Nasopharyngeal carcinoma (NPC) is a unique head and neck malignancy arising from the epithelium of the nasopharynx, with a distinctive epidemiologic and etiologic profile. It is strongly associated with Epstein-Barr virus (EBV) infection, which is present in nearly 100% of non-keratinizing NPC. The disease shows remarkable geographic variation, with high incidence in southern China, Southeast Asia, and among Inuit populations. NPC is highly radiosensitive and chemosensitive, with good cure rates for locoregional disease but poor prognosis for distant metastases.
Ask a research question about Nasopharyngeal Carcinoma. OpenScientist will conduct autonomous deep research using the Disorder Mechanisms Knowledge Base and PubMed literature (typically 10-30 minutes).
Do not include personal health information in your question. Questions and results are cached in your browser's local storage.
name: Nasopharyngeal Carcinoma
creation_date: '2026-01-26T02:55:13Z'
updated_date: '2026-05-10T13:48:49Z'
description: >-
Nasopharyngeal carcinoma (NPC) is a unique head and neck malignancy arising from
the epithelium of the nasopharynx, with a distinctive epidemiologic and etiologic
profile. It is strongly associated with Epstein-Barr virus (EBV) infection, which
is present in nearly 100% of non-keratinizing NPC. The disease shows remarkable
geographic variation, with high incidence in southern China, Southeast Asia, and
among Inuit populations. NPC is highly radiosensitive and chemosensitive, with
good cure rates for locoregional disease but poor prognosis for distant metastases.
categories:
- Head and Neck Cancer
- Viral-Associated Cancer
- EBV-Related Cancer
parents:
- pharyngeal carcinoma
has_subtypes:
- name: Non-keratinizing Carcinoma
description: >-
The most common type (greater than 95% in endemic areas), characterized by
poorly differentiated cells without keratinization. Further subdivided into
differentiated and undifferentiated subtypes. Virtually always EBV-positive.
- name: Keratinizing Squamous Cell Carcinoma
description: >-
A minority subtype (approximately 25% in non-endemic areas) showing squamous
differentiation with keratin formation. More similar to other HNSCC, often
associated with tobacco and alcohol rather than EBV.
infectious_agent:
- name: Epstein-Barr Virus (EBV)
description: >-
EBV is present in virtually all non-keratinizing NPC and is essential for
carcinogenesis. The virus establishes latent infection with expression of
specific viral proteins (LMP1, LMP2, EBNA1) and non-coding RNAs (EBERs,
BARTs) that drive oncogenic transformation.
evidence:
- reference: PMID:41016806
reference_title: "[Exploration and Functional Analysis of Epstein-Barr Virus Pathogenic Factors Using a Multidimensional Approach]."
supports: PARTIAL
snippet: "In addition to its involvement in a wide range of malignancies such as lymphomas, nasopharyngeal carcinoma, and gastric cancer, recent evidence has shown its potential association with autoimmune diseases, positioning EBV as an interdisciplinary research model linking virology, oncology, and immunology."
explanation: "Supports the association of EBV with nasopharyngeal carcinoma."
infectious_agent_term:
preferred_term: Epstein-Barr virus
term:
id: NCBITaxon:10376
label: human gammaherpesvirus 4
pathophysiology:
- name: EBV Latent Membrane Protein 1 (LMP1) Signaling
description: >-
LMP1 is the primary EBV oncoprotein in NPC, functioning as a constitutively
active receptor that mimics CD40 signaling. LMP1 activates NF-kB, MAPK,
and PI3K/AKT pathways, promoting cell survival, proliferation, and
epithelial-mesenchymal transition.
cell_types:
- preferred_term: squamous epithelial cell
term:
id: CL:0000076
label: squamous epithelial cell
biological_processes:
- preferred_term: NF-kappaB signaling
modifier: INCREASED
term:
id: GO:0038061
label: non-canonical NF-kappaB signal transduction
- preferred_term: cell population proliferation
modifier: INCREASED
term:
id: GO:0008283
label: cell population proliferation
locations:
- preferred_term: nasopharynx
term:
id: UBERON:0001728
label: nasopharynx
downstream:
- target: Anti-Apoptotic Signaling
description: NF-kB activation induces BCL2 and other survival factors
- target: Epithelial-Mesenchymal Transition
description: LMP1 promotes invasive phenotype and metastasis
- name: LMP2A-Mediated B Cell Receptor Mimicry
description: >-
LMP2A is a viral protein that mimics an activated B cell receptor,
providing survival signals that prevent viral lytic reactivation and
maintain latency. In epithelial cells, LMP2A activates PI3K/AKT and
promotes cell motility.
biological_processes:
- preferred_term: phosphatidylinositol 3-kinase signaling
modifier: INCREASED
term:
id: GO:0043491
label: phosphatidylinositol 3-kinase/protein kinase B signal transduction
- name: EBNA1-Mediated Viral Maintenance
description: >-
EBNA1 is essential for EBV genome replication and maintenance during
latency. It tethers viral episomes to host chromosomes and contributes
to genomic instability by inducing oxidative stress and interfering
with DNA damage responses.
biological_processes:
- preferred_term: viral genome replication
term:
id: GO:0019079
label: viral genome replication
- name: Host Genetic Susceptibility
description: >-
Specific HLA haplotypes, particularly HLA-A2, are associated with
increased NPC risk in endemic populations. Additional susceptibility
loci have been identified in GWAS studies, including genes involved
in immune function and DNA repair.
genes:
- preferred_term: HLA-A
term:
id: hgnc:4931
label: HLA-A
- name: Immune Evasion
conforms_to: "immune_checkpoint_blockade#Adaptive Immune Resistance"
description: >-
EBV-infected NPC cells evade immune surveillance through multiple
mechanisms including PD-L1 upregulation, suppression of antigen
presentation, and recruitment of regulatory T cells. This provides
rationale for immune checkpoint inhibition.
biological_processes:
- preferred_term: negative regulation of T cell mediated immunity
modifier: INCREASED
term:
id: GO:0002710
label: negative regulation of T cell mediated immunity
evidence:
- reference: PMID:25361008
reference_title: "EBV-driven LMP1 and IFN-γ up-regulate PD-L1 in nasopharyngeal carcinoma: Implications for oncotargeted therapy."
supports: SUPPORT
evidence_source: IN_VITRO
snippet: >-
Expression of PD-L1 was higher in EBV positive NPC cell lines compared
with EBV negative cell lines. PD-L1 expression could be increased by
exogenous and endogenous induction of LMP1 induced PD-L1.
explanation: >-
Demonstrates that EBV-driven LMP1 upregulates PD-L1 in NPC cell lines,
establishing the mechanism of immune evasion via checkpoint ligand
expression in EBV-associated nasopharyngeal carcinoma.
- reference: PMID:25361008
reference_title: "EBV-driven LMP1 and IFN-γ up-regulate PD-L1 in nasopharyngeal carcinoma: Implications for oncotargeted therapy."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Furthermore, we showed that PD-L1 was associated with worse
disease-free survival in NPC patients. These results imply that
blocking both the LMP1 oncogenic pathway and PD-1/PD-L1 checkpoints
may be a promising therapeutic approach for EBV positive NPC patients.
explanation: >-
Clinical evidence that PD-L1 expression correlates with worse
outcomes in NPC patients, supporting the role of PD-L1-mediated
immune evasion in disease progression.
histopathology:
- name: Squamous Cell Carcinoma
finding_term:
preferred_term: Squamous Cell Carcinoma
term:
id: NCIT:C2929
label: Squamous Cell Carcinoma
frequency: OCCASIONAL
description: Nasopharyngeal squamous cell carcinoma is an uncommon subtype of NPC.
evidence:
- reference: PMID:24733735
reference_title: "Nasopharyngeal squamous cell carcinoma: a comparative analysis of keratinizing and nonkeratinizing subtypes."
supports: SUPPORT
snippet: "Nasopharyngeal squamous cell carcinoma (NPSCC) is uncommon in non-endemic regions."
explanation: Abstract identifies nasopharyngeal squamous cell carcinoma as an uncommon subtype.
phenotypes:
- category: Head and Neck
name: Cervical Lymphadenopathy
frequency: VERY_FREQUENT
diagnostic: true
description: >-
Painless neck mass from nodal metastases is the most common presenting
symptom (60-90% of cases). Often the primary tumor is small and
asymptomatic while nodal disease is prominent.
phenotype_term:
preferred_term: cervical lymphadenopathy
term:
id: HP:0002716
label: Lymphadenopathy
evidence:
- reference: PMID:7845856
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Presenting symptoms may be subtle and may include epistaxis, neck pain, hearing impairment, otorrhea, rhinorrhea, and, most likely, painless cervical adenopathy."
explanation: >-
Painless cervical adenopathy is identified as the most likely
presenting sign of nasopharyngeal carcinoma, supporting its role as
the predominant clinical feature at diagnosis.
- category: Nasal
name: Nasal Obstruction
frequency: FREQUENT
description: >-
Nasal stuffiness and obstruction occur when the tumor enlarges in
the nasopharynx, blocking the posterior nares.
phenotype_term:
preferred_term: Nasal congestion
term:
id: HP:0001742
label: Nasal congestion
evidence:
- reference: PMID:22314474
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "A 24 years old lady came to our Department of Otolaryngology and Head-Neck Surgery with the complaints of epistaxis, right sided neck swelling, nasal obstruction and headache."
explanation: >-
Case report documenting nasal obstruction as a presenting complaint
in nasopharyngeal carcinoma alongside other classic symptoms.
- category: Otologic
name: Hearing Loss
frequency: FREQUENT
description: >-
Conductive hearing loss and middle ear effusion occur due to
eustachian tube obstruction by the nasopharyngeal tumor.
phenotype_term:
preferred_term: Conductive hearing impairment
term:
id: HP:0000405
label: Conductive hearing impairment
evidence:
- reference: PMID:7845856
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Presenting symptoms may be subtle and may include epistaxis, neck pain, hearing impairment, otorrhea, rhinorrhea, and, most likely, painless cervical adenopathy."
explanation: >-
Hearing impairment is recognized as one of the subtle presenting
symptoms of nasopharyngeal carcinoma, attributable to eustachian
tube obstruction by the tumor.
- category: Nasal
name: Epistaxis
frequency: FREQUENT
description: >-
Nosebleeds may occur from tumor surface ulceration or erosion
into blood vessels.
phenotype_term:
preferred_term: Epistaxis
term:
id: HP:0000421
label: Epistaxis
evidence:
- reference: PMID:7845856
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Presenting symptoms may be subtle and may include epistaxis, neck pain, hearing impairment, otorrhea, rhinorrhea, and, most likely, painless cervical adenopathy."
explanation: >-
Epistaxis is listed among the early presenting symptoms of
nasopharyngeal carcinoma in this clinical review.
- category: Neurologic
name: Cranial Nerve Involvement
frequency: OCCASIONAL
description: >-
Skull base invasion can cause cranial nerve palsies, particularly
CN V (trigeminal) causing facial numbness, and CN VI (abducens)
causing diplopia. Advanced tumors may involve CN IX-XII.
phenotype_term:
preferred_term: Cranial nerve paralysis
term:
id: HP:0006824
label: Cranial nerve paralysis
evidence:
- reference: PMID:16739664
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "The cases of CN palsy most commonly involved CN V (38%), CN VI (26%), and CN XII (11%), which accounted for the majority of the cases (75%)."
explanation: >-
Retrospective study of 93 NPC patients with cranial nerve palsy
at diagnosis quantifies the predominant involvement of CN V, VI,
and XII, supporting the description of cranial nerve involvement
as a recognized NPC phenotype.
- category: Neurologic
name: Headache
frequency: OCCASIONAL
description: >-
Headache may indicate skull base invasion or intracranial extension.
phenotype_term:
preferred_term: Headache
term:
id: HP:0002315
label: Headache
evidence:
- reference: PMID:23304077
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Headache can be the only symptom of NPC. A timely diagnosis, albeit challenging to physicians, provides good outcomes in terms of both pain relief and tumor control."
explanation: >-
Retrospective case series demonstrates that headache can be the
sole presenting symptom of nasopharyngeal carcinoma, supporting
its inclusion as a recognized clinical phenotype.
biochemical:
- name: EBV DNA (Plasma)
notes: >-
Circulating EBV DNA is a sensitive and specific biomarker for NPC.
Plasma EBV DNA levels correlate with tumor burden and can be used
for screening in endemic populations, diagnosis, monitoring treatment
response, and surveillance for recurrence.
- name: EBV-Encoded RNA (EBERs) In Situ Hybridization
notes: >-
Detection of EBERs by in situ hybridization confirms EBV presence
in tumor cells and is the gold standard for diagnosing EBV-associated
NPC.
genetic:
- name: HLA-A
association: Susceptibility Alleles
notes: >-
HLA-A2 and other specific HLA alleles are associated with increased
NPC risk in endemic populations. The HLA region shows the strongest
genetic association with NPC susceptibility.
- name: TP53
association: Occasionally Mutated
notes: >-
TP53 mutations are less common in NPC than in HPV-negative HNSCC,
occurring in approximately 10% of cases.
- name: CDKN2A
association: Deletion/Methylation
notes: >-
CDKN2A inactivation through homozygous deletion or promoter methylation
occurs in approximately 30-50% of NPC, contributing to cell cycle
dysregulation.
- name: NF-kB Pathway Alterations
association: Various Mutations
notes: >-
Mutations in NF-kB pathway genes (TRAF3, CYLD, NFKBIA) occur in
approximately 30-40% of NPC, leading to constitutive NF-kB activation
independent of LMP1.
treatments:
- name: Intensity-Modulated Radiation Therapy
description: >-
NPC is highly radiosensitive. IMRT is the standard of care for
locoregional disease, allowing precise dose delivery while sparing
critical structures including parotid glands, temporal lobes, and
brainstem.
treatment_term:
preferred_term: radiation therapy
term:
id: MAXO:0000014
label: radiation therapy
- name: Concurrent Chemoradiation
description: >-
Concurrent cisplatin during radiation followed by adjuvant chemotherapy
is standard for locally advanced NPC (stages III-IVA). This approach
improves overall survival compared to radiation alone.
treatment_term:
preferred_term: radiation therapy
term:
id: MAXO:0000014
label: radiation therapy
therapeutic_agent:
- preferred_term: cisplatin
term:
id: CHEBI:27899
label: cisplatin
- name: Induction Chemotherapy
description: >-
Induction chemotherapy (gemcitabine-cisplatin or TPF) before
chemoradiation is increasingly used for locally advanced disease
based on recent trials showing improved survival.
treatment_term:
preferred_term: chemotherapy
term:
id: MAXO:0000647
label: chemotherapy
therapeutic_agent:
- preferred_term: gemcitabine
term:
id: CHEBI:175901
label: gemcitabine
- preferred_term: cisplatin
term:
id: CHEBI:27899
label: cisplatin
- name: Immunotherapy
description: >-
PD-1 inhibitors have shown significant activity in recurrent/metastatic
NPC, with durable responses in a subset of patients. EBV antigens may
serve as targets for immunotherapy, and adoptive T cell therapy
targeting EBV is under investigation.
treatment_term:
preferred_term: immunotherapy
term:
id: NCIT:C15262
label: Immunotherapy
target_mechanisms:
- target: Immune Evasion
treatment_effect: INHIBITS
description: >-
Anti-PD-1 antibodies block PD-L1-mediated immune evasion in NPC,
restoring T cell recognition of EBV-associated and somatic neoantigens.
NPC's viral antigen load and PD-L1 upregulation make it susceptible
to checkpoint blockade.
disease_term:
preferred_term: nasopharyngeal carcinoma
term:
id: MONDO:0015459
label: nasopharyngeal carcinoma
classifications:
icdo_morphology:
classification_value: Squamous Cell Carcinoma
harrisons_chapter:
- classification_value: cancer
- classification_value: solid tumor
references:
- reference: DOI:10.1002/advs.202403161
title: Primary and Orthotopic Murine Models of Nasopharyngeal Carcinoma Reveal Molecular Mechanisms Underlying its Malignant Progression
found_in:
- Nasopharyngeal_Carcinoma-deep-research-falcon.md
findings:
- statement: Nasopharyngeal carcinoma (NPC), a squamous cell carcinoma originating in the nasopharynx, is a leading malignancy in south China and other south and east Asia areas.
supporting_text: Nasopharyngeal carcinoma (NPC), a squamous cell carcinoma originating in the nasopharynx, is a leading malignancy in south China and other south and east Asia areas.
evidence:
- reference: DOI:10.1002/advs.202403161
reference_title: Primary and Orthotopic Murine Models of Nasopharyngeal Carcinoma Reveal Molecular Mechanisms Underlying its Malignant Progression
supports: SUPPORT
evidence_source: MODEL_ORGANISM
snippet: Nasopharyngeal carcinoma (NPC), a squamous cell carcinoma originating in the nasopharynx, is a leading malignancy in south China and other south and east Asia areas.
explanation: Deep research cited this publication as relevant literature for Nasopharyngeal Carcinoma.
- reference: DOI:10.1007/s00210-025-04572-3
title: 'Efficacy and safety of immune checkpoint inhibitors for locoregionally advanced, recurrent and metastatic nasopharyngeal carcinoma: a systematic review of phase III randomised controlled trials'
found_in:
- Nasopharyngeal_Carcinoma-deep-research-falcon.md
findings:
- statement: Immune checkpoint inhibitors (ICIs) are an emerging treatment option for cancer.
supporting_text: Immune checkpoint inhibitors (ICIs) are an emerging treatment option for cancer.
evidence:
- reference: DOI:10.1007/s00210-025-04572-3
reference_title: 'Efficacy and safety of immune checkpoint inhibitors for locoregionally advanced, recurrent and metastatic nasopharyngeal carcinoma: a systematic review of phase III randomised controlled trials'
supports: SUPPORT
evidence_source: OTHER
snippet: Immune checkpoint inhibitors (ICIs) are an emerging treatment option for cancer.
explanation: Deep research cited this publication as relevant literature for Nasopharyngeal Carcinoma.
- reference: DOI:10.1007/s00262-024-03698-2
title: 'The efficacy and safety of adding PD-1 blockade to induction chemotherapy and concurrent chemoradiotherapy (IC-CCRT) for locoregionally advanced nasopharyngeal carcinoma: an observational, propensity score-matched analysis'
found_in:
- Nasopharyngeal_Carcinoma-deep-research-falcon.md
findings:
- statement: Despite the success of PD-1 blockade in recurrent/metastatic nasopharyngeal carcinoma (NPC), its effect for locoregionally advanced NPC (LANPC) remains unclear.
supporting_text: Despite the success of PD-1 blockade in recurrent/metastatic nasopharyngeal carcinoma (NPC), its effect for locoregionally advanced NPC (LANPC) remains unclear.
evidence:
- reference: DOI:10.1007/s00262-024-03698-2
reference_title: 'The efficacy and safety of adding PD-1 blockade to induction chemotherapy and concurrent chemoradiotherapy (IC-CCRT) for locoregionally advanced nasopharyngeal carcinoma: an observational, propensity score-matched analysis'
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Despite the success of PD-1 blockade in recurrent/metastatic nasopharyngeal carcinoma (NPC), its effect for locoregionally advanced NPC (LANPC) remains unclear.
explanation: Deep research cited this publication as relevant literature for Nasopharyngeal Carcinoma.
- reference: DOI:10.1007/s12672-024-01242-3
title: Recent advances in early detection of nasopharyngeal carcinoma
found_in:
- Nasopharyngeal_Carcinoma-deep-research-falcon.md
findings:
- statement: Recent advances in early detection of nasopharyngeal carcinoma
supporting_text: Recent advances in early detection of nasopharyngeal carcinoma
- reference: DOI:10.1016/j.xgen.2023.100474
title: 'Host genetic variants, Epstein-Barr virus subtypes, and the risk of nasopharyngeal carcinoma: Assessment of interaction and mediation'
found_in:
- Nasopharyngeal_Carcinoma-deep-research-falcon.md
findings:
- statement: 'Host genetic variants, Epstein-Barr virus subtypes, and the risk of nasopharyngeal carcinoma: Assessment of interaction and mediation'
supporting_text: 'Host genetic variants, Epstein-Barr virus subtypes, and the risk of nasopharyngeal carcinoma: Assessment of interaction and mediation'
- reference: DOI:10.1093/jnci/djad012
title: Recommendations for Epstein-Barr virus–based screening for nasopharyngeal cancer in high- and intermediate-risk regions
found_in:
- Nasopharyngeal_Carcinoma-deep-research-falcon.md
findings:
- statement: Recommendations for Epstein-Barr virus–based screening for nasopharyngeal cancer in high- and intermediate-risk regions
supporting_text: A meeting of experts was held in November 2021 to review and discuss available data on performance of Epstein-Barr virus (EBV)–based approaches to screen for early stage nasopharyngeal carcinoma (NPC) and methods for the investigation and management of screen-positive individuals.
evidence:
- reference: DOI:10.1093/jnci/djad012
reference_title: Recommendations for Epstein-Barr virus–based screening for nasopharyngeal cancer in high- and intermediate-risk regions
supports: SUPPORT
evidence_source: OTHER
snippet: A meeting of experts was held in November 2021 to review and discuss available data on performance of Epstein-Barr virus (EBV)–based approaches to screen for early stage nasopharyngeal carcinoma (NPC) and methods for the investigation and management of screen-positive individuals.
explanation: Deep research cited this publication as relevant literature for Nasopharyngeal Carcinoma.
- reference: DOI:10.1136/bmjopen-2024-091087
title: 'Global epidemiological profile in nasopharyngeal carcinoma: a prediction study'
found_in:
- Nasopharyngeal_Carcinoma-deep-research-falcon.md
findings:
- statement: This study delineates the global nasopharyngeal carcinoma’s (NPC) incidence and mortality across 185 countries in 2020 and projects the disease’s burden by 2040.
supporting_text: This study delineates the global nasopharyngeal carcinoma’s (NPC) incidence and mortality across 185 countries in 2020 and projects the disease’s burden by 2040.
evidence:
- reference: DOI:10.1136/bmjopen-2024-091087
reference_title: 'Global epidemiological profile in nasopharyngeal carcinoma: a prediction study'
supports: SUPPORT
evidence_source: COMPUTATIONAL
snippet: This study delineates the global nasopharyngeal carcinoma’s (NPC) incidence and mortality across 185 countries in 2020 and projects the disease’s burden by 2040.
explanation: Deep research cited this publication as relevant literature for Nasopharyngeal Carcinoma.
- reference: DOI:10.1186/s12885-025-14539-5
title: Diagnostic performance of EBV DNA load testing for nasopharyngeal carcinoma in nasopharyngeal swab outperforms the approach in other specimens
found_in:
- Nasopharyngeal_Carcinoma-deep-research-falcon.md
findings:
- statement: Diagnostic performance of EBV DNA load testing for nasopharyngeal carcinoma in nasopharyngeal swab outperforms the approach in other specimens
supporting_text: Diagnostic performance of EBV DNA load testing for nasopharyngeal carcinoma in nasopharyngeal swab outperforms the approach in other specimens
- reference: DOI:10.21037/tcr-2025-415
title: 'Efficacy, safety and cost-effectiveness of chemo-immunotherapy combinations for recurrent or metastatic nasopharyngeal carcinoma: an updated systematic review and cost-effectiveness analysis'
found_in:
- Nasopharyngeal_Carcinoma-deep-research-falcon.md
findings:
- statement: 'Efficacy, safety and cost-effectiveness of chemo-immunotherapy combinations for recurrent or metastatic nasopharyngeal carcinoma: an updated systematic review and cost-effectiveness analysis'
supporting_text: 'Efficacy, safety and cost-effectiveness of chemo-immunotherapy combinations for recurrent or metastatic nasopharyngeal carcinoma: an updated systematic review and cost-effectiveness analysis'
- reference: DOI:10.3389/fmicb.2023.1116143
title: The role of Epstein–Barr virus in nasopharyngeal carcinoma
found_in:
- Nasopharyngeal_Carcinoma-deep-research-falcon.md
findings:
- statement: Nasopharyngeal carcinoma (NPC) is a metastasis-prone malignancy closely associated with the Epstein–Barr virus (EBV).
supporting_text: Nasopharyngeal carcinoma (NPC) is a metastasis-prone malignancy closely associated with the Epstein–Barr virus (EBV).
evidence:
- reference: DOI:10.3389/fmicb.2023.1116143
reference_title: The role of Epstein–Barr virus in nasopharyngeal carcinoma
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Nasopharyngeal carcinoma (NPC) is a metastasis-prone malignancy closely associated with the Epstein–Barr virus (EBV).
explanation: Deep research cited this publication as relevant literature for Nasopharyngeal Carcinoma.
- reference: DOI:10.3389/fonc.2025.1687320
title: 'Shifting burden of nasopharyngeal carcinoma: global patterns and forecasts to 2050 from the GBD 2021'
found_in:
- Nasopharyngeal_Carcinoma-deep-research-falcon.md
findings:
- statement: Nasopharyngeal carcinoma (NPC) exhibits pronounced geographical variation, with a high burden in specific regions.
supporting_text: Nasopharyngeal carcinoma (NPC) exhibits pronounced geographical variation, with a high burden in specific regions.
evidence:
- reference: DOI:10.3389/fonc.2025.1687320
reference_title: 'Shifting burden of nasopharyngeal carcinoma: global patterns and forecasts to 2050 from the GBD 2021'
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Nasopharyngeal carcinoma (NPC) exhibits pronounced geographical variation, with a high burden in specific regions.
explanation: Deep research cited this publication as relevant literature for Nasopharyngeal Carcinoma.
- reference: DOI:10.3390/microorganisms12010014
title: Recent Advances in Assessing the Clinical Implications of Epstein-Barr Virus Infection and Their Application to the Diagnosis and Treatment of Nasopharyngeal Carcinoma
found_in:
- Nasopharyngeal_Carcinoma-deep-research-falcon.md
findings:
- statement: Reports about the oncogenic mechanisms underlying nasopharyngeal carcinoma (NPC) have been accumulating since the discovery of Epstein-Barr virus (EBV) in NPC cells.
supporting_text: Reports about the oncogenic mechanisms underlying nasopharyngeal carcinoma (NPC) have been accumulating since the discovery of Epstein-Barr virus (EBV) in NPC cells.
evidence:
- reference: DOI:10.3390/microorganisms12010014
reference_title: Recent Advances in Assessing the Clinical Implications of Epstein-Barr Virus Infection and Their Application to the Diagnosis and Treatment of Nasopharyngeal Carcinoma
supports: SUPPORT
evidence_source: OTHER
snippet: Reports about the oncogenic mechanisms underlying nasopharyngeal carcinoma (NPC) have been accumulating since the discovery of Epstein-Barr virus (EBV) in NPC cells.
explanation: Deep research cited this publication as relevant literature for Nasopharyngeal Carcinoma.
- reference: DOI:10.47391/jpma.20757
title: 'Toripalimab: A new age in fighting Nasopharyngeal Carcinoma'
found_in:
- Nasopharyngeal_Carcinoma-deep-research-falcon.md
findings:
- statement: 'Toripalimab: A new age in fighting Nasopharyngeal Carcinoma'
supporting_text: Madam, Nasopharyngeal carcinomas (NPCs) lie amongst a group of malignant tumours whose incidence has steadily increased over the past 30 years.[1] These have a significantly higher incidence rate in Asian populations, which account for over 70% of new cases worldwide.[2] The leading risk factors associated with NPCs are tobacco and alcohol consumption, followed by HPV infections.
evidence:
- reference: DOI:10.47391/jpma.20757
reference_title: 'Toripalimab: A new age in fighting Nasopharyngeal Carcinoma'
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: Madam, Nasopharyngeal carcinomas (NPCs) lie amongst a group of malignant tumours whose incidence has steadily increased over the past 30 years.[1] These have a significantly higher incidence rate in Asian populations, which account for over 70% of new cases worldwide.[2] The leading risk factors associated with NPCs are tobacco and alcohol consumption, followed by HPV infections.
explanation: Deep research cited this publication as relevant literature for Nasopharyngeal Carcinoma.
Nasopharyngeal carcinoma is an epithelial head-and-neck malignancy originating from the mucosal lining of the nasopharynx (zhou2026shiftingburdenof pages 1-2). It is notable for pronounced geographic clustering (endemic regions in Southern China and parts of Southeast Asia and North Africa) and for a strong association with Epstein–Barr virus (EBV), particularly in endemic non-keratinizing forms (jiang2024recentadvancesin pages 1-2, su2023theroleof pages 1-2).
Not retrieved in the available corpus (therefore not asserted): ICD-10/ICD-11 codes, MeSH ID, Orphanet ID, OMIM disease ID.
This report synthesizes aggregated disease-level resources (expert recommendations, reviews, global burden datasets) and primary human studies (screening/diagnostic accuracy, case-control host–virus genetics) plus experimental models (organoid-initiated murine orthotopic models). (lam2023recommendationsforepsteinbarr pages 4-4, li2025diagnosticperformanceof pages 2-4, xu2024hostgeneticvariants pages 5-6, wan2024primaryandorthotopic pages 9-12)
EBV as principal etiologic driver in endemic NPC. Reviews and expert sources emphasize that endemic NPC is EBV-associated and that EBV–host and tumor–immune interactions are central to its pathogenesis. For example, a 2023 review states that “EBV is the primary causative agent of NPC” and highlights EBV immune interactions as defining pathology (undifferentiated carcinoma with extensive lymphocyte infiltration). (yoshizaki2023recentadvancesin pages 8-9)
NPC is “closely associated with the Epstein–Barr virus (EBV)” and EBV-associated biomarkers have been leveraged for mass screening in endemic regions (su2023theroleof pages 1-2).
A 2024 population-based case-control study in endemic southern China (Cell Genomics; published Feb 2024; URL https://doi.org/10.1016/j.xgen.2023.100474) quantified a strong host HLA × EBV subtype interaction. The authors reported GWAS evidence that “HLA genes have the most consistent and prominent evidence for the association with NPC,” citing rs2860580 (OR 1.72) and rs2894207 (OR 1.64) (xu2024hostgeneticvariants pages 3-4). They found that an EBV subtype defined by variant 163364 was associated with a 6.86-fold increased NPC risk and demonstrated substantial additive interaction (RERI 4.08 and 3.37 for the two HLA SNPs), implying that a large fraction of inherited susceptibility manifests in the presence of high-risk EBV (xu2024hostgeneticvariants pages 5-6).
Recent synthesis sources highlight: - Salt-preserved foods (nitrosamines and EBV-reactivating chemicals). A 2024 early-detection review reports preserved-food intake associated with relative risks spanning roughly 1.4–3.2 (weekly) and 1.8–7.5 (daily) across Chinese studies (jiang2024recentadvancesin pages 2-5). - Smoking and occupational exposures including dusts/formaldehyde are repeatedly described as contributing to NPC risk and geographic heterogeneity (zhang2024globalepidemiologicalprofile pages 1-1, jiang2024recentadvancesin pages 2-5).
Robust protective genetic or environmental factors were not directly supported in the retrieved primary corpus and are therefore not asserted.
The most clearly quantified interaction in the retrieved 2023–2024 primary literature is host HLA × EBV subtype (gene–virus). The Cell Genomics study concluded that targeting high-risk EBV carriers and/or high-risk viral lineages could substantially reduce risk in endemic settings (xu2024hostgeneticvariants pages 1-3, xu2024hostgeneticvariants pages 5-6).
Clinical presentation can be non-specific, contributing to delayed diagnosis. A 2023 review lists common symptoms including “headache, epistaxis, and facial pain” (su2023theroleof pages 1-2).
Candidate HPO terms (suggestions): - Epistaxis — HP:0000421 - Headache — HP:0002315 - Facial pain — HP:0000337
A 2023 review describes WHO histologic categories: keratinizing squamous cell carcinoma (type 1), non-keratinizing squamous cell carcinoma (type 2), and undifferentiated carcinoma (type 3), noting EBV prevalence is “100% in type 2 and type 3 NPC” in endemic areas (su2023theroleof pages 1-2). A 2024 review similarly emphasizes that endemic NPC is dominated by EBV-associated non-keratinizing tumors (“accounting for over 95% of cases” in endemic areas) (jiang2024recentadvancesin pages 1-2).
NPC has strong sex and age patterns: a 2024 review states men are “two to three times more likely” than women to develop NPC and that the “peak age of disease occurrence” is ~45 years (jiang2024recentadvancesin pages 1-2). A key clinical pattern is late presentation: “up to 80%” diagnosed at stage III–IV and “10%” with distant metastases (jiang2024recentadvancesin pages 1-2).
Direct QoL instrument data (e.g., EORTC QLQ-H&N, EQ-5D) were not retrieved. Indirectly, advanced-stage disease requires more intensive multimodality therapy and has worse outcomes than early-stage disease (su2023theroleof pages 1-2, yoshizaki2023recentadvancesin pages 8-9).
EBV latent and lytic gene programs. A 2023 review highlights EBV–host and tumor–immune interactions and notes key EBV genes including LMP1 (oncogene) and BZLF1 (lytic induction) (yoshizaki2023recentadvancesin pages 8-9). Reviews also emphasize that elevated anti-EBV antibodies and plasma EBV DNA are clinically used biomarkers for EBV-associated NPC (yoshizaki2023recentadvancesin pages 8-9, yoshizaki2023recentadvancesin pages 9-11).
Pathway-level concepts (review-synthesized). EBV latent proteins are described to influence oncogenic signaling and immune evasion; authoritative reviews cite involvement of immune checkpoints and immunosuppressive tumor microenvironment (yoshizaki2023recentadvancesin pages 8-9, su2023theroleof pages 1-2).
The Cell Genomics 2024 study provides primary, quantitative evidence that common HLA-associated SNPs (rs2860580; rs2894207) confer modest risk (OR ~1.6–1.7) but interact strongly with a high-risk EBV subtype (variant 163364), indicating that host genetics and EBV strain jointly drive NPC risk (xu2024hostgeneticvariants pages 3-4, xu2024hostgeneticvariants pages 5-6).
Recent reviews emphasize aberrant DNA methylation as an early and important molecular theme (e.g., tumor suppressor methylation in NPC) (jiang2024recentadvancesin pages 2-5).
A 2024 Advanced Science study (published Jul 2024; URL https://doi.org/10.1002/advs.202403161) developed organoid-initiated murine models: “we created a serial of primary, orthotopic, and genetic driver-defined NPC mouse models initiated with gene-edited normal nasopharyngeal organoids.” (wan2024primaryandorthotopic pages 9-12). In these models, the authors “experimentally validated TP53 and CDKN2A as bona fide tumor suppressors of NPC” and reported that TGFBR2 loss promoted progression and lung metastasis and LMP1 promoted distal metastasis (wan2024primaryandorthotopic pages 9-12, wan2024primaryandorthotopic pages 6-7).
Suggested GO Biological Process terms (examples): - EBV infection / host–virus interaction — “viral process” (GO:0016032) - Immune evasion / immune checkpoint signaling — “negative regulation of T cell activation” (GO:0050868) - DNA methylation — “DNA methylation” (GO:0006306) - EMT and metastasis — “epithelial to mesenchymal transition” (GO:0001837)
Suggested CL (cell type) terms (examples): - Nasopharyngeal epithelial cell / squamous epithelial cell (epithelial lineage; CL suggestions) - Tumor-infiltrating lymphocytes (T cell; B cell; macrophage)
NPC’s geographic clustering is attributed to a combination of EBV, host genetics, and environmental/lifestyle risks. A GLOBOCAN-based epidemiology analysis explicitly lists etiologic contributors including “Epstein-Barr virus (EBV) infection, smoking, consumption of salted fish and other preserved foods and occupational exposure to wood dust” (zhang2024globalepidemiologicalprofile pages 1-1).
1) EBV infection of nasopharyngeal epithelium with persistence/latency and tumor–immune interactions (yoshizaki2023recentadvancesin pages 8-9, su2023theroleof pages 1-2). 2) Host susceptibility (notably HLA-region variation) shapes immune recognition of EBV and—together with high-risk viral lineages—markedly increases cancer risk (xu2024hostgeneticvariants pages 5-6). 3) Oncogenic signaling + epigenetic reprogramming (including methylation patterns) support malignant transformation and immune escape (jiang2024recentadvancesin pages 2-5). 4) Progression and metastasis are promoted by viral oncogenes (e.g., LMP1) and by loss of tumor suppressors / microenvironmental remodeling (TP53/CDKN2A/TGFBR2 in murine orthotopic models) (wan2024primaryandorthotopic pages 9-12).
Suggested UBERON term (example): - Nasopharynx — UBERON:0001736 (suggested; ontology mapping not directly retrieved in sources)
NPC often has an insidious course with non-specific symptoms; late-stage diagnosis is common (su2023theroleof pages 1-2, jiang2024recentadvancesin pages 1-2).
The TNM system is the primary framework for risk evaluation and treatment stratification (jiang2024recentadvancesin pages 1-2).
A 2024 BMJ Open prediction study using GLOBOCAN 2020 reports 133,354 NPC cases and 80,008 deaths globally in 2020, with East Asia as the “epicentre” accounting for 49.39% of cases and 45.56% of deaths (published Dec 2024; URL https://doi.org/10.1136/bmjopen-2024-091087) (zhang2024globalepidemiologicalprofile pages 1-1). The study projects growth to 179,476 cases and 113,851 deaths by 2040 under demographic change assumptions (zhang2024globalepidemiologicalprofile pages 4-5).
A 2024 review highlights extreme regional variation (incidence >15/100,000 person-years in some Southeast Asian communities vs <1/100,000 in the United States) and endemic concentration in Southern China, Southeast Asia, and Northern Africa (published Aug 2024; URL https://doi.org/10.1007/s12672-024-01242-3) (jiang2024recentadvancesin pages 1-2).
NPC is best characterized as multifactorial (polygenic susceptibility interacting with EBV and environment). The strongest quantified 2024 human evidence is a host HLA × EBV subtype interaction (xu2024hostgeneticvariants pages 5-6).
Nasopharyngeal endoscopy with pathologic examination remains the diagnostic gold standard (yoshizaki2023recentadvancesin pages 8-9). Screening-positive individuals can undergo confirmatory evaluation with endoscopy and, per expert recommendations, MRI to improve sensitivity (lam2023recommendationsforepsteinbarr pages 1-2).
Expert recommendations (2023). A 2023 JNCI expert meeting report concluded that serum EBV antibody testing and plasma EBV DNA testing “were found to have favorable performance characteristics and to be cost-effective in high-risk populations,” and that MRI use in evaluation of screen-positive individuals increases sensitivity (published Feb 2023; URL https://doi.org/10.1093/jnci/djad012) (lam2023recommendationsforepsteinbarr pages 1-2).
Screening performance metrics (Table evidence). The same JNCI report tabulated 1-year screening metrics: EBV IgA serology sensitivity 93%, specificity 97%, PPV 4.4%; plasma EBV DNA sensitivity 97%, specificity 99%, PPV 11.0% (lam2023recommendationsforepsteinbarr pages 4-4). The table is captured as an image (lam2023recommendationsforepsteinbarr media a09887fa).
Specimen-based EBV DNA diagnostic accuracy (2025 case-control). In a paired-specimen case-control study (150 NPC cases vs 150 controls), EBV DNA in nasopharyngeal swabs had higher AUC (0.97) than plasma (0.93); at specified cutoffs, swab sensitivity 92.0% and specificity 98.67%, plasma sensitivity 85.33% and specificity 98.67% (published Jul 2025; URL https://doi.org/10.1186/s12885-025-14539-5) (li2025diagnosticperformanceof pages 2-4).
Detailed differential diagnosis lists were not comprehensively retrieved. However, expert recommendations discuss advanced MRI approaches to distinguish early NPC from benign hyperplasia in diagnostic evaluation contexts (lam2023recommendationsforepsteinbarr pages 9-10).
Stage at diagnosis strongly influences survival. A 2023 review reports a “5-year overall survival (OS) rate… as high as 94%” for early-stage NPC and “73.7%” for late-stage (III–IV) disease (su2023theroleof pages 1-2). In a 2024 review, stage II 5-year disease-specific survival is cited as 97.3% (jiang2024recentadvancesin pages 1-2). These figures underscore the importance of earlier detection and screening in high-risk populations.
A 2023 review states early-stage NPC is treated with radiotherapy alone, whereas advanced-stage disease typically requires combined chemotherapy and radiotherapy (yoshizaki2023recentadvancesin pages 8-9). Locoregionally advanced disease is commonly approached with induction chemotherapy and concurrent chemoradiotherapy in contemporary practice (jin2024theefficacyand pages 1-3).
Regulatory implementation (United States). A 2025 commentary letter reports that toripalimab was approved by the US FDA on 10/27/2023 for first-line treatment of locally advanced/recurrent/metastatic NPC in combination with cisplatin + gemcitabine, and as monotherapy after progression on platinum therapy (published Jan 2025; URL https://doi.org/10.47391/jpma.20757) (siddiqui2025toripalimabanew pages 1-1).
Clinical evidence base (summarized). Systematic and consensus sources describe multiple phase III trials adding PD-1 inhibitors to gemcitabine/cisplatin chemotherapy in recurrent/metastatic NPC (e.g., JUPITER-02 and CAPTAIN-1st) (qiu2025efficacysafetyand pages 1-3, manoharan2025efficacyandsafety pages 6-7). In locoregionally advanced NPC, a 2024 real-world propensity score-matched analysis reported improved complete response and cfEBV DNA clearance and numerically improved 3-year DFS (84% to 95%) with added PD-1 blockade, with comparable grade 3–4 toxicity (published May 2024; URL https://doi.org/10.1007/s00262-024-03698-2) (jin2024theefficacyand pages 1-3).
Examples of ongoing/registered immunotherapy trials from retrieved ClinicalTrials.gov records: - NCT04376866 (Phase 3; recruiting): toripalimab + concurrent cisplatin chemoradiotherapy vs chemoradiotherapy alone for locoregionally recurrent NPC; primary outcome overall survival (5-year) (NCT04376866 chunk 1). - NCT05211232: neoadjuvant and adjuvant tislelizumab in stage III–IVA nonkeratinizing NPC; toxicity outcomes include CTCAE v5.0 acute/late radiation toxicity (NCT05211232 chunk 2).
Suggested MAXO treatment action terms (examples; ontology suggestions): - Radiotherapy — MAXO:0000017 (suggested) - Chemotherapy — MAXO:0000010 (suggested) - Immune checkpoint inhibitor therapy — MAXO:0001023 (suggested)
No licensed EBV vaccine exists; reviews note this as an unmet need (yoshizaki2023recentadvancesin pages 8-9). Risk-factor modification efforts focus on reducing preserved-food exposures, smoking, and occupational carcinogen exposures (zhang2024globalepidemiologicalprofile pages 1-1, jiang2024recentadvancesin pages 2-5).
A 2023 expert panel recommended EBV-based screening (serology or plasma EBV DNA) in high- and intermediate-risk regions, with endoscopy and MRI used for assessment of screen-positive individuals (published Feb 2023; URL https://doi.org/10.1093/jnci/djad012) (lam2023recommendationsforepsteinbarr pages 1-2). The panel reported 1-year screening metrics (Table 1) consistent with high specificity and improved PPV for plasma EBV DNA relative to serology (lam2023recommendationsforepsteinbarr media a09887fa).
No evidence for naturally occurring nasopharyngeal carcinoma in non-human species was retrieved in the current tool-based corpus.
A major 2024 advance is the availability of organoid-initiated, orthotopic murine models. Wan et al. reported creation of “the first primary and orthotopic NPC models” from gene-edited nasopharyngeal organoids and used these to establish functional roles for TP53, CDKN2A, TGFBR2, and EBV oncoprotein LMP1 in initiation/progression/metastasis (published Jul 2024; URL https://doi.org/10.1002/advs.202403161) (wan2024primaryandorthotopic pages 9-12). They explicitly note the limitation that “it is impossible to directly study EBV infection in mice,” highlighting the need for complementary in vitro/humanized systems (wan2024primaryandorthotopic pages 9-12).
Within the retrieved corpus, ICD/MeSH/Orphanet identifiers, detailed differential diagnosis lists, and QoL instrument statistics were not directly accessible; these are therefore not asserted and should be filled from dedicated ontology/registry resources in a follow-on curation pass.
References
(OpenTargets Search: Nasopharyngeal carcinoma,Nasopharyngeal cancer): Open Targets Query (Nasopharyngeal carcinoma,Nasopharyngeal cancer, 21 results). Buniello, A. et al. (2025). Open Targets Platform: facilitating therapeutic hypotheses building in drug discovery. Nucleic Acids Research.
(jiang2024recentadvancesin pages 1-2): Wen Jiang, Bohao Zheng, and Hongquan Wei. Recent advances in early detection of nasopharyngeal carcinoma. Discover Oncology, Aug 2024. URL: https://doi.org/10.1007/s12672-024-01242-3, doi:10.1007/s12672-024-01242-3. This article has 18 citations.
(zhou2026shiftingburdenof pages 1-2): Enhui Zhou, Feifei Xu, Tianjiao Zhou, Jingyu Zhang, Fan Song, Jianxiang Li, Hongliang Yi, Qingliang Wang, and Weijun Huang. Shifting burden of nasopharyngeal carcinoma: global patterns and forecasts to 2050 from the gbd 2021. Frontiers in Oncology, Jan 2026. URL: https://doi.org/10.3389/fonc.2025.1687320, doi:10.3389/fonc.2025.1687320. This article has 1 citations.
(zhang2024globalepidemiologicalprofile pages 1-1): Yuna Zhang, Shanshan Gu, Hongxia Deng, and Zhisen Shen. Global epidemiological profile in nasopharyngeal carcinoma: a prediction study. BMJ Open, 14:e091087, Dec 2024. URL: https://doi.org/10.1136/bmjopen-2024-091087, doi:10.1136/bmjopen-2024-091087. This article has 27 citations and is from a peer-reviewed journal.
(zhang2024globalepidemiologicalprofile pages 2-3): Yuna Zhang, Shanshan Gu, Hongxia Deng, and Zhisen Shen. Global epidemiological profile in nasopharyngeal carcinoma: a prediction study. BMJ Open, 14:e091087, Dec 2024. URL: https://doi.org/10.1136/bmjopen-2024-091087, doi:10.1136/bmjopen-2024-091087. This article has 27 citations and is from a peer-reviewed journal.
(zhang2024globalepidemiologicalprofile pages 4-5): Yuna Zhang, Shanshan Gu, Hongxia Deng, and Zhisen Shen. Global epidemiological profile in nasopharyngeal carcinoma: a prediction study. BMJ Open, 14:e091087, Dec 2024. URL: https://doi.org/10.1136/bmjopen-2024-091087, doi:10.1136/bmjopen-2024-091087. This article has 27 citations and is from a peer-reviewed journal.
(su2023theroleof pages 1-2): Zhi Yi Su, Pui Yan Siak, Chee-Onn Leong, and Shiau-Chuen Cheah. The role of epstein–barr virus in nasopharyngeal carcinoma. Frontiers in Microbiology, Feb 2023. URL: https://doi.org/10.3389/fmicb.2023.1116143, doi:10.3389/fmicb.2023.1116143. This article has 167 citations and is from a peer-reviewed journal.
(lam2023recommendationsforepsteinbarr pages 4-4): W K Jacky Lam, Ann D King, Jacob A Miller, Zhiwei Liu, Kelly J Yu, Melvin L K Chua, Brigette B Y Ma, Ming Yuan Chen, Benjamin A Pinsky, Pei-Jen Lou, John K S Woo, Wan-Lun Hsu, Julia Simon, Denise L Doolan, Tim Waterboer, Edwin P Hui, Hui Li, Raymond K Tsang, Kenneth C W Wong, Julian P Goh, Alexander C Vlantis, Qi Yong Ai, Lun M Wong, Victor Abdullah, Jin Ching Lin, Chien-Jen Chen, Ruth M Pfeiffer, Quynh-Thu Le, Anne W M Lee, Mingfang Ji, Sumei Cao, Jun Ma, Anthony T C Chan, K C Allen Chan, and Allan Hildesheim. Recommendations for epstein-barr virus–based screening for nasopharyngeal cancer in high- and intermediate-risk regions. JNCI: Journal of the National Cancer Institute, 115:355-364, Feb 2023. URL: https://doi.org/10.1093/jnci/djad012, doi:10.1093/jnci/djad012. This article has 53 citations.
(lam2023recommendationsforepsteinbarr pages 1-2): W K Jacky Lam, Ann D King, Jacob A Miller, Zhiwei Liu, Kelly J Yu, Melvin L K Chua, Brigette B Y Ma, Ming Yuan Chen, Benjamin A Pinsky, Pei-Jen Lou, John K S Woo, Wan-Lun Hsu, Julia Simon, Denise L Doolan, Tim Waterboer, Edwin P Hui, Hui Li, Raymond K Tsang, Kenneth C W Wong, Julian P Goh, Alexander C Vlantis, Qi Yong Ai, Lun M Wong, Victor Abdullah, Jin Ching Lin, Chien-Jen Chen, Ruth M Pfeiffer, Quynh-Thu Le, Anne W M Lee, Mingfang Ji, Sumei Cao, Jun Ma, Anthony T C Chan, K C Allen Chan, and Allan Hildesheim. Recommendations for epstein-barr virus–based screening for nasopharyngeal cancer in high- and intermediate-risk regions. JNCI: Journal of the National Cancer Institute, 115:355-364, Feb 2023. URL: https://doi.org/10.1093/jnci/djad012, doi:10.1093/jnci/djad012. This article has 53 citations.
(li2025diagnosticperformanceof pages 2-4): Xue-Qi Li, Dong-Feng Lin, Yu-Cong Cai, Shang-Hang Xie, Ke-Na Lin, Hang-Ning Zhou, Zhi-Cong Wu, Jun-Ping Ye, Yi-Nan Peng, Zheng Ma, Ling Guo, Wei Lin, and Su-Mei Cao. Diagnostic performance of ebv dna load testing for nasopharyngeal carcinoma in nasopharyngeal swab outperforms the approach in other specimens. BMC Cancer, Jul 2025. URL: https://doi.org/10.1186/s12885-025-14539-5, doi:10.1186/s12885-025-14539-5. This article has 2 citations and is from a peer-reviewed journal.
(xu2024hostgeneticvariants pages 1-3): Miao Xu, Ruimei Feng, Zhonghua Liu, Xiang Zhou, Yanhong Chen, Yulu Cao, Linda Valeri, Zilin Li, Zhiwei Liu, Su-Mei Cao, Qing Liu, Shang-Hang Xie, Ellen T. Chang, Wei-Hua Jia, Jincheng Shen, Youyuan Yao, Yong-Lin Cai, Yuming Zheng, Zhe Zhang, Guangwu Huang, Ingemar Ernberg, Minzhong Tang, Weimin Ye, Hans-Olov Adami, Yi-Xin Zeng, and Xihong Lin. Host genetic variants, epstein-barr virus subtypes, and the risk of nasopharyngeal carcinoma: assessment of interaction and mediation. Cell Genomics, 4:100474, Feb 2024. URL: https://doi.org/10.1016/j.xgen.2023.100474, doi:10.1016/j.xgen.2023.100474. This article has 28 citations and is from a peer-reviewed journal.
(xu2024hostgeneticvariants pages 5-6): Miao Xu, Ruimei Feng, Zhonghua Liu, Xiang Zhou, Yanhong Chen, Yulu Cao, Linda Valeri, Zilin Li, Zhiwei Liu, Su-Mei Cao, Qing Liu, Shang-Hang Xie, Ellen T. Chang, Wei-Hua Jia, Jincheng Shen, Youyuan Yao, Yong-Lin Cai, Yuming Zheng, Zhe Zhang, Guangwu Huang, Ingemar Ernberg, Minzhong Tang, Weimin Ye, Hans-Olov Adami, Yi-Xin Zeng, and Xihong Lin. Host genetic variants, epstein-barr virus subtypes, and the risk of nasopharyngeal carcinoma: assessment of interaction and mediation. Cell Genomics, 4:100474, Feb 2024. URL: https://doi.org/10.1016/j.xgen.2023.100474, doi:10.1016/j.xgen.2023.100474. This article has 28 citations and is from a peer-reviewed journal.
(xu2024hostgeneticvariants pages 3-4): Miao Xu, Ruimei Feng, Zhonghua Liu, Xiang Zhou, Yanhong Chen, Yulu Cao, Linda Valeri, Zilin Li, Zhiwei Liu, Su-Mei Cao, Qing Liu, Shang-Hang Xie, Ellen T. Chang, Wei-Hua Jia, Jincheng Shen, Youyuan Yao, Yong-Lin Cai, Yuming Zheng, Zhe Zhang, Guangwu Huang, Ingemar Ernberg, Minzhong Tang, Weimin Ye, Hans-Olov Adami, Yi-Xin Zeng, and Xihong Lin. Host genetic variants, epstein-barr virus subtypes, and the risk of nasopharyngeal carcinoma: assessment of interaction and mediation. Cell Genomics, 4:100474, Feb 2024. URL: https://doi.org/10.1016/j.xgen.2023.100474, doi:10.1016/j.xgen.2023.100474. This article has 28 citations and is from a peer-reviewed journal.
(wan2024primaryandorthotopic pages 9-12): Xudong Wan, Yuantao Liu, Yiman Peng, Jian Wang, Shu‐mei Yan, Lu Zhang, Wanchun Wu, Lei Zhao, Xuelan Chen, Kexin Ren, Haicheng Long, Yiling Luo, Qin Yan, Lele Zhang, Dengzhi Lei, Pengpeng Liu, Shujun Li, Lihui Liu, Linjie Guo, Jiajia Du, Mengsha Zhang, Siqi Dai, Yi Yang, Hongyu Liu, Nianyong Chen, Jinxin Bei, Lin Feng, Yu Liu, Mu‐sheng Zeng, Chong Chen, and Qian Zhong. Primary and orthotopic murine models of nasopharyngeal carcinoma reveal molecular mechanisms underlying its malignant progression. Advanced Science, Jul 2024. URL: https://doi.org/10.1002/advs.202403161, doi:10.1002/advs.202403161. This article has 9 citations and is from a peer-reviewed journal.
(yoshizaki2023recentadvancesin pages 8-9): Tomokazu Yoshizaki, Satoru Kondo, Hirotomo Dochi, Eiji Kobayashi, Harue Mizokami, Shigetaka Komura, and Kazuhira Endo. Recent advances in assessing the clinical implications of epstein-barr virus infection and their application to the diagnosis and treatment of nasopharyngeal carcinoma. Microorganisms, 12:14, Dec 2023. URL: https://doi.org/10.3390/microorganisms12010014, doi:10.3390/microorganisms12010014. This article has 18 citations.
(jiang2024recentadvancesin pages 2-5): Wen Jiang, Bohao Zheng, and Hongquan Wei. Recent advances in early detection of nasopharyngeal carcinoma. Discover Oncology, Aug 2024. URL: https://doi.org/10.1007/s12672-024-01242-3, doi:10.1007/s12672-024-01242-3. This article has 18 citations.
(yoshizaki2023recentadvancesin pages 9-11): Tomokazu Yoshizaki, Satoru Kondo, Hirotomo Dochi, Eiji Kobayashi, Harue Mizokami, Shigetaka Komura, and Kazuhira Endo. Recent advances in assessing the clinical implications of epstein-barr virus infection and their application to the diagnosis and treatment of nasopharyngeal carcinoma. Microorganisms, 12:14, Dec 2023. URL: https://doi.org/10.3390/microorganisms12010014, doi:10.3390/microorganisms12010014. This article has 18 citations.
(wan2024primaryandorthotopic pages 6-7): Xudong Wan, Yuantao Liu, Yiman Peng, Jian Wang, Shu‐mei Yan, Lu Zhang, Wanchun Wu, Lei Zhao, Xuelan Chen, Kexin Ren, Haicheng Long, Yiling Luo, Qin Yan, Lele Zhang, Dengzhi Lei, Pengpeng Liu, Shujun Li, Lihui Liu, Linjie Guo, Jiajia Du, Mengsha Zhang, Siqi Dai, Yi Yang, Hongyu Liu, Nianyong Chen, Jinxin Bei, Lin Feng, Yu Liu, Mu‐sheng Zeng, Chong Chen, and Qian Zhong. Primary and orthotopic murine models of nasopharyngeal carcinoma reveal molecular mechanisms underlying its malignant progression. Advanced Science, Jul 2024. URL: https://doi.org/10.1002/advs.202403161, doi:10.1002/advs.202403161. This article has 9 citations and is from a peer-reviewed journal.
(lam2023recommendationsforepsteinbarr media a09887fa): W K Jacky Lam, Ann D King, Jacob A Miller, Zhiwei Liu, Kelly J Yu, Melvin L K Chua, Brigette B Y Ma, Ming Yuan Chen, Benjamin A Pinsky, Pei-Jen Lou, John K S Woo, Wan-Lun Hsu, Julia Simon, Denise L Doolan, Tim Waterboer, Edwin P Hui, Hui Li, Raymond K Tsang, Kenneth C W Wong, Julian P Goh, Alexander C Vlantis, Qi Yong Ai, Lun M Wong, Victor Abdullah, Jin Ching Lin, Chien-Jen Chen, Ruth M Pfeiffer, Quynh-Thu Le, Anne W M Lee, Mingfang Ji, Sumei Cao, Jun Ma, Anthony T C Chan, K C Allen Chan, and Allan Hildesheim. Recommendations for epstein-barr virus–based screening for nasopharyngeal cancer in high- and intermediate-risk regions. JNCI: Journal of the National Cancer Institute, 115:355-364, Feb 2023. URL: https://doi.org/10.1093/jnci/djad012, doi:10.1093/jnci/djad012. This article has 53 citations.
(lam2023recommendationsforepsteinbarr pages 9-10): W K Jacky Lam, Ann D King, Jacob A Miller, Zhiwei Liu, Kelly J Yu, Melvin L K Chua, Brigette B Y Ma, Ming Yuan Chen, Benjamin A Pinsky, Pei-Jen Lou, John K S Woo, Wan-Lun Hsu, Julia Simon, Denise L Doolan, Tim Waterboer, Edwin P Hui, Hui Li, Raymond K Tsang, Kenneth C W Wong, Julian P Goh, Alexander C Vlantis, Qi Yong Ai, Lun M Wong, Victor Abdullah, Jin Ching Lin, Chien-Jen Chen, Ruth M Pfeiffer, Quynh-Thu Le, Anne W M Lee, Mingfang Ji, Sumei Cao, Jun Ma, Anthony T C Chan, K C Allen Chan, and Allan Hildesheim. Recommendations for epstein-barr virus–based screening for nasopharyngeal cancer in high- and intermediate-risk regions. JNCI: Journal of the National Cancer Institute, 115:355-364, Feb 2023. URL: https://doi.org/10.1093/jnci/djad012, doi:10.1093/jnci/djad012. This article has 53 citations.
(jin2024theefficacyand pages 1-3): Ya-Nan Jin, Meng-Yun Qiang, Ying Wang, Yu-Jing Lin, Ren-Wei Jiang, Wan-Wei Cao, Wang-Jian Zhang, Si-Yang Wang, Hong-Yu Zhang, and Ji-Jin Yao. The efficacy and safety of adding pd-1 blockade to induction chemotherapy and concurrent chemoradiotherapy (ic-ccrt) for locoregionally advanced nasopharyngeal carcinoma: an observational, propensity score-matched analysis. Cancer Immunology, Immunotherapy : CII, May 2024. URL: https://doi.org/10.1007/s00262-024-03698-2, doi:10.1007/s00262-024-03698-2. This article has 20 citations.
(siddiqui2025toripalimabanew pages 1-1): Taha Ahmad Siddiqui, Aamrah Wakil, and Maham Imran. Toripalimab: a new age in fighting nasopharyngeal carcinoma. Journal of the Pakistan Medical Association, 75:349-349, Jan 2025. URL: https://doi.org/10.47391/jpma.20757, doi:10.47391/jpma.20757. This article has 1 citations.
(qiu2025efficacysafetyand pages 1-3): Lei Qiu, Qiran Wei, Yachun Hu, Jinling Yuan, Mengxing Wu, Yurong Li, Yuting Xu, Xin Guan, Yuandong Cao, Juan Pu, Zhou Ding, Yinjiao Fei, Weilin Xu, and Shu Zhou. Efficacy, safety and cost-effectiveness of chemo-immunotherapy combinations for recurrent or metastatic nasopharyngeal carcinoma: an updated systematic review and cost-effectiveness analysis. Translational Cancer Research, 14:7102-7118, Oct 2025. URL: https://doi.org/10.21037/tcr-2025-415, doi:10.21037/tcr-2025-415. This article has 2 citations.
(manoharan2025efficacyandsafety pages 6-7): Sivananthan Manoharan and Lee Ying Ying. Efficacy and safety of immune checkpoint inhibitors for locoregionally advanced, recurrent and metastatic nasopharyngeal carcinoma: a systematic review of phase iii randomised controlled trials. Naunyn-Schmiedeberg's Archives of Pharmacology, 399:1987-1998, Sep 2025. URL: https://doi.org/10.1007/s00210-025-04572-3, doi:10.1007/s00210-025-04572-3. This article has 2 citations.
(NCT04376866 chunk 1): Song Qu. Toripalimab for Local-regional Recurrent Nasopharyngeal Carcinoma. Cancer Hospital of Guangxi Medical University. 2020. ClinicalTrials.gov Identifier: NCT04376866
(NCT05211232 chunk 2): Hai-Qiang Mai,MD,PhD. Neoadjuvant and Adjuvant Tislelizumab for Nasopharyngeal Carcinoma. Sun Yat-sen University. 2022. ClinicalTrials.gov Identifier: NCT05211232