherapy and local ablative treatment to distant metastases are recommended in those who achieve completed or PR after systemic treatment.

• #58 Nasopharyngeal Cancer Treatment Options | American Cancer Society

  https://www.cancer.org/cancer/types/nasopharyngeal-cancer/treating/by-stage.html

  If NPC returns after treatment, your choices depend on where it returns, the extent of the cancer, which treatments were used the first time around, and your overall health. […] Some tumors that recur in the nasopharynx can be removed through the nose by surgery (called endoscopic surgery). […] Recurrent NPC in neck lymph nodes can sometimes be treated with radiation therapy a second time. […] If the cancer recurs in distant sites, options might include chemotherapy or immunotherapy (or both). […] If the cancer can’t be cured, further treatments may be aimed at slowing its growth or relieving symptoms caused by the cancer.

• #59 Current Management Strategy of Nasopharyngeal Carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2848311/

  The use of IMRT in treatment of NPC have multiple advantages. […] While modern radiotherapy like IMRT achieves good local control, distant metastases become the predominant pattern of failure, especially among those with loco-regionally advanced disease. NPC is also chemosensitive. […] The conclusion seems to be that, of the three basic approaches tested in these studies (induction, concurrent, and adjuvant chemotherapy), concurrent chemoradiotherapy is the most efficacious. […] Survivors of NPC following radiotherapy or chemoradiation have impaired health-related quality of life. […] Despite the improved results of concomitant chemoradiation in the management of nasopharyngeal carcinoma, there are still some patients who developed local or regional failure presenting as persistent or recurrent tumor.

• #60 Surgical treatment of nasopharyngeal carcinoma

  https://www.oaepublish.com/articles/2574-1225.2023.124

  Nasopharyngeal carcinoma (NPC) is a relatively rare cancer, primarily prevalent in China and other parts of Asia. Radiotherapy is the preferred treatment for primary NPC and has proven to be highly effective. However, approximately 10% of patients experience recurrence after treatment. Surgical intervention serves as a key treatment option for locally recurrent NPC and selected primary cases, aiming to completely remove the tumor while preserving normal tissues and functions as much as possible. This review provides a comprehensive overview of surgical treatment options for NPC discussing the advantages, disadvantages, appropriate indications, and outcomes of various surgical techniques, thus offering guidance for selecting the most suitable treatment approaches. […] Surgical resection of the nasopharynx is inherently challenging due to its complex anatomy. In 1951, Wilson made a significant breakthrough in addressing this complexity by introducing three surgical approaches for nasopharyngeal resection: transnasal, transmaxillary, and transoral routes. Over time, technological advancements have led to the development of additional techniques to manage NPC, including the temporal fossa approach, inferior/transpalatal approach, maxillary swing approach, endoscopic nasopharyngectomy, and robot-assisted resection. A landmark prospective randomized controlled study by Liu et al. revealed that endoscopic nasopharyngectomy provides superior patient survival compared to re-irradiation, with a 3-year overall survival rate of 85.8% vs. 68.0%. Additionally, this technique resulted in fewer postoperative complications and significantly improved patients quality of life. Similarly, Teo et al. found that nasopharyngeal resection is more effective than local re-irradiation in the treatment of NPC.

• #61 Nasopharyngeal Cancer Treatment | American Cancer Society

  https://www.cancer.org/cancer/types/nasopharyngeal-cancer/treating.html

  Its important to discuss all treatment options, including treatment goals and possible related side effects, with your doctors to help make the decision that best fits your needs. […] Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-of-the-art cancer treatment. […] You may hear about alternative or complementary methods to relieve symptoms or treat your cancer that your doctors havent mentioned. […] Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known (or not known) about the method, which can help you make an informed decision. […] Whether you are thinking about treatment, getting treatment, or not being treated at all, you can still get supportive care to help with pain or other symptoms.

• #62 Advances in systemic treatment for nasopharyngeal carcinoma – Tan – Chinese Clinical Oncology

  https://cco.amegroups.org/article/view/9596/html

  However, compliance to adjuvant chemotherapy was a significant problem with only about 50-75% of patients who were initially planned for adjuvant chemotherapy receiving the three planned cycles. […] The role of induction chemotherapy followed by RT or CRT is similarly uncertain. […] In light of this, additional phase III clinical trials are underway to confirm the optimal approach. […] While current data has not fully defined the role of adjuvant chemotherapy, the current focus of research has shifted somewhat towards two strategies of (I) identification of patient subgroups that may benefit most from adjuvant chemotherapy; and (II) exploration of different chemotherapy regimens apart from cisplatin/5-FU. […] Systemic chemotherapy is an integral part of the multidisciplinary management of NPC, both in the curative and palliative setting. Despite the inherent chemoradiosensitivity of NPC, relapse at both distant and/or local sites is not uncommon particularly amongst patients with locally advanced disease. Ongoing strategies are focused towards identifying patients at high risk of relapse and optimizing CRT as well as adjuvant chemotherapeutic regimens particularly for these patients. In the metastatic setting, despite the relative chemosensitivity of NPC, resistance to chemotherapy inevitably develops with median OS generally less than 24 months. Novel strategies evaluating EBV directed immunotherapy as well as immune checkpoint blockade may offer new hope in palliative treatment of NPC.

• #63 Nasopharyngeal Cancer Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/988165-treatment

  Larger studies are needed to confirm the study’s findings. […] Data using IMRT reveal equivalent or better locoregional control compared with conventional radiotherapy and sparing of the parotid glands from high doses of radiation therapy. […] Some centers use amifostine, a radioprotective agent, to help reduce radiation-related xerostomia. Possible adverse effects of amifostine (eg, flulike symptoms, nausea, low calcium levels, hypotension) have limited its widespread use in the oncologic community. […] Surgical therapy for these patients is often limited to a biopsy for tissue diagnosis. Nearly all tumors are unresectable at diagnosis because of their location. […] Consultation with an otolaryngologist is often required in the initial management to obtain tissue diagnosis and in follow-up endoscopic examinations to rule out recurrence. […] Many patients experience severe mucositis during radiotherapy. Certain foods may irritate irradiated mucosa, causing pain or difficulty swallowing or chewing. Soft foods such as milkshakes, mashed potatoes, and pureed meats are advisable during the course of radiotherapy.

• #64 Nasopharyngeal Cancer: Symptoms, Causes, and Treatment

  https://www.webmd.com/cancer/nasopharyngeal-cancer

  If you are diagnosed with nasopharyngeal cancer, you will need regular follow-ups with your medical team before, during, and after treatment. […] Your treatment will depend on many things, including: […] Treatment may include: […] Radiation therapy uses X-rays to kill cancer cells and stop them from growing. It is usually part of the standard treatment for early-stage nasopharyngeal cancer. […] One type called IMRT delivers high-dose radiation directly to the tumor while minimizing damage to nearby healthy tissue. […] Chemotherapy uses drugs to kill cancer cells. By itself, it is not usually helpful for treating nasopharyngeal cancer. But it may help you live longer when combined with radiation therapy or biological drugs. […] Surgery to remove the tumor is not often performed because of the tumor’s location near nerves and blood vessels.

• #65 Nasopharyngeal Cancer: Symptoms, Causes, and Treatment

  https://www.webmd.com/cancer/nasopharyngeal-cancer

  Not all people with nasopharyngeal cancer can have surgery. Your doctor will consider the location and stage of your tumor when discussing your treatment options. […] These drugs affect how your body’s immune system fights disease. […] The goal of palliative treatment is to control symptoms related to cancer and cancer treatment and make you as comfortable as possible. […] If treatment does not work, consider joining a clinical trial. Researchers are always testing new ways to treat cancer, and they need your help. Ask your doctor or nurse if there are any clinical trials on nasopharyngeal cancer that you would fit into.

• #66 Learn About Nasopharyngeal Cancer & Its Treatment | ACTC

  https://actchealth.com/blogs/a-comprehensive-guide-to-nasopharyngeal-cancer-symptoms-and-treatment

  This traditional cancer treatment procedure employs high-energy X-rays or particles to eliminate cancer cells or impede their growth rate. Both external beam radiation therapy and brachytherapy are recommended for nasopharyngeal cancer treatment. […] Given the effectiveness of radiation therapy for most nasopharyngeal cancers, oncologists integrate it into the initial treatment plan when the NPC has not extended beyond the head and neck region. […] This treatment process entails the utilization of anti-cancer medications administered via intravenous injection (IV) or oral consumption to combat cancer. […] Oncologists may recommend chemotherapy as the initial treatment before chemoradiation to extend the survival of individuals with more advanced cases of NPC. […] It involves using medications that specifically target certain proteins in cancer cells responsible for their growth, spread, and survival.

• #67 Nasopharyngeal (Upper Throat) Cancer: Staging and Treatment | OncoLink

  https://www.oncolink.org/cancers/head-and-neck/nasopharyngeal-cancer/nasopharyngeal-upper-throat-cancer-staging-and-treatment

  How is nasopharyngeal cancer treated? […] Treatment for nasopharyngeal cancer is based on things like your cancer stage, age, overall health, and testing results. […] Your treatment may include some or all the following: Surgery, Radiation Therapy, Chemotherapy, Targeted Therapy, Immunotherapy, Supportive/Palliative Treatment, Clinical Trials. […] The type of surgery you have depends on where your tumor is, the stage, and your overall health. […] Radiation therapy is the use of high-energy x-rays to kill cancer cells. […] Chemotherapy is the use of anti-cancer medications to kill cancer cells. […] Nasopharyngeal cancer may be treated with targeted therapies that focus on specific gene mutations or proteins in the tumor. […] Immunotherapy is the use of a person’s own immune system to kill cancer cells. […] Supportive and palliative treatments are used to lessen symptoms or side effects that you may have. […] You may be offered a clinical trial as part of your treatment plan. […] Your care team will make sure you are included in choosing your treatment plan.

• #68 Nasopharyngeal Cancer | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/n/nasopharyngeal-cancer.html

  Radiation therapy combined with chemotherapy (chemoradiation) is the most common treatment. In most cases, surgery is only required if the tumor returns after chemoradiation therapy. […] Radiation therapy, including intensity modulated radiation therapy, stops cancer cells from dividing and slows the growth of the tumor. Radiotherapy also destroys cancer cells and can shrink or eliminate tumors. Intensity modulated radiation therapy allows the use of more effective radiation doses with fewer side effects than conventional radiotherapy techniques. Radiation therapy involves 5-6 weeks of daily treatments. […] Chemotherapy is prescribed for different reasons: Together with radiotherapy as an alternative to surgery (called chemoradiation), After surgery to decrease the risk of the cancer returning, To slow the growth of a tumor and control symptoms when the cancer cannot be cured (palliative treatment).

• #69 Nasopharyngeal Cancer | Harold C. Simmons Comprehensive Cancer Center | Condition | UT Southwestern Medical Center

  https://utswmed.org/conditions-treatments/nasopharyngeal-cancer/

  Chemoradiation: We often combine radiation therapy with chemotherapy, known as chemoradiation. This combination makes cancer cells more sensitive to radiation. […] Targeted therapy: Certain anticancer medications target specific characteristics within cancer cells, which can be detected through specialized testing. People whose cancers have these characteristics can be treated with targeted therapy, usually in combination with radiation or chemotherapy. […] Surgery: We sometimes perform surgery if nasopharyngeal tumors do not respond to radiation therapy. Surgery is also effective if cancer has spread to nearby lymph nodes or other tissues in the neck. […] For patients who are having radiation therapy for nasopharyngeal cancer, we recommend having any necessary dental work done before treatment. Radiation treatment slows healing and can cause other side effects. […] At UT Southwesterns Harold C. Simmons Comprehensive Cancer Center, patients have access to every available treatment option, delivered by the most experienced head and neck cancer specialists in Dallas.

• #70 Precision medicine in nasopharyngeal carcinoma: comprehensive review of past, present, and future prospect | Journal of Translational Medicine | Full Text

  https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-023-04673-8

  Nasopharyngeal carcinoma (NPC) is an aggressive malignancy with high propensity for lymphatic spread and distant metastasis. […] Studies on NPC pathogenesis mechanism in the past decades such as through Epstein Barr Virus (EBV) infection and oncogenic molecular aberrations have explored several potential targets for therapy and diagnosis. […] With the apparent heterogeneity and distinct molecular aberrations of NPC tumor, the focus has turned into a more personalized treatment in NPC. […] The importance of recent advances on the key molecular aberration involved in pathogenesis of NPC for precision medicine progression has also been reported in the present review. […] Recent focus has shifted towards targeted therapy and immunotherapy for NPC treatment, such as inhibitors of epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), phosphoinositide 3-kinase (PI3K)/serine/threonine-protein kinase (Akt)/mammalian target of rapamycin (mTOR) pathways, programmed death-ligand 1 (PD-L1) and adoptive T-cell therapy, which are currently under study.

• #71 Treatment option of advanced nasopharyngeal carcinoma | CMAR

  https://www.dovepress.com/advanced-nasopharyngeal-carcinoma-current-and-emerging-treatment-optio-peer-reviewed-fulltext-article-CMAR

  The standard of care for recurrent and distant NPC is multi-agent chemotherapy, including platinum-based agents. […] The probability of 5-year OS in the GP arm versus the FP arm was 19.2% versus 7.8%. […] With the recent development of endoscopic techniques, good results of endoscopic resection of locally recurrent NPC have also been reported in recent years. […] Treatment for advanced nasopharyngeal carcinoma is expected to become more personalized in the future.

• #72 Testing the Addition of Relatlimab to the Usual Immunotherapy After Initial Treatment for Recurrent or Metastatic Nasopharyngeal Cancer

  https://www.nrgoncology.org/hn011

  NRG-HN011 is a clinical study for people with nasopharyngeal carcinoma that has come back or spread outside of your nasopharynx (metastatic) and who are not a candidate for surgery. This study will be testing whether a combination of the drugs nivolumab and BMS-986016 (relatlimab) after initial chemotherapy and immunotherapy will extend the length of time without your cancer getting worse compared to the usual treatment approach of nivolumab. Researchers want to know if this combined approach is better than the usual approach to your type of cancer. […] This study is being done to determine if the drug nivolumab plus relatlimab after initial chemotherapy and immunotherapy will extend the length of time without your cancer worsening compared to the usual approach of nivolumab alone. […] The usual approach for patients who are not in a study is initial treatment with chemotherapy along with immunotherapy. After the initial treatment is finished, patients may continue to receive additional immunotherapy.

• #73 Testing the Addition of Relatlimab to the Usual Immunotherapy After Initial Treatment for Recurrent or Metastatic Nasopharyngeal Cancer

  https://www.nrgoncology.org/hn011

  There is evidence that nivolumab with relatlimab is effective in keeping your type of cancer from growing or spreading. It is not possible to know now if the study approach will extend your time without your disease worsening compared to the usual approach. […] You will get initial treatment with chemotherapy and immunotherapy for up to 20 weeks. Both study groups (Nivolumab alone and Nivolumab plus relatlimab) will receive immunotherapy treatment for up to two years. […] If your cancer has grown or spread: You will not be able to continue treatment on this study and your doctor will discuss other treatment options with you. […] If your cancer has not grown or spread: Your blood will be collected for EBV DNA again. Your blood will not be tested until the end of the study. You and your doctor will get the test results. You will continue receiving immunotherapy treatment with either Nivolumab alone or Nivolumab plus relatlimab for up to 2 years.

• #74 UCSF Nasopharyngeal Cancer Clinical Trials for 2025 — San Francisco Bay Area

  https://clinicaltrials.ucsf.edu/nasopharyngeal-cancer

  Toripalimab in Combination With Cisplatin and Gemcitabine in Participants With Recurrent Metastatic Nasopharyngeal Cancer […] This study aims to investigate toripalimab with chemotherapy in participants with nasopharyngeal cancer. […] Nivolumab, in Combination With Chemotherapy Drugs to Treat Nasopharyngeal Carcinoma (NPC) […] This phase II trial tests effects of nivolumab in combination with chemotherapy drugs prior to radiation therapy patients with nasopharyngeal carcinoma (NPC). Immunotherapy with monoclonal antibodies, such as nivolumab, may help the body’s immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Chemotherapy drugs, such as gemcitabine and cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Radiation therapy uses high energy x-rays, particles, or radioactive seeds to kill cancer cells and shrink tumors.

• #75 UCSF Nasopharyngeal Cancer Clinical Trials for 2025 — San Francisco Bay Area

  https://clinicaltrials.ucsf.edu/nasopharyngeal-cancer

  Induction Chemotherapy Response-Guided Radiation for EBV-Associated Nasopharyngeal Carcinoma […] This clinical trial tests the effect of induction chemotherapy response-guided radiation (de-escalated intensity-modulated radiation therapy [IMRT]) compared to standard IMRT in patients with Epstein-Barr virus (EBV)-associated nasopharyngeal cancer. […] Individualized Treatment in Treating Patients With Stage II-IVB Nasopharyngeal Cancer Based on EBV DNA […] All patients will first undergo standard concurrent chemotherapy and radiation therapy. When this standard treatment is completed, if there is no detectable EBV DNA in their plasma, then patients are randomized to either standard adjuvant cisplatin and fluorouracil chemotherapy or observation. If there is still detectable levels of plasma EBV DNA, patients will be randomized to standard cisplatin and fluorouracil chemotherapy versus gemcitabine and paclitaxel. Radiation therapy uses high energy x rays to kill tumor cells. Drugs used in chemotherapy, such as cisplatin, fluorouracil, gemcitabine hydrochloride, and paclitaxel work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. It is not yet known whether giving cisplatin and fluorouracil is more effective than gemcitabine hydrochloride and paclitaxel after radiation therapy in treating patients with nasopharyngeal cancer.

• #76 Advances in targeted therapy mainly based on signal pathways for nasopharyngeal carcinoma | Signal Transduction and Targeted Therapy

  https://www.nature.com/articles/s41392-020-00340-2

  To sum up, the targeted inhibition of MAP2K6, PAK1, MNK1, FGF2, PIN1, PBK, and the targeted activation of DAPK1, BLU, miR-124 in the targeted therapy of NPC could be a potential therapeutic strategy through the MAPK pathway. […] For STAT3 pathways, except for directly targeting STAT3 for NPC treatment, targeted inhibition of LMP1, AP1, LncRNA DANCR, and targeted activation of miR-29a, miR-124-3p, and RKIP may become potential treatment strategies for NPC. […] To sum up, the targeted inhibition of -catenin, Capn4, CBP, LHX2, FOXO3a, and the targeted activation of GSK3 in the targeted therapy of NPC could be a potential therapeutic strategy through the Wnt/-catenin pathway. […] For EGFR pathways, apart from directly targeting EGFR for NPC treatment, targeting DLC-1, as well as a combination of EGFR targeting inhibitors with chemoradiotherapy may be potential therapeutic strategies for NPC.

• #77 Nasopharyngeal Cancer: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/2047748-overview

  Radiation therapy is the mainstay of treatment, with chemotherapy used in advanced cases. Surgical therapy is often limited to a biopsy for tissue diagnosis. Nearly all tumors are unresectable at diagnosis because of their location. […] The results of clinical trials that include both radiation therapy and chemotherapy generally report long-term survival rates of 50-80% overall. […] When radiotherapy is used alone, survival rates range from 40-50%. Use of combination radiation therapy and chemotherapy allows long-term survival rates of 55-80%. […] Patients and parents should be educated regarding the importance of follow-up after completion of all therapy. A detailed discussion of the risks of chemotherapy, especially the risk of febrile neutropenia, is necessary. Families should also be well informed of the issues of late effects.

• #78 Nasopharyngeal Cancer Treatment (Adult) | Vanderbilt-Ingram Cancer Center

  https://vicc.org/cancer-info/adult-nasopharyngeal-cancer-treatment-adult

  Treatment of stage IV nasopharyngeal cancer may include the following: Chemotherapy given with radiation therapy, followed by more chemotherapy. […] Treatment of recurrent nasopharyngeal cancer may include the following: Intensity-modulated radiation therapy, stereotactic radiation therapy, or internal radiation therapy. […] New types of treatment are being tested in clinical trials. […] Patients may want to think about taking part in a clinical trial. […] Follow-up tests may be needed.

• #79 Nasopharyngeal Cancer | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/throat-cancer/nasopharyngeal-cancer.html

  Regular follow-up and screenings are vital due to the high risk of throat cancer returning to the throat or other areas in the head and neck region. Patients need to see their doctors every three to six months for the first two years after treatment, since most cancers that recur, or come back, do so within that time. […] The right treatment plan can greatly reduce the chance of recurrence and help maintain your quality of life, including your ability to speak, swallow and hear. […] At MD Anderson you will get care from a multidisciplinary team of nasopharyngeal cancer specialists, including a medical oncologist, radiation oncologist, and surgical oncologist. Their focus on throat cancer allows them to recognize the small differences among nasopharyngeal cancers and develop treatment plans tailored to each individual patient. […] MD Anderson also offers dedicated survivorship care for nasopharyngeal cancer patients. This care can help monitor for the disease’s return and offer interventions to help maximize your quality of life.

• #80 Nasopharyngeal cancer – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/3000314

  Nasopharyngeal cancer (NPC) most commonly presents with a neck mass. […] Radiation therapy is the main treatment modality for nonmetastatic NPC. Some patients with early-stage NPC can be treated with radiation therapy alone. Concurrent chemotherapy is added for locally advanced disease. Surgery, reradiation, and chemotherapy are options for locoregional nasopharyngeal/neck nodal recurrence and metastatic disease. […] Documentation of remission after completion of treatment is important and can be done with clinical and radiographic assessments. […] Plasma EBV after treatment can provide prognostic information and it can also be used for early detection of recurrences.

• #81 Diagnosis and Therapy of Nasopharyngeal Carcinoma | IntechOpen

  https://www.intechopen.com/chapters/78042

  There is a consensus among guidelines that concurrent chemoradiotherapy sequential chemotherapy may be mainstay treatment in stage III to IVB diseases with a remarkable survival benefit. […] Close follow-up for NPC patients is essential in terms of disease surveillance. Despite relatively desirable treatment outcomes among solid cancers, unfortunately, about 10-20% of NPC patients will suffer from residual disease or develop recurrent disease after primary treatment. […] Patients with metastatic NPC have various clinical characteristics and outcomes. Around 10% of newly diagnosed NPC patients present with synchronous distance metastases. Unfortunately, up to 15%-30% of the non-metastatic NPC patients will experience distant failure after primarily curative treatment. […] Remarkably, several single-arm trials evaluating immunotherapy targeted the programmed death 1/programmed death-ligand 1 (PD1/PD-L1) pathway in recurrent/metastatic NPC patients have shown promising outcomes.

• #82 Medications for Nasopharyngeal Cancer | NYU Langone Health

  https://nyulangone.org/conditions/nasopharyngeal-cancer/treatments/medications-for-nasopharyngeal-cancer

  The drug cetuximab targets a protein called epidermal growth factor receptor, which may be present in nasopharyngeal tumors. […] Most side effects from medications used to manage nasopharyngeal cancer are temporary. […] An experimental test given before and after chemoradiation therapy may help doctors determine how well the cancer is responding to treatment and decide which additional therapies may be needed. […] Measuring EBV levels in blood can also help doctors monitor nasopharyngeal cancer recurrence.

• #83 Nasopharyngeal Cancer Program | Stanford Cancer Institute

  https://med.stanford.edu/cancer/research/nasopharyngeal-cancer-program.html

  Dr. Colevas is a medical oncologist with expertise in new drug development and multimodality treatment of head and neck cancers. […] He is a principal investigator on numerous clinical trials, including both institutional and international studies enrolling NPC patients; these include trials that involve cellular immunotherapy, checkpoint inhibitors, and targeted small molecules. […] Dr. Le is a radiation oncologist. Her research focuses on translating laboratory findings to the clinic and vice versa in head and neck cancer (HNC), specifically in the area of GalectinGalectin-1 and salivary gland stem cells. […] Her recent work includes exploration of EBV DNA as a biomarker for prognosis and treatment effect in patients with NPC, as well as harmonization of the EBV DNA assay for use in clinical trial in collaboration with Ben Pinsky.

• #84 Nasopharyngeal Carcinoma Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/head-and-neck/hp/adult/nasopharyngeal-treatment-pdq

  If a patient has metastatic disease or local recurrence that is no longer amenable to surgery or radiation therapy, chemotherapy or immunotherapy may be considered. […] The U.S. Food and Drug Administration has approved toripalimab with cisplatin and gemcitabine as first-line treatment for patients with metastatic or recurrent locally advanced nasopharyngeal carcinoma.

• #85 Frontiers | Advances in the Treatment of Nasopharyngeal Cancer

  https://www.frontiersin.org/research-topics/67622/advances-in-the-treatment-of-nasopharyngeal-cancerundefined

  The optimal treatment strategy for patients with advanced NPC should be discussed within a multidisciplinary team (MDT). Treatment of patients in high-volume facilities is recommended as this was reported as an independent prognostic factor for improved survival, at least in areas where the disease is endemic.

• #86 Learn About Nasopharyngeal Cancer & Its Treatment | ACTC

  https://actchealth.com/blogs/a-comprehensive-guide-to-nasopharyngeal-cancer-symptoms-and-treatment

  This approach typically targets specific immune system proteins to increase immune response, often with milder side effects compared to chemotherapy and radiation therapy. […] After undergoing treatment for nasopharyngeal cancer, follow-up care is crucial to reduce the risk of cancer recurrence and the potential development of new cancers. […] According to the American Cancer Society, the 5-year survival rate for localized nasopharyngeal cancer is 82%. Therefore, it is crucial to report any symptoms to a healthcare provider at the earliest to get more effective results from the treatment.

• #87 Precision medicine in nasopharyngeal carcinoma: comprehensive review of past, present, and future prospect | Journal of Translational Medicine | Full Text

  https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-023-04673-8

  Current treatment has excellent control with a good prognosis up to 90% for the early stage NPC, but the treatment outcomes in advanced NPC remain disappointing. […] The overall survival (OS) of NPC patients is still unsatisfactory and this is mainly due to: (1) the emergence of radio- or chemo-resistance, (2) the development of distant metastasis or disease recurrence after radiotherapy, and (3) the fatal toxicity of salvage radiotherapy and concurrent chemotherapy in advanced stage of NPC. […] Hence, it is crucial to develop effective therapeutics, early diagnosis strategies, as well as prognostic approaches. […] The challenge and future outlook of NPC management will also be highlighted.

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