Unraveling the potential of sodium butyrate in combating nasopharyngeal carcinoma: a narrative review

Nasopharyngeal carcinoma (NPC) is an epithelial malignancy with significant regional distribution characteristics, and its treatment faces challenges such as local recurrence, distant metastasis, and drug resistance. Sodium butyrate (NaB), as a short-chain fatty acid and histone deacetylase inhibitor, exhibits anti-tumor activity in various tumors, but its mechanism of action in NPC is not fully understood. Research has shown that NaB inhibits NPC in epigenetic regulation, immune regulation, and autophagy apoptosis regulation. However, NaB has a “double-edged sword” effect: low concentrations may promote tumor survival, while high concentrations can be toxic to normal cells, and caution should be exercised regarding the carcinogenic risks associated with EB virus reactivation. Current research is mostly limited to in vitro experiments, lacking in vivo model validation and clinical translational evidence. Its targets, drug resistance, and mechanisms of combination therapy still need to be further explored. In the future, it is necessary to optimize NaB delivery systems (such as nano-targeted carriers), evaluate their synergistic effects with cisplatin and PD-1 inhibitors, and develop personalized treatment plans to balance efficacy and safety. NaB has significant potential in the treatment of NPC, but its clinical application still faces many challenges.