Immunotherapy

The use of Epstein-Barr virus (EBV)–specific cytotoxic T-lymphocyte therapy is a promising approach, with minimal toxicity and evidence of significant antitumor activity in patients with relapsed or refractory nasopharyngeal carcinoma.[2] In a phase I/II study of EBV-specific cytotoxic T-lymphocyte therapy in patients with refractory disease, response rates were observed in 33.3% of patients. Long-term remissions were obtained in 62% of patients treated in their second or subsequent remission.[3]

Anti–programmed death 1 (PD-1) and programmed death-ligand 1 (PD-L1) monoclonal antibodies have been studied in adults with refractory nasopharyngeal carcinoma. In a meta-analysis that included nine studies and 842 patients with recurrent or metastatic nasopharyngeal carcinoma who received PD-1 inhibitors, the objective response rate was 24% (95% confidence interval [CI], 21%–26%), the 1-year progression-free survival rate was 25% (95% CI, 18%–32%), and the 1-year overall survival rate was 53% (95% CI, 37%–68%).[4]