Abstract
Nasopharyngeal carcinoma (NPC), a rare head and neck malignancy, arises from the epithelial
lining of nasopharyngeal mucosa. The confluence of various risk factors, such as latent
Epstein–Barr virus infection, genetic susceptibility, smoking, alcohol consumption,
and high nitrosamine diet, is thought to contribute to NPC pathogenesis. Radiation
therapy serves as the mainstay of treatment for early stage while concurrent chemotherapy
and radiation are the basis of treatment for locoregional advanced disease with overall
80% five-year survival rate. Recurrent or metastatic disease pose treatment challenges
as reirradiation, repeat cycles of chemotherapy, and surgery follow with high likelihood
of treatment toxicity or postoperative morbidities. Typically reserved for nonresectable
recurrent or metastatic disease, immunotherapy serves as novel treatment for NPC.
NPC tumor microenvironment predominated by a dense infiltrate of immune cells hosts
an ideal target for immunotherapy. Several clinical trials have investigated the efficacy
of anti-programmed cell death protein 1 antibodies such as pembrolizumab, nivolumab,
and camrelizumab with promising results. Treatment of recurrent and metastatic NPC
remains a challenge; however, the advent of immunotherapy has provided additional
options and potential for preventative and therapeutic measures.
Keywords
nasopharyngeal carcinoma - immunotherapy - nasopharynx - head and neck cancer - EBV
- immune checkpoint inhibitors - recurrent disease - adoptive cell therapy
