Efficacy and safety of induction immunotherapy plus chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma: a meta-analysis.

BACKGROUND

Locally advanced nasopharyngeal carcinoma (LA-NPC) has a heterogeneous prognosis, with approximately one-fourth of patients experiencing poor outcomes. Studies have explored the application of induction chemoimmunotherapy followed by chemoradiotherapy, but its efficacy was controversial.

METHODS

The protocol was registered in the Prospective Register of Systematic Reviews (PROSPERO, CRD42024619387). The primary outcome measures were objective response rate (ORR), complete response rate (CRR), and the incidence of treatment-related adverse events (TRAEs). Meta-analysis was performed using Cochrane Collaboration Review Manager 5.4.1 and Meta-Analyst Beta 3.13 statistical software.

RESULTS

The meta-analysis involving 1680 patients with LA-NPC from 7 studies showed that the induction chemoimmunotherapy group had significantly better ORR (odds ratio[OR] = 2.03, 95% confidence interval [CI]:1.44-2.86, P < 0.01), and CRR (OR = 2.61, 95% CI:1.55-4.38, P < 0.01) than the induction chemotherapy group. The pooled ORR and CRR of induction chemoimmunotherapy were 92.7% (95% CI: 90.7-94.7%) and 24.3% (95% CI: 15.2-33.6%), respectively. There was no significant difference of TRAEs between induction chemotherapy group and induction chemoimmunotherapy group (OR = 1.13; 95% CI: 0.92-1.39, P = 0.23).

CONCLUSIONS

Induction chemoimmunotherapy could be a promising induction treatment option for LA-NPC patients, improving ORR and CRR with an acceptable safety profile. However, due to limitations in this meta-analysis, further large-scale, well-designed clinical trials are required to validate these results and optimise treatment strategies.