Real-World Overall Survival (OS) in Recurrent/Metastatic Nasopharyngeal
Carcinoma (R/M NPC) in Asia: A Literature ReviewDarren WT Lim,1 Melvin LK Chua,1 Brigette BY Ma,2 Jennifer S Evans,3 Yan Ran Wee,3 Min Hee Choi,3 Natsumi
Fujita,3 Shikha Dhawan,4 Junice Ng4National Cancer Centre Singapore;1

Department of Clinical Oncology, Charlie Lee Precision Immuno-Oncology, Phase 1 Clinical Trial Center, The
Chinese University of Hong Kong, Hong Kong SAR;
2

3Costello Medical Singapore;

4

BeiGene Singapore.

Background:
Platinum-based chemotherapy (CT)±radiotherapy (RT) was the standard of care (SoC) for R/M NPC until therecent introduction of immuno-oncology (IO) therapy, but meta-analyses (MAs) of randomised clinical trials(RCTs) report mixed results for IOs. This targeted literature review (LR) aimed to summarise real-world (RW)
treatments (tx) and OS for patients (pts) with R/M NPC in Asia.
Methods:
MEDLINE and Embase (2020–25 April 2023), recent oncology congresses (2021–2023) and systematic
LRs/MAs were searched. Observational studies were eligible if they reported tx patterns (CT±RT or IO) andOS of pts with R/M NPC in Asia.
Results:
Of 5,210 abstracts retrieved and 486 full-texts reviewed, 20 unique studies were extracted from 24 eligible
articles. Most (18/20) were from mainland China and patient characteristics (eg, performance status, EpsteinBarr viral status, age, sex) were similar between studies, where reported. CT-based modalities were mostcommon, and only mainland China reported studies with IO (n=3). The Table reports OS by line of tx (LOT).
In LOT1, OS decreased sharply in CT only pts after 1 year compared with CT followed by RT (CT+RT). IO
studies showed higher 1-year OS than CT only studies, both in LOT2+ and where LOT was unspecified.

ESMO 2024

Median OS for LOT1 pts was similar between IO+CT, CT only, and the lower range of CT+RT, but CT+RT pts
had the longest median OS at the higher range. For unspecified LOTs, median OS was shorter in CT only,compared with CT+RT.
Conclusions:
While this LR found limited RW IO use in R/M NPC, likely reflecting access to recently introduced/approved IOcompounds, the results complement RCT data to support a potential place for IO in R/M NPC tx. However, theheterogeneous evidence base (eg, differences in study design) made overarching conclusions challenging.
This highlights a need for more long-term RW research for R/M NPC pts, particularly in parts of Asia outside
mainland China, to better understand the role and benefits of novel tx such as IO.

Table. Real-World OS in R/M NPC
Treatment

1-year OS,%

2-year OS,%

3-year OS,%

5-year OS,%Median OS,Months

IO+CTNRNRNRNR19.9 (n=1)

CT followed by RT(CT+RT)

75.0–89.8(n=3)

63.9–69.8(n=3)

25.9–61.8(n=6)

36.2–43.7(n=2)

16.2–69.5(n=7)

CT only

71.1–77.5(n=2)

32.6–49.4(n=3)

11.7–31.8
(n=3)

3.4
(n=1)

17.8–23.0(n=3)

IO only

65.4 (n=1)

NRNR

NRNRCT+RTNR

NRNR

NR

NR

CT only

60.0
(n=1)

30.0
(n=1)

28.0
(n=1)

NR

16.0–29.4(n=2)

LOT1 (n=11 studies)

LOT2+ (n=3 studies)

Unspecified LOT (n=7 studies)
IO±
targeted/local therapy

85.6–91.7
(n=1)

NR

47.8–61.2(n=1)

31.6–46.2(n=1)

NRCT+RTNRNR

50.0
(n=1)

NR

35.1–37.0(n=2)

CT only

70.4–75.0(n=2)

28.7–32.1(n=2)

0.0–36.7
(n=4)

24.5
(n=1)

13.2–25.6(n=7)

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