Important research into nasopharyngeal cancer (NPC) is under way in many university hospitals, medical centers, and other institutions around the world. Each year, scientists find out more about what causes the disease, how to prevent it, and how to improve treatment.

Causes: Many studies are being done to learn more about how Epstein-Barr virus (EBV) infection and other risk factors cause cells of the nasopharynx to become cancerous. Researchers are optimistic that these studies may eventually lead to vaccines to prevent NPC by avoiding EBV infection. Recent discoveries concerning EVB, its interaction with nasopharyngeal cells, and the immune system's reaction to EVB have led to new blood tests for early detection of NPC and to better predict the response to treatment. These tests are now being studied in areas of the world where this cancer is common.

Scientists have recently discovered exciting information about how certain mutations (DNA changes) in nasopharyngeal cells cause them to become cancerous. Clinical trials are now testing the possibility of replacing damaged tumor suppressor genes in the cancer cells through gene therapy.

New chemotherapy: Researchers continue to develop new chemotherapy drugs, new drug combinations, and new ways to administer drugs that might be more effective against advanced NPC. Clinical trials are also testing ways to best combine chemotherapy with radiation therapy. For example, studies are comparing the effectiveness of chemotherapy given before, during, or after radiation therapy.

New radiation therapy techniques: Recent advances in radiation therapy have contributed significantly to improving the outlook for patients with NPC. Radiation oncologists can now use 3-dimensional images (obtained by CT or MRI scans) to perform computerized analyses that point out how best to target multiple external and internal radiation sources at the cancer while minimizing exposure of normal tissue to radiation. High cure rate with sparing of the salivary gland to reduce permanent dry mouth has been obtained with intensity modulated radiotherapy (IMRT).

Other studies are testing the effectiveness of combining several types of radiation beams (photons, electron, etc.). External beam radiation treatments are usually given once a day in one fraction, but studies are now comparing the standard practice to accelerated and hyperfractionated radiation therapy, in which radiation is given faster or in smaller doses each time but to higher total dose.

New surgical techniques: The field of skull base surgery now permits tumor removal from difficult areas such as the nasopharynx. This type of surgery requires a specialized team that has developed expertise in this field. This type of surgery offers hope to patients with recurrent NPC and even patients with small primary keratinizing cancer type.

T Lymphocyte treatment: NPC seems to be in part caused by the EB virus. Although patients can be shown to have immunity to EBV, this doesn't seem to be enough to kill the cancer. To overcome this, researchers removed T lymphocytes from the blood of 10 patients with NPC and manipulated them in the laboratory to increase their numbers and their power to kill EBV virus. The cells were then put back into a series of 10 patients by intravenous injection. Four patients who were in remission remained in remission. Two out of the remaining 6 with advanced NPC had complete disappearance of their tumor and one other had partial disappearance of the tumor. Another patient had stable disease -- no further growth -- and the remaining 2 patients did not benefit. Last Revised: 08/03/2006