Wang Shaoli, Chen Siying, Zhong Qionglei, Liu Yan
Otolaryngological Department, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Xiuhua Road, Haikou, Hainan, People's Republic of China.
Otolaryngological Department, The First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road Xigang, Dalian, Liaoning, People's Republic of China.
J Cancer Res Clin Oncol. 2023 May;149(5):2071-2079. doi: 10.1007/s00432-022-04214-8. Epub 2022 Jul 25.
Nasopharyngeal carcinoma (NPC) is ranked the top otorhinolaryngology malignant tumors in the world. However, the general prognosis of recurrent and metastatic (R/M) nasopharyngeal carcinomas (NPCs) remains poor, and current surgery and chemoradiotherapy do not generate satisfactory outcomes.
As a new therapeutic choice, immunotherapy, especially with regard to the development of checkpoint inhibitors including PD-1 and CTLA-4 inhibitors have made considerable progress in recent years. As Epstein-Barr virus (EBV) infection is associated with increased risk of NPC, EBV-related immunotherapy may lead to a breakthrough in advanced NPCs.
In this review, we summarized the clinical characters of NPC, and several past and ongoing clinical trials of checkpoint inhibitors and EBV-CTLs (CTLs: cytotoxic T lymphocytes) in R/M NPC immunotherapy.
We conclude that although the evaluated effects of new immunotherapy drugs have brought us hope on NPC treatment, further phase II-III trials with larger samples are still required to improve the proportion and scheme of drug collocation for better clinical outcomes and less drug-related safety.
鼻咽癌（NPC）是全球排名首位的耳鼻咽喉恶性肿瘤。然而，复发性和转移性（R/M）鼻咽癌的总体预后仍然较差，目前的手术及放化疗并未产生令人满意的效果。
作为一种新的治疗选择，免疫疗法，尤其是近年来在包括程序性死亡受体1（PD-1）和细胞毒性T淋巴细胞相关抗原4（CTLA-4）抑制剂在内的检查点抑制剂的研发方面取得了显著进展。由于爱泼斯坦-巴尔病毒（EBV）感染与鼻咽癌风险增加相关，EBV相关免疫疗法可能会在晚期鼻咽癌治疗上取得突破。
在本综述中，我们总结了鼻咽癌的临床特征，以及过去和正在进行的一些关于检查点抑制剂和EBV特异性细胞毒性T淋巴细胞（CTLs）用于R/M鼻咽癌免疫治疗的临床试验。
我们得出结论，尽管新免疫疗法药物的评估效果给鼻咽癌治疗带来了希望，但仍需要进一步开展更大样本量的II-III期试验，以优化药物搭配比例和方案，从而获得更好的临床疗效并降低药物相关安全性问题。
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