Multimodality Management of EBV-Associated Nasopharyngeal Carcinoma

Abstract

Nasopharyngeal carcinoma (NPC) is a rare cancer of the nasopharyngeal mucosa with a specific geographic predisposition. NPC is often associated with Epstein–Barr Virus (EBV) infection and as a result contains many characteristic biomarkers. Treatment of locally-contained NPC is generally achieved through use of radiotherapy (RT), as part of a multimodality treatment regimen. Induction chemotherapy followed by concurrent RT and platinum-based chemotherapy regimen has emerged as the definitive treatment of choice for locoregionally-advanced NPC. Recently, immunotherapy is finding a role in the treatment of recurrent or metastatic NPC. Immune checkpoint blockade therapies targeted against the programmed death-1 (PD-1) receptor have demonstrated efficacy in early phase clinical trials, with ongoing phase III trials in effect. Biomarkers for treatment efficacy remain an ongoing area of investigation, with important prognostic implications on the horizon.

TRIM11, a new target of p53, facilitates the migration and invasion of nasopharyngeal carcinoma cells

“…Multimodality therapy, such as chemotherapy and radiotherapy, has demonstrated efficacy in metastatic and recurrent NPC. On the other hand, immune checkpoint blockage therapies have now emerged as a new therapeutic approach for advanced NPC [ 19 , 20 ]. Preventing distant metastasis is key to NPC treatment, and more effective systemic drugs should be investigated.…”

Precision Medicine for Nasopharyngeal Cancer—A Review of Current Prognostic Strategies

“…The biomarkers associated with NPC, some of which will be touched on in this paper, are unique due to their relations to EBV. More research is still required on how epigenetic changes such as DNA methylation, microRNA expression, and cell-free EBV DNA play a role in the selection of patients and prediction of immunotherapy response [ 27 , 28 ].…”

Intraoperative Imaging Techniques to Improve Surgical Resection Margins of Oropharyngeal Squamous Cell Cancer: A Comprehensive Review of Current Literature

“…However, the expected (functional) sequelae and toxicity of each treatment modality as well as the accessibility of the tumor for surgery are other important factors [3]. The treatment of choice in oral cancer is in principle surgery, whereas the treatment of choice for nasopharyngeal cancer is (C)RT [7,8]. The oropharynx is not easily accessible for open surgery, often needing an extensive procedure to remove the tumor.…”