Clinical characteristics and prognostic analysis of 95 cases of recurrent/metastatic nasopharyngeal carcinoma treated with immunotherapy: a single-center retrospective study

Background : Immunotherapy has become established as the standard treatment for advanced nasopharyngeal cancer; however, there remains a subset of patients whose outcomes are unsatisfactory. The present study aims to investigate the clinical characteristics and prognostic factors affecting the prognosis of recurrent/metastatic nasopharyngeal carcinoma patients receiving PD-1 monoclonal antibody-containing therapy. Methods : A retrospective analysis was conducted on the clinical data and peripheral blood biochemical and immunological indices of 95 nasopharyngeal carcinoma patients diagnosed from March 2019 to July 2024 in the General Hospital of Southern Theater Command. The current study documented the clinical, pathological, therapeutic and outcome data in order to ascertain the clinical characteristics and survival of the patients. Results : The demographic composition of the patient cohort included 81 males and 14 females, with a median age of 49.72 years (range 16–74 years). A total of 91 patients (95.79%) were classified as stage IV. All patients were treated with immunotherapy ± chemotherapy regimens, with a median progression-free survival (mPFS) of 10.5 months, an objective remission rate (ORR) of 70.53%, and a disease control rate (DCR) of 89.47%. Patients treated with platinum-based regimens exhibited a comparatively longer PFS, with a statistically significant difference. The combination of paclitaxel, cisplatin and fluorouracil (TPF) demonstrated a superior PFS outcome in comparison to gemcitabine, cisplatin (GP) and paclitaxel, cisplatin (TP), though this discrepancy did not attain statistical significance. The findings of univariate and multivariate Cox regression analyses demonstrated that tumour recurrence status, initial plasma EBV infection status, number of treatment cycles, and baseline peripheral blood SII index were independent correlates of the prediction of efficacy in patients with recurrent/metastatic nasopharyngeal carcinoma treated with a PD-1 inhibitor (P < 0.05). Conclusion : For patients diagnosed with recurrent or metastatic nasopharyngeal carcinoma who have been treated with PD-1 inhibitors, it has been observed that patients who do not recur, those with positive initial plasma EBV infection, patients who have received a minimum of four treatment cycles, and patients with a baseline peripheral blood SII index of less than 772.81 have been shown to have a relatively longer progression-free survival. This finding is of significant clinical relevance as it facilitates the identification of patients who demonstrate a poor response to immunotherapy, enabling early intervention and the implementation of individualised treatment plans.