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Advanced Nasopharyngeal Carcinoma: Current and Emerging Treatment Options

Nasopharyngeal carcinoma (NPC) has seen improved treatment outcomes and a decrease in incidence worldwide in recent years due to developments in medicine and improved public health. However, 70% of cases are still diagnosed at advanced stages and these advanced NPC cases show a poor prognosis. Repor...

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Autores principales: Jiromaru, Rina, Nakagawa, Takashi, Yasumatsu, Ryuji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9480178/
https://www.ncbi.nlm.nih.gov/pubmed/36117730
http://dx.doi.org/10.2147/CMAR.S341472
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author Jiromaru, Rina
Nakagawa, Takashi
Yasumatsu, Ryuji
author_facet Jiromaru, Rina
Nakagawa, Takashi
Yasumatsu, Ryuji
author_sort Jiromaru, Rina
collection PubMed
description Nasopharyngeal carcinoma (NPC) has seen improved treatment outcomes and a decrease in incidence worldwide in recent years due to developments in medicine and improved public health. However, 70% of cases are still diagnosed at advanced stages and these advanced NPC cases show a poor prognosis. Reports on current and future treatment in advanced NPC are summarized. Chemoradiotherapy is the mainstay of treatment for advanced NPC. The administration of platinum agents as a concurrent drug and intensity modulated radiotherapy (IMRT) is the most appropriate irradiation method, and is associated with high local control rates. For induction and adjuvant chemotherapy, platinum-based two- or three-drug combination chemotherapy is recommended. The tumour volume, plasma Epstein-Barr virus (EBV)-DNA levels, and the tumour site are used to determine the indication for adjuvant and neo-adjuvant chemotherapy. The tolerability of induction chemotherapy is controversial, and the indications and timing should be carefully considered in each case. Chemotherapy is used for patients with distant metastasis. Gemcitabine/cisplatin is the first-line regimen. The efficacy of immune checkpoint inhibitor (ICI) treatment has recently been reported for NPC and, as in other areas of the head and neck, it is expected to be effective for patients with recurrent/distant metastasis. Trials are underway for various uses of ICIs, including induction chemotherapy, postoperative treatment, and use in combination with chemoradiotherapy. Immunotherapy for NPC, an EBV-associated cancer, has been reported to have some efficacy with immunotherapy used in other EBV-associated cancers. Immunotherapy may be introduced for NPC in the future, depending on the results of clinical trials. Future changes in the treatment of NPC are expected to include risk classification based on plasma EBV-DNA levels and the development of personalized treatment with individual selection of timing and type of therapy.
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spelling pubmed-94801782022-09-17 Advanced Nasopharyngeal Carcinoma: Current and Emerging Treatment Options Jiromaru, Rina Nakagawa, Takashi Yasumatsu, Ryuji Cancer Manag Res Review Nasopharyngeal carcinoma (NPC) has seen improved treatment outcomes and a decrease in incidence worldwide in recent years due to developments in medicine and improved public health. However, 70% of cases are still diagnosed at advanced stages and these advanced NPC cases show a poor prognosis. Reports on current and future treatment in advanced NPC are summarized. Chemoradiotherapy is the mainstay of treatment for advanced NPC. The administration of platinum agents as a concurrent drug and intensity modulated radiotherapy (IMRT) is the most appropriate irradiation method, and is associated with high local control rates. For induction and adjuvant chemotherapy, platinum-based two- or three-drug combination chemotherapy is recommended. The tumour volume, plasma Epstein-Barr virus (EBV)-DNA levels, and the tumour site are used to determine the indication for adjuvant and neo-adjuvant chemotherapy. The tolerability of induction chemotherapy is controversial, and the indications and timing should be carefully considered in each case. Chemotherapy is used for patients with distant metastasis. Gemcitabine/cisplatin is the first-line regimen. The efficacy of immune checkpoint inhibitor (ICI) treatment has recently been reported for NPC and, as in other areas of the head and neck, it is expected to be effective for patients with recurrent/distant metastasis. Trials are underway for various uses of ICIs, including induction chemotherapy, postoperative treatment, and use in combination with chemoradiotherapy. Immunotherapy for NPC, an EBV-associated cancer, has been reported to have some efficacy with immunotherapy used in other EBV-associated cancers. Immunotherapy may be introduced for NPC in the future, depending on the results of clinical trials. Future changes in the treatment of NPC are expected to include risk classification based on plasma EBV-DNA levels and the development of personalized treatment with individual selection of timing and type of therapy. Dove 2022-09-12 /pmc/articles/PMC9480178/ /pubmed/36117730 http://dx.doi.org/10.2147/CMAR.S341472 Text en © 2022 Jiromaru et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Review
Jiromaru, Rina
Nakagawa, Takashi
Yasumatsu, Ryuji
Advanced Nasopharyngeal Carcinoma: Current and Emerging Treatment Options
title Advanced Nasopharyngeal Carcinoma: Current and Emerging Treatment Options
title_full Advanced Nasopharyngeal Carcinoma: Current and Emerging Treatment Options
title_fullStr Advanced Nasopharyngeal Carcinoma: Current and Emerging Treatment Options
title_full_unstemmed Advanced Nasopharyngeal Carcinoma: Current and Emerging Treatment Options
title_short Advanced Nasopharyngeal Carcinoma: Current and Emerging Treatment Options
title_sort advanced nasopharyngeal carcinoma: current and emerging treatment options
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9480178/
https://www.ncbi.nlm.nih.gov/pubmed/36117730
http://dx.doi.org/10.2147/CMAR.S341472
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