The Role of PD-1/PD-L1 Inhibitors in the Treatment of Nasopharyngeal Carcinoma in the Epstein-barr Virus Microenvironment

Abstract

This article offers an extensive examination of nasopharyngeal carcinoma (NPC), with a particular emphasis on its epidemiological features, relationship with Epstein-Barr virus (EBV) infection, classification system, and current immunotherapy approaches. NPC is notably prevalent in East and Southeast Asia, displaying a robust association with EBV infection, particularly in the non-keratinized subtype. Considering the successful implementation of PD-1/PD-L1 immune checkpoint substance across various cancer, their potential therapeutic benefits in NPC have attracted considerable attention. Although PD-1/PD-L1 inhibitors have exhibited effectualness in NPC patients, the response rate remains inconsistent, suggesting a requirement for deeper investigation into the regulatory mechanisms that govern PD-L1 expression. Furthermore, the approach of combined interferon therapy, designed to augment anti-tumor immunity, has demonstrated potential in enhancing therapeutic outcomes and extending patient survival when administered concomitantly with PD-1/PD-L1 inhibitors. However, several obstacles remain, including drug resistance and the substantial heterogeneity observed in NPC tumors. Tumors from different patients display variations in gene expression patterns, immune microenvironment composition, and other factors, which may lead to divergent patient responses to the combined treatment regimen of PD-1/PD-L1 inhibitors and interferon. This article highlights the research significance of PD-1/PD-L1 combined with interferon in NPC treatment and anticipates its extensive clinical application in the future. Nonetheless, to achieve this goal, several challenges must be tackled through persistent and rigorous research and exploration.