SYSTEMATIC REVIEW article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1485609
This article is part of the Research TopicAdvances in the Treatment of Nasopharyngeal CancerView all 5 articles
Efficacy and safety of first-line treatments for recurrent or metastatic nasopharyngeal carcinoma: a systematic review and network meta-analysis
Provisionally accepted
- 1Guangxi Traditional Chinese Medical University, Nanning, China
- 2Guangxi International Zhuang Medical Hospital, Nanning, Guangxi Zhuang Region, China
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To compare the efficacy and safety of first-line treatments for recurrent or metastatic nasopharyngeal carcinoma (RM-NPC).We searched databases, including PubMed, Embase, Cochrane Library, ClinicalTrials.gov, and major international conferences, to identify comparative randomized controlled trials (RCTs) for the first-line treatment of patients with nasopharyngeal carcinoma who have metastasis or recurrence from inception to March 1, 2024. Then, we conducted a Bayesian network meta-analysis and systematic review of RCTs that met the specified inclusion criteria. By calculating the surface under the cumulative ranking curve (SUCRA) for each treatment, we determined their relative advantage: the higher the SUCRA score, the more likely that treatment is to be the optimal choice.Seven RCTs were included, which involved 1495 patients who received 8 different treatment regimens. Overall, programmed cell death protein 1 (PD-1) inhibitors combined with chemotherapy could be the optimal treatment for patients with RM-NPC.Chemotherapy combined with radiotherapy has a tendency to improve progression-free survival and overall survival. The safety assessment showed no significant difference in the incidence of grade 3 or higher adverse events between any two treatments. Tislelizumab, combined with the standard first-line chemotherapy regimen, appeared to confer the best progression-free survival (SUCRA = 83.16%), overall survival (SUCRA = 83.16%), and objective response rate (SUCRA = 89%).Systematic reviews and network meta-analyses integrate evidence from multiple studies, which enables clinicians to make more informed treatment decisions based on comprehensive comparative efficacy and safety data. For patients with RM-NPC, the combination of tislelizumab and chemotherapy is the optimal first-line treatment.
Keywords: nasopharyngeal carcinoma, First-line, recurrent, Metastatic, Network meta-analysis
Received: 24 Aug 2024; Accepted: 14 May 2025.
Copyright: © 2025 Cai, Zhou, Zheng, Lin, Li and Mo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jianlong Zhou, Guangxi International Zhuang Medical Hospital, Nanning, Guangxi Zhuang Region, China
Jinghui Zheng, Guangxi Traditional Chinese Medical University, Nanning, China
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