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Spotlight

This roundtable series assesses immunotherapy plus chemotherapy as treatment for metastatic or recurrent nasopharyngeal carcinoma, as discussed by key opinion leaders at virtual live events and interviews.

Combination Therapy for Patients With Nasopharyngeal Carcinoma

Deborah Wong, MD, PhD, discusses therapeutic options for patients with nasopharyngeal carcinoma.

Understanding Treatment Options in Nasopharyngeal Carcinoma

Deborah Wong, MD, PhD, associate clinical professor in the Department of Medicine, Division of Hematology-Oncology and director of the Head and Neck Medical Oncology Program at the University of California, Los Angeles, discusses therapeutic options for patients with nasopharyngeal carcinoma.

This rare head and neck cancer is often linked to the Epstein–Barr virus, typically presenting with locally advanced disease. This will many times involve a tumor in the nasopharynx that could possibly spread to neck lymph nodes. Standard treatment involves induction chemotherapy with gemcitabine and cisplatin followed by chemotherapy with radiation, curing many patients, according to Wong.

However, some patients relapse or present with de novo metastatic disease. For those not recently exposed to platinum-based therapies, the standard of care includes gemcitabine, cisplatin, and the anti-PD-1 immunotherapy toripalimab-tpzi (Loqtorzi), to manage or potentially cure metastatic cases.

 Nasopharyngeal carcinoma is a relatively rare subgroup of head and neck cancers, and many of these are driven by a virus called Epstein–Barr virus. Most patients will present with locally advanced disease, meaning a tumor in their nasopharynx and potentially spread to the lymph nodes in the neck. In that setting, the standard treatment is usually to treat with induction chemotherapy with gemcitabine and cisplatin. Following induction chemotherapy, patients receive chemotherapy concurrence with radiation.

 A good number of patients will be cured with this approach. However, some patients will unfortunately relapse and develop a recurrent or metastatic disease. In addition, there are some patients who present with a de novo metastatic disease from nasopharyngeal cancer. For those patients who have not received gemcitabine and cisplatin recently, within the past 6 months or so, those patients are considered platinum sensitive, and the standard of care would be to treat with a combination of gemcitabine and platinum [chemotherapy], along with toripalimab, which is an anti–PD-1 immunotherapy.