MedComm | Advances in pathogenesis and precision medicine for nasopharyngeal carcinoma


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Nasopharyngeal carcinoma (NPC) is a squamous carcinoma involving genetic predisposition, infection with Epstein-Barr virus (EBV), and environmental factors, with apparent geographical and racial distribution, mostly prevalent in East and Southeast Asia, particularly concentrated in southern China. The epidemiological trend over the past decades has suggested a substantial reduction in the incidence rate and mortality rate due to NPC. This reduced incidence rate in NPC may be the results of promotion in healthy eating habits, economic growth, and restricted use of tobacco. Although there is no licensed EBV vaccine, it is deemed to be a promising strategy to prevent NPC. In addition to the decreased incidence, lower mortality rates are observed and are likely due to advances in screening and treatment for NPC. Therefore, this review will focus on how precision medicine is impacting the prevention, screening, and treatment of NPC, and will also discuss the future prospects for the improved clinical management of NPC.

This review presented the recent advances on the key signal pathways involved in pathogenesis of NPC, the mechanism of Epstein-Barr virus (EBV) entry into the cell (Fig. 1), and the progress of EBV vaccine and screening biomarkers. The authors also discuss in depth the development of various therapeutic approaches including radiotherapy, chemotherapy, surgery, targeted therapy, and immunotherapy. These research advancements have led to a new era of precision medicine in NPC.

Fig. 1 Mechanisms of EBV infection of epithelial cell and B cell

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