Efficacy and Safety of Combining Camrelizumab with Tyrosine Kinase Inhibitors in Advanced Nasopharyngeal Carcinoma: A Meta-Analysis

Introduction: Nasopharyngeal carcinoma (NPC) is a malignancy of the head and neck with high prevalence in southern China and Southeast Asia. It is histopathologically diverse and often associated with Epstein-Barr virus (EBV) infection, along with genetic and environmental risk factors. Standard treatment involves radiotherapy, supplemented by chemotherapy in advanced stages. However, for recurrent or metastatic NPC, newer therapeutic strategies, such as combining Camrelizumab—a PD-1 monoclonal antibody—with tyrosine kinase inhibitors (TKIs) have emerged as promising options. This systematic review and meta-analysis evaluates the efficacy and safety of this combination in patients with advanced NPC. Methods: A comprehensive literature search was conducted in PubMed, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science databases up to June 2024. Inclusion criteria encompassed clinical trials or cohort studies reporting on the efficacy and safety of Camrelizumab plus TKIs in advanced or recurrent NPC. Exclusion criteria included animal studies, case reports, and reviews. Both randomized and non-randomized studies were included due to limited data availability. Study quality was assessed using the Cochrane Risk of Bias (ROB1) tool. Data extraction focused on treatment outcomes, adverse events, and survival rates. Statistical analysis was performed using RevMan 5.4. Results: Five studies encompassing 217 patients met the inclusion criteria. Pooled analysis showed a partial response (PR) rate of 50% (95% CI: 36%–65%), while a complete response was 10% (95% CI: 0%–21%). Stable disease was observed in 19% (95% CI: 5%–33%), and progressive disease in 10% (95% CI: 0%–20%). One-year progression-free survival (PFS) and overall survival (OS) rates were 46% (95% CI: 37%–54%) and 78% (95% CI: 62%–94%), respectively. Common treatment-related adverse events included anemia (62%), nausea (52%), leukopenia (46%), hypertension (45%), and neutropenia (43%). Conclusion: The combination of Camrelizumab and TKIs appears to be an effective and welltolerated treatment for patients with recurrent or advanced NPC, offering favorable response rates and survival outcomes. Further large-scale, randomized studies are warranted to validate these findings and refine treatment protocols.