Shenzhen University Medicine School, Shenzhen University, 518060, Shenzhen, Guangdong, China; Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, 518053, Shenzhen, Guangdong, China.
Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, 518053, Shenzhen, Guangdong, China.
Cancer Treat Rev. 2024 Dec;131:102840. doi: 10.1016/j.ctrv.2024.102840. Epub 2024 Oct 11.
Nasopharyngeal carcinoma (NPC) is a prevalent malignant tumor of the head and neck, with approximately 70 % of patients being diagnosed at a locally advanced stage. Despite the responsiveness to radiotherapy and chemotherapy, the 5-year survival rate of locally advanced NPC (LANPC) remains at approximately 80 %. Hence, there is an urgent need for novel treatment strategies to improve the prognosis of patients with LANPC. Numerous studies have illustrated the efficacy of immune checkpoint inhibitors (ICIs) in recurrent/metastatic NPC. Hence, the potential of immunotherapy for LANPC is under investigation. Using the Web of Clinical Trials, we identified 84 relevant trials exploring immunotherapy for NPC, encompassing 17 trials focusing on ICIs for LANPC. Preliminary findings from several trials suggest that adding ICIs into the primary treatment for LANPC significantly enhances the objective response rate and progression-free survival, with manageable safety profiles. However, the type, dosage, and timing of integration (induction phase, concurrent phase, and adjuvant phase) of ICIs into standard primary treatment of LANPC varies among these trials and further researches are warranted. This review provides an overview of immunotherapy principles in NPC, discusses recent advances and challenges associated with ICIs in the primary treatment for LANPC derived from published and ongoing clinical trials, and outlines the current landscape of other immunotherapies in LANPC, such as adoptive cell therapy, immunomodulatory agents, and tumor vaccines in LANPC. These insights aim to inform clinical practice and guide future researches.
鼻咽癌（NPC）是一种常见的头颈部恶性肿瘤，约 70%的患者被诊断为局部晚期。尽管对放疗和化疗有反应，但局部晚期鼻咽癌（LANPC）的 5 年生存率仍约为 80%。因此，迫切需要新的治疗策略来改善 LANPC 患者的预后。许多研究表明免疫检查点抑制剂（ICIs）在复发性/转移性 NPC 中的疗效。因此，免疫疗法治疗 LANPC 的潜力正在研究中。使用临床试验网络，我们确定了 84 项探索 NPC 免疫治疗的相关试验，其中包括 17 项针对 LANPC 的 ICI 试验。几项试验的初步结果表明，将 ICI 加入 LANPC 的主要治疗中，显著提高了客观缓解率和无进展生存率，且具有可管理的安全性。然而，这些试验中 ICI 整合到 LANPC 标准主要治疗中的类型、剂量和时间（诱导期、同期和辅助期）各不相同，需要进一步研究。本综述概述了 NPC 免疫治疗的原则，讨论了源自已发表和正在进行的临床试验的 ICI 在 LANPC 主要治疗中的最新进展和挑战，并概述了其他免疫疗法在 LANPC 中的现状，如过继细胞疗法、免疫调节剂和肿瘤疫苗。这些见解旨在为临床实践提供信息并指导未来的研究。
