Advances in systemic treatment for nasopharyngeal carcinoma.
Nasopharyngeal carcinoma (NPC) is a unique disease endemic in Asia. It is etiologically linked to the Epstein-Barr virus and is both radio- and chemo-sensitive. While radiotherapy (RT) remains the primary treatment modality with high cure rates for early stage disease, systemic treatment forms an important integral component in the treatment of NPC, both in the non-metastatic as well as palliative setting. Presently, standard therapy in locally advanced NPC comprises conventional cytotoxic chemotherapy administered concurrently during RT. The role of induction chemotherapy and adjuvant chemotherapy remain to be well-defined. Further research strategies in non-metastatic disease will require better identification of patients with high risk disease, and determining the optimal sequence and combination of chemotherapeutic regimens. In metastatic disease, whilst chemotherapy remains the mainstay of care, resistance inevitably develops. Development of molecularly targeted therapies has not yielded much success to date, and further research has been focused on development of EBV-targeted strategies such as vaccination or administration of cytotoxic T-cells directed towards EBV, as well as evaluation of immune checkpoint inhibition approaches.
Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610. tan.wan.ling@nccs.com.sg.
Wan-Ling
WL
Tan
Division of Medical Oncology, National Cancer Centre Singapore, Singapore.
Eng-Huat
EH
Tan
Division of Medical Oncology, National Cancer Centre Singapore, Singapore.
Darren Wan-Teck
DW
Lim
Division of Medical Oncology, National Cancer Centre Singapore, Singapore.
Quan-Sing
QS
Ng
Division of Medical Oncology, National Cancer Centre Singapore, Singapore.
Daniel Shao-Weng
DS
Tan
Division of Medical Oncology, National Cancer Centre Singapore, Singapore.
Amit
A
Jain
Division of Medical Oncology, National Cancer Centre Singapore, Singapore.
Mei-Kim
MK
Ang
D019496:Cancer Vaccines / Q000627:therapeutic use; D002277:Carcinoma; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003131:Combined Modality Therapy / Q000379:methods*; D004854:Herpesvirus 4, Human / Q000472:pathogenicity; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D060828:Induction Chemotherapy / Q000379:methods; D058990:Molecular Targeted Therapy / Q000379:methods; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000628:therapy* / Q000821:virology; D020360:Neoadjuvant Therapy / Q000379:methods; D010166:Palliative Care / Q000379:methods
D019496:Cancer Vaccines
Nasopharyngeal carcinoma (NPC); chemoradiotherapy; chemotherapy; systemic treatment