Treatment with programmed cell death protein 1 and programmed cell death ligand 1 inhibitors was associated with a median progression-free survival of 4.21 months and a median overall survival of 16.27 months in patients with recurrent or metastatic nasopharyngeal carcinoma, according to a systematic review and meta-analysis.

The analysis evaluated programmed cell death protein 1/programmed cell death ligand 1 inhibitors (PD-1/PD-L1 inhibitors) in patients with recurrent or metastatic nasopharyngeal carcinoma (NPC) through a systematic search of PubMed, Embase, and the Cochrane Library through November 2024. Nine studies comprising 10 datasets and 883 patients were included, including 2 randomized controlled trials and 7 single-arm studies. Outcomes included progression-free survival (PFS), overall survival (OS), 1-year survival rates, objective response rate (ORR), disease control rate (DCR), and adverse events.

Across studies, the pooled median PFS was 4.21 months and the median OS was 16.27 months, with substantial heterogeneity for PFS but not OS. The 1-year PFS rate was 43%, and the 1-year OS rate was 80%. The pooled ORR was 45%, and the DCR was 65%.

Adverse events occurred in 90% of patients, with grade 3 or higher events reported in 34%.

Subgroup analyses showed substantial heterogeneity across outcomes. Stratification by agent demonstrated minimal heterogeneity for camrelizumab and nivolumab, whereas variability remained high in toripalimab studies, likely reflecting differences in sample size and treatment regimens. Sensitivity analyses indicated that pooled survival estimates were sensitive to the inclusion of individual studies.

Key limitations included the predominance of single-arm studies, small sample sizes in several cohorts, and heterogeneity across treatment regimens, dosing, and patient characteristics.

“These updated findings enrich the existing body of evidence and may suggest a trend toward improved ORR and DCR in more recent studies, potentially due to refined patient selection and enhanced treatment strategies. However, definitive conclusions cannot be drawn in the absence of more robust, high-quality evidence,” wrote lead author Weiliang Bai, PhD, of Shengjing Hospital of China Medical University, and colleagues.

Disclosures: The authors reported no conflicts of interest. 

Source: Medicine