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ORIGINAL RESEARCH article

Front. Immunol.

Sec. Cancer Immunity and Immunotherapy

Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1654616

This article is part of the Research TopicThe Role of Immunotherapy in Cancer Therapy and Its ChallengeView all 3 articles

PD-1 Inhibitor Combined with TPF Induction Chemotherapy in Locally Advanced Nasopharyngeal Carcinoma: A Retrospective Study of Efficacy and Safety

Provisionally accepted
Weiwei  ZhangWeiwei Zhang1,2*Yousheng  MengYousheng Meng1,2Ping  ZhangPing Zhang1,2Dujuan  TianDujuan Tian1,2Xianghua  ZengXianghua Zeng1,2MINGQING  DONGMINGQING DONG3Lang  HeLang He1,2
  • 1Chengdu Fifth People's Hospital, Chengdu, China
  • 2Chengdu University of Traditional Chinese Medicine, Chengdu, China
  • 3The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

The final, formatted version of the article will be published soon.

Abstract Background: The efficacy of PD-1 inhibitors in the induction therapy of locally advanced nasopharyngeal carcinoma (LA-NPC) remains unclear. The aim of this study was to retrospectively investigate the efficacy and safety of PD-1 inhibitor combined with induction chemotherapy in patients with LA-NPC. Patients and Methods: A retrospective study was conducted on 158 LA-NPC patients, 80 patients received TPF (nab-paclitaxel, cisplatin and 5-fuorouracil) induction chemotherapy, and 78 patients received TPF-ICB (TPF plus PD-1 inhibitor) chemoimmunotherapy. Treatment response was evaluated immediately following completion of induction therapy using RECIST v1.1 criteria, including cervical lymph nodes and primary nasopharynx lesions. Responses were categorized as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD), with objective response rate (ORR) calculated as the combined CR+PR rate. Secondary endpoints included progression-free survival (PFS), overall survival (OS), and toxicity assessment. Acute treatment-related toxicities during induction therapy were graded according to CTCAE v5.0 criteria and compared between treatment groups. Results: After induction therapy, the ORR in the TPF group was significantly lower than that in the TPF-ICB group (71.2% vs. 88.5%, p = 0.007). The complete response (CR) rate in the TPF-ICB group was significantly higher than in the TPF group (29.5% vs. 11.3%,p = 0.007). The 3 and 5 years PFS rates in TPF-ICB group were 99% and 95%, which were significantly higher than the TPF group (89% and 87%, both p < 0.05). The 3-year (99% vs. 89%, p <0.001) and 5-years OS rates (95% vs. 87%, p < 0.0001) were superior in the TPF-ICB group. Grade ≥3 TRAEs occurred in 7 (8.6%) and 12 (15.5%) patients in the TPF and TPF-ICB groups, respectively (p = 0.596). Conclusions: The induction therapy of PD-1 inhibitor combined with TPF showed high CR and ORR rates in LA-NPC, and the safety was acceptable. Keywords: Locally advanced stage nasopharyngeal, TPF, PD-1 inhibitor, concurrent chemoradiotherapy, efficacy and safety

Keywords: Locally advanced stage nasopharyngeal, TPF, PD-1 inhibitor, concurrent chemoradiotherapy, efficacy and safety

Received: 26 Jun 2025; Accepted: 27 Aug 2025.

Copyright: © 2025 Zhang, Meng, Zhang, Tian, Zeng, DONG and He. 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: Weiwei Zhang, Chengdu Fifth People's Hospital, Chengdu, China

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