The current role of immunotherapy in treating nasopharyngeal carcinoma

Immunotherapy has emerged as a cornerstone in the management of both recurrent/metastatic nasopharyngeal carcinoma (R/M NPC) and locoregionally advanced NPC (LANPC). Evidence indicates that programmed death-1/programmed death ligand-1 (PD-1/PD-L1) inhibitors, whether administered as monotherapy or in combination with chemotherapy or antiangiogenic agents, can significantly improve outcomes in R/M NPC. For LANPC, incorporating immunotherapy into induction, concurrent chemoradiotherapy, and adjuvant phases has demonstrated potential benefits in enhancing antitumor immune responses and reducing the incidence of disease recurrence. However, challenges persist regarding the identification of optimal patient populations, the determination of optimal timing and duration of treatment, and the management of immune-related adverse events. Biomarkers such as PD-L1 expression and plasma Epstein-Barr virus-DNA levels show promise in facilitating risk stratification and tailoring individualized treatment regimens. Accordingly, this review provides a comprehensive review of immunotherapy for NPC, evaluating current progress an persistent challenges by drawing insights from both completed and ongoing clinical trials.