Modulation Therapy for Locally Advanced NPC Based on Plasma EBV DNA Level Post-ICT
Status:
Recruiting
Trial end date:
2027-07-01
Target enrollment:
Participant gender:
Summary
Nasopharyngeal carcinoma is biologically different from traditional head and neck squamous
cell carcinoma. The mainstay treatment for locally advanced nasopharyngeal carcinoma is
cisplatin-based concurrent chemoradiation. Recent phase III randomized control trials have
demonstrated that induction chemotherapy plus concurrent chemoradiation further improved
progression-free survival.
However, not every patient has good response to induction chemotherapy. Evidence has
accumulated that those with poor response to induction chemotherapy, or those with detectable
Epstein-Barr Virus (EBV) DNA post induction chemotherapy, correlated with poorer
progression-free survival. Huang CL et al. (Int J Radiat Oncol Bio Phys. 2019) reported that
plasma EBV DNA load at completion of induction chemotherapy was an independent and earlier
predictor for progression-free survival and overall survival in locally advanced
nasopharyngeal carcinoma. Lv J et al. (Nat Commun. 2019) demonstrated that real-time
monitoring of plasma EBV DNA response added prognostic information, and had the potential
uitility for risk-adapted treatment intensification in nasopharyngeal carcinoma.
Therefore, investigators selects those with poor plasma EBV DNA response during and after
induction chemotherapy, and intensifies the treatment with combination of anti-PD-1 antibody,
in order to improve progression-free survival in locally advanced nasopharyngeal carcinoma,
according to response-adapted strategy.