What's New in Nasopharyngeal Cancer Research?

Research into the causes, prevention, and treatment of nasopharyngeal cancer (NPC) is being done in many university hospitals, medical centers, and other institutions around the world. Because NPC is rare, it's has been hard to study it well. Most experts agree that treatment in a clinical trial should be considered for any type or stage of NPC. This way people can get the best treatment available now and may also get the new treatments that are thought to be even better. The new and promising treatments discussed here are only available in clinical trials.

Causes, prevention, and early detection

Many studies are looking at how Epstein-Barr virus (EBV) infection as well as other risk factors cause cells of the nasopharynx to become cancer.These studies may someday lead to vaccines to help prevent some cases of NPC by preventing EBV infection.

Recent discoveries about EBV, its interaction with nasopharyngeal cells, and the immune system’s reaction to EBV have led to new blood tests that may help detect NPC early and better predict the response to treatment.

Researchers hope that newer, very sensitive tests for EBV might lead to screening tests for NPC, and better ways to predict when NPC is likely to come back after treatment. These possibilities are now being studied in areas of the world where this cancer is more common.

Researchers believe there also may be certain gene changes that make a person more likely to have NPC. Studies to look for other gene changes linked to NPC are going on in countries where NPC is more common.

Treatment

New radiation therapy techniques

Most types of radiation therapy use radiation in the form of x-rays. Other types of radiation uses protons and carbon ions to kill cancer cells. These are being studied, especially in China, but so far haven't been proven to be better than standard x-ray radiation.

Doctors are also studying the best schedule for giving radiation therapy. External beam radiation treatments are usually given once a day, 5 days a week, for many weeks in a row. Studies are now under way to see if schedules that either give the doses over fewer days or give smaller doses twice a day might work better.

Photodynamic therapy

Researchers are looking at ways to use this cancer-focused treatment for NPC. Photodynamic therapy or PDT uses a cell-killing drug that's activated by a laser light. It's already used to treat some head and neck cancers. Doctors are studing how it might be used to shrink NPC tumors that are causing problems, and its role in treating tumors that come back after radiation.

Chemotherapy

Researchers continue to develop new chemo drugs , new drug combinations, and new ways to give drugs that might be more effective against advanced NPC. Several drugs that are already used to treat other cancers, such as capecitabine, oxaliplatin, and gemcitabine, have been studied for use against NPC as well. Clinical trials are looking for the best combination of chemo drugs and how they should be used along with radiation therapy. For example, studies are comparing how well chemo works when given before, during, or after radiation therapy.

Immunotherapy

NPC seems to be caused at least in part by infection with the Epstein-Barr virus (EBV). Although patients’ immune systems can be shown to have reacted against EBV, this doesn’t seem to be enough to kill the cancer. Finding and targeting cell proteins linked to EBV and the cells it affects could lead to new, more cancer-focused treatment options. Understanding how EBV interacts with the immune system could also lead to treatments that boost the immune system's response to NPC and maybe even keep it from developing.

One way to do this is to remove T lymphocytes (immune system cells) from a patient's and alter them in the lab to make more cells and increase their power to kill EBV. The cells are then injected back into the patient. Early results with small numbers of patients have been promising, and larger studies of this technique are now under way.

Predicting treatment outcomes

Researchers are looking for ways to know how well NPC will respond to treatment and understand how likely it is to come back after treatment. This information would allow doctors to tailor treatment for each patient so that the best treatment is used. One area of research is looking for a link between a person's blood cell counts and overall survival. Results have suggested a link, but a lot more research is needed.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master's-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

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Last Medical Review: September 24, 2018 Last Revised: September 24, 2018

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