A 48-Year-Old Man with Recurrent Nasopharyngeal Carcinoma

A panelist discusses how nasopharyngeal carcinoma (NPC) differs from other head and neck malignancies through its distinct geographical distribution, Epstein-Barr virus association, unique genetic profile, and characteristic clinical presentation, including early lymph node involvement.

A panelist discusses how a 48-year-old man with recurrent nasopharyngeal carcinoma (NPC) presents with nasal congestion, epistaxis, neck swelling, and unilateral hearing issues, highlighting the importance of recognizing these symptoms in patients with a family history of NPC.

A panelist discusses how treatment strategies for recurrent nasopharyngeal carcinoma (NPC) have evolved, with the updated NCCN guidelines now recommending toripalimab plus gemcitabine/cisplatin as category 1 first-line therapy for recurrent/metastatic (R/M) disease based on the JUPITER-02 trial results showing significantly improved 4-year overall survival (OS) rates of 48% vs 27.7% with chemotherapy alone, while emphasizing that treatment decisions should consider patient-specific factors, such as Epstein-Barr virus status, prior treatments, and comorbidities, alongside nonpatient factors, including drug accessibility, need for rapid response, and capacity to manage immune-related adverse events.

A panelist discusses how immunotherapy combined with chemotherapy has revolutionized recurrent/metastatic (R/M) nasopharyngeal carcinoma (NPC) treatment through improved survival outcomes demonstrated in landmark trials such as JUPITER-02 with toripalimab and KEYNOTE-590 with pembrolizumab, emphasizing that although most patients benefit regardless of PD-L1 status or Epstein-Barr virus positivity, clinicians must carefully consider patient-specific factors, such as performance status and comorbidities, alongside the management of unique immune-related adverse events through early recognition, established treatment algorithms, and multidisciplinary collaboration to optimize outcomes in this evolving treatment landscape.

A panelist discusses how the integration of immunotherapy into recurrent/metastatic (R/M) nasopharyngeal carcinoma (NPC) treatment requires careful patient monitoring for immune-related adverse events, strategic sequencing with other modalities, consideration of biomarker-guided approaches, and awareness of emerging combination strategies that may further improve outcomes, while ongoing research into novel immunotherapeutic agents, maintenance strategies, and treatment de-escalation protocols aims to optimize efficacy while minimizing toxicity in the evolving landscape of NPC management.