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Article: Treatment strategy for de novo metastatic nasopharyngeal carcinoma: a literature review

TitleTreatment strategy for de novo metastatic nasopharyngeal carcinoma: a literature review
Authors
Keywordschemotherapy
immunotherapy
Metastatic nasopharyngeal carcinoma
radiation therapy
Issue Date31-Aug-2023
Citation
Chinese Clinical Oncology, 2023, v. 12, n. 4 How to Cite?
Abstract

Background and Objective: Nasopharyngeal carcinoma (NPC) with de novo distant metastasis (M1) is classified as stage IVB in the 8th edition of the staging system jointly adopted by the American Joint Committee on Cancer and the International Union against Cancer Control. Patients with M1 disease generally have a relatively short life expectancy. This review discusses the personalized and intensified treatment strategies for de novo metastatic NPC.

Methods: A literature search was conducted on PubMed to identify peer-reviewed publications on subdivisions of M1 disease and treatment of de novo metastatic NPC. Clinicaltrials.gov and Chinese Clinical Trial Register were searched to identify ongoing clinical trials evaluating systemic or local therapy of previously untreated metastatic NPC.

Key Content and Findings: M1 encompasses a diverse group of diseases. Several important factors, including tumor burden, EBV-DNA levels, location of involvement, the number of metastasis, and treatment strategies, influence the prognosis of NPC patients. Researchers have attempted to define M1 subcategorization to reflect the underlying risk profile and tailor personalized treatment. Recent advancements have brought new hope for this otherwise incurable condition. In the era of immunotherapy, checkpoint inhibitors have become the first-line systemic treatment for metastatic NPC in JUPITER-02, CAPTAIN-1st, and RATIONALE-309. Additionally, the value of radical locoregional radiation therapy and ablative treatment to distant metastatic sites should not be overlooked in patients with de novo metastatic diseases. Locoregional radiation with concurrent chemotherapy, maintenance chemotherapy, and radical local treatment to metastatic sites are emerging as potential treatment options.

Conclusions: Given the diversity of metastatic NPC, a multimodality approach incorporating chemotherapy, immunotherapy, locoregional radiation and ablative treatment to metastatic sites has been shown to improve overall control. Further research is needed to determine the efficacy and optimal duration of maintenance therapy.


Persistent Identifierhttp://hdl.handle.net/10722/342834
ISSN
2023 Impact Factor: 2.1
2023 SCImago Journal Rankings: 0.690

 

DC FieldValueLanguage
dc.contributor.authorLiu, Qin-
dc.contributor.authorLi, Jishi-
dc.contributor.authorNg, Wai Tong-
dc.contributor.authorLee, Anne W M-
dc.date.accessioned2024-05-02T03:06:13Z-
dc.date.available2024-05-02T03:06:13Z-
dc.date.issued2023-08-31-
dc.identifier.citationChinese Clinical Oncology, 2023, v. 12, n. 4-
dc.identifier.issn2304-3865-
dc.identifier.urihttp://hdl.handle.net/10722/342834-
dc.description.abstract<p><strong>Background and Objective: </strong>Nasopharyngeal carcinoma (NPC) with <em>de novo</em> distant metastasis (M1) is classified as stage IVB in the 8th edition of the staging system jointly adopted by the American Joint Committee on Cancer and the International Union against Cancer Control. Patients with M1 disease generally have a relatively short life expectancy. This review discusses the personalized and intensified treatment strategies for de novo metastatic NPC.</p><p><strong>Methods: </strong>A literature search was conducted on PubMed to identify peer-reviewed publications on subdivisions of M1 disease and treatment of <em>de novo</em> metastatic NPC. Clinicaltrials.gov and Chinese Clinical Trial Register were searched to identify ongoing clinical trials evaluating systemic or local therapy of previously untreated metastatic NPC.</p><p><strong>Key Content and Findings: </strong>M1 encompasses a diverse group of diseases. Several important factors, including tumor burden, EBV-DNA levels, location of involvement, the number of metastasis, and treatment strategies, influence the prognosis of NPC patients. Researchers have attempted to define M1 subcategorization to reflect the underlying risk profile and tailor personalized treatment. Recent advancements have brought new hope for this otherwise incurable condition. In the era of immunotherapy, checkpoint inhibitors have become the first-line systemic treatment for metastatic NPC in JUPITER-02, CAPTAIN-1st, and RATIONALE-309. Additionally, the value of radical locoregional radiation therapy and ablative treatment to distant metastatic sites should not be overlooked in patients with <em>de novo</em> metastatic diseases. Locoregional radiation with concurrent chemotherapy, maintenance chemotherapy, and radical local treatment to metastatic sites are emerging as potential treatment options.</p><p><strong>Conclusions: </strong>Given the diversity of metastatic NPC, a multimodality approach incorporating chemotherapy, immunotherapy, locoregional radiation and ablative treatment to metastatic sites has been shown to improve overall control. Further research is needed to determine the efficacy and optimal duration of maintenance therapy.</p>-
dc.languageeng-
dc.relation.ispartofChinese Clinical Oncology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectchemotherapy-
dc.subjectimmunotherapy-
dc.subjectMetastatic nasopharyngeal carcinoma-
dc.subjectradiation therapy-
dc.titleTreatment strategy for de novo metastatic nasopharyngeal carcinoma: a literature review-
dc.typeArticle-
dc.identifier.doi10.21037/cco-23-32-
dc.identifier.scopuseid_2-s2.0-85171119535-
dc.identifier.volume12-
dc.identifier.issue4-
dc.identifier.issnl2304-3865-

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