Efficacy and safety of toripalimab in the treatment of nasopharyngeal carcinoma: a meta-analysis of single-arm trials

Nasopharyngeal carcinoma (NPC) is common in East Asia, and treatment options are limited. Toripalimab, a PD-1 inhibitor, has potential in NPC therapy. This meta-analysis aimed to evaluate the efficacy and safety of toripalimab in the treatment of NPC. A systematic search of PubMed, Embase, the Cochrane Library and Web of Science was conducted to identify studies assessing toripalimab in NPC. The search time ranged from the establishment of the database to January 10, 2025. R4.4.1 software was used for data analysis. Nine papers (with a total of 801 patients) were included, of which 2 were randomized controlled studies and 7 were single-arm studies. Meta-analysis results suggest that after treatment with toripalimab, the ORR of NPC was 77% (95% CI 55%-90%)], DCR was 93% (95% CI 81%-100%), 1-year OS was 81% (95% CI 43%-100%), 2-year OS was 68% (95% CI 0%-100%), 3-year OS was 75% (95% CI 42%-97%), 1-year PFS was 81% (95% CI 62%-91%), 2-year PFS was 56% (95% CI 26%- 82%), 3-year PFS was 25% (95% CI 7%-60%), the rate of adverse events was 98% (95% CI: 90%-100%), and the rate of grade ≥ 3 was 76% (95% CI: 52%-94%). These results suggest that toripalimab has better efficacy in the treatment of NPC, especially in terms of disease control and survival. However, it was also accompanied by a high incidence of adverse events, especially grade ≥ 3 adverse events. Because there was no control group in this study, caution is needed when interpreting the results.