title: Nasopharyngeal carcinoma: review of the literature with a focus on therapeutical implications.
abstract: Nasopharyngeal carcinoma (NPC) is a rare neoplasm which is associated with Epstein-Barr virus (EBV). First of all, we reviewed the literature on NPC treatment. Radio/chemotherapy is currently the gold standard but unfortunately is affected by rates of failure ranging from 7% up to 58%. Because NPC development is promoted by the EBV latent life cycle, EBV-targeted treatments were investigated. Firstly, forcing cytolytic virus activation through administration of gemcitabine and/or valproic acid before administration of a nucleoside analogue showed anti-tumoral activity in vitro as well as in murine model and it was also well tolerated in humans. Secondly, the association of autologous EBV-specific cytotoxic T lymphocytes with chemotherapy correlated with an improved median survival and was safe but not effective versus metastatic lesions. Thirdly, suppression of late membrane protein-1 in the clinic proved controversial because it gave resistance to chemotherapy and, on the other hand, increased radiosensitivity. Finally, we suggest future perspectives for clinical research which should include both prospective and observational cohort studies to assess the role of different risk factors in the development of NPC and the effectiveness of new investigational treatments.
authors.affiliation: Unit of Infectious Diseases, Mater Domini Teaching Hospital, Magna Graecia University, Catanzaro, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Strazzulla
authors.affiliation: Unit of Clinical Microbiology, Mater Domini Teaching Hospital, Magna Graecia University, Catanzaro, Italy.
authors.forename: Giorgio Settimo
authors.initials: GS
authors.lastname: Barreca
authors.affiliation: Unit of Clinical Microbiology, Mater Domini Teaching Hospital, Magna Graecia University, Catanzaro, Italy.
authors.forename: Aida
authors.initials: A
authors.lastname: Giancotti
authors.affiliation: Unit of Infectious Diseases, Mater Domini Teaching Hospital, Magna Graecia University, Catanzaro, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pisani
authors.affiliation: Unit of Infectious Diseases, Mater Domini Teaching Hospital, Magna Graecia University, Catanzaro, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Costa
authors.affiliation: Unit of Clinical Microbiology, Mater Domini Teaching Hospital, Magna Graecia University, Catanzaro, Italy.
authors.forename: Emilia
authors.initials: E
authors.lastname: Zicca
authors.affiliation: Unit of Otorhynolaryngology, Mater Domini Teaching Hospital, Magna Graecia University, Catanzaro, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: La Boria
authors.affiliation: Unit of Surgical Oncology, Mater Domini Teaching Hospital, Magna Graecia University, Catanzaro, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Roveda
authors.affiliation: Unit of Clinical Microbiology, Mater Domini Teaching Hospital, Magna Graecia University, Catanzaro, Italy.
authors.forename: Maria Carla
authors.initials: MC
authors.lastname: Liberto
authors.affiliation: Unit of Anatomic Pathology, "Pugliese" Hospital, Catanzaro, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Tucci
authors.affiliation: Unit of Anatomic Pathology, Mater Domini Teaching Hospital, Magna Graecia University, Catanzaro, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Donato
authors.affiliation: Unit of Clinical Microbiology, Mater Domini Teaching Hospital, Magna Graecia University, Catanzaro, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Focà
authors.affiliation: Unit of Infectious Diseases, Mater Domini Teaching Hospital, Magna Graecia University, Catanzaro, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Torti
mesh_terms: D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002277:Carcinoma; D059248:Chemoradiotherapy / Q000379:methods; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D019317:Evidence-Based Medicine; D006801:Humans; D016219:Immunotherapy, Adoptive / Q000379:methods; D008213:Lymphocyte Activation; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000628:therapy*; D016896:Treatment Outcome; D014635:Valproic Acid / Q000008:administration & dosage; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D014635:Valproic Acid; D000093542:Gemcitabine