The next decade of clinical trials in locoregionally advanced nasopharyngeal carcinoma

Br J Radiol. 2019 Oct;92(1102):20181031. doi: 10.1259/bjr.20181031. Epub 2019 May 24.

Abstract

Clinical trials are powerful weapons in the battle against nasopharyngeal carcinoma (NPC). Based on clinical trials conducted in the past two decades, concurrent chemoradiotherapy combined with adjuvant chemotherapy or induction chemotherapy has been recommended as the standard treatment for locoregionally advanced NPC in various guidelines. However, there remain shortcomings concerning current treatment modalities that should be refined in future research. In this article, we review the achievements of published clinical trials for locoregionally advanced NPC and propose future directions for subsequent clinical trials. We believe that refinement of current regimens of chemotherapy, de-intensification of treatment for specific groups of patients, developing personalized treatment based on predictors ( e.g. applying plasma Epstein-Barr virus DNA) and investigating novel therapies, such as targeted therapy and immunotherapy, should be applied with the highest priority when designing clinical trials for locoregionally advanced NPC in the next decade.

Publication types

  • Review

MeSH terms

  • Chemoradiotherapy / mortality
  • Chemotherapy, Adjuvant / mortality
  • Clinical Trials as Topic / methods*
  • Clinical Trials as Topic / standards
  • Clinical Trials, Phase II as Topic
  • Clinical Trials, Phase III as Topic
  • DNA, Viral / blood
  • Forecasting
  • Herpesvirus 4, Human / genetics
  • Humans
  • Immunotherapy / methods
  • Induction Chemotherapy
  • Medication Adherence
  • Molecular Targeted Therapy / methods
  • Nasopharyngeal Carcinoma / mortality
  • Nasopharyngeal Carcinoma / pathology
  • Nasopharyngeal Carcinoma / therapy*
  • Nasopharyngeal Carcinoma / virology
  • Nasopharyngeal Neoplasms / mortality
  • Nasopharyngeal Neoplasms / pathology
  • Nasopharyngeal Neoplasms / therapy*
  • Nasopharyngeal Neoplasms / virology
  • Network Meta-Analysis
  • Precision Medicine
  • Randomized Controlled Trials as Topic
  • Survival Rate
  • Time Factors

Substances

  • DNA, Viral

Grants and funding

This work was supported by the Natural Science Foundation of Guang Dong Province [grant number 2017A030312003], the Health & Medical Collaborative Innovation Project of Guangzhou City, China [grant number 201803040003], the Innovation Team Development Plan of the Ministry of Education [grant number IRT_17R110], and the Overseas Expertise Introduction Project for Discipline Innovation (111 Project) [grant number B14035].