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. 2023 Sep 27;84(3):e113-e115.
doi: 10.1055/s-0043-1774333. eCollection 2023 Jul.

Nasopharyngeal Carcinoma: Case Presentation and Literature Review of Treatment Innovation with Immunotherapy

Somtochi Okafor  1 , Jameel Muzaffar  2 , David Jang  1 , Ivan El Sayed  3 , Ralph Abi Hachem  1
Affiliations

Nasopharyngeal Carcinoma: Case Presentation and Literature Review of Treatment Innovation with Immunotherapy

Somtochi Okafor et al. J Neurol Surg Rep. .

Abstract

Nasopharyngeal carcinoma (NPC), a rare head and neck malignancy, arises from the epithelial lining of nasopharyngeal mucosa. The confluence of various risk factors, such as latent Epstein-Barr virus infection, genetic susceptibility, smoking, alcohol consumption, and high nitrosamine diet, is thought to contribute to NPC pathogenesis. Radiation therapy serves as the mainstay of treatment for early stage while concurrent chemotherapy and radiation are the basis of treatment for locoregional advanced disease with overall 80% five-year survival rate. Recurrent or metastatic disease pose treatment challenges as reirradiation, repeat cycles of chemotherapy, and surgery follow with high likelihood of treatment toxicity or postoperative morbidities. Typically reserved for nonresectable recurrent or metastatic disease, immunotherapy serves as novel treatment for NPC. NPC tumor microenvironment predominated by a dense infiltrate of immune cells hosts an ideal target for immunotherapy. Several clinical trials have investigated the efficacy of anti-programmed cell death protein 1 antibodies such as pembrolizumab, nivolumab, and camrelizumab with promising results. Treatment of recurrent and metastatic NPC remains a challenge; however, the advent of immunotherapy has provided additional options and potential for preventative and therapeutic measures.

Keywords: EBV; adoptive cell therapy; head and neck cancer; immune checkpoint inhibitors; immunotherapy; nasopharyngeal carcinoma; nasopharynx; recurrent disease.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Magnetic resonance imaging (MRI) throughout treatment course: presurgical, postsurgical, 3 months postsurgery, and 6 months postsurgery. ( A ) Presurgical MRI. ( B ) Postoperative MRI. ( C ) Three months postoperative MRI. ( D ) Six months postoperative MRI illustrating recurrence in the left nasopharynx.
Fig. 2
Fig. 2
Positron emission tomography/computed tomography (PET/CT) scan imaging illustrating recurrence postsurgery and immunotherapy treatment response. ( A ) PET/CT illustrating recurrence postsurgery. Six months PET/CT illustrating complete response to pembrolizumab.
See this image and copyright information in PMC

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