Real-world treatment practices and survival outcomes of patients with de novo metastatic nasopharyngeal carcinoma after chemoimmunotherapy

To evaluate the real-world treatment practices and survival outcomes of patients with de novo metastatic nasopharyngeal carcinoma (dnMNPC) after the combination of programmed death-1(PD-1) inhibitors with chemotherapy. We retrospectively gathered data from patients with dnMNPC who were treated with a combination of chemotherapy and PD-1 inhibitors between August 2019 and August 2023. Kaplan–Meier analysis and Cox proportional hazards regression model were used for statistical analyses. A total of 42 patients with dnMNPC were included. There were 22 and 20 patients who had oligometastasis (OM) (52.3%) and polymetastasis (PM) (47.6%), respectively. After systemic chemotherapy and PD-1 inhibitor treatment, 20 patients (47.6%) received locoregional radiotherapy. Over the entire course of chemotherapy and PD-1 inhibitor treatment, the patient cohort comprised 10 cases of complete response (23.8%), 27 cases of partial response (64.3%), 3 cases of stable disease (7.1%), and 2 cases of progressive disease (4.8%). The observed response rate was 88.1%. With a median follow-up duration of 19.4 months, the 2-year progression-free survival (PFS) and overall survival (OS) were 32.0% and 70.7%, respectively. Patients with PM (PFS, P = 0.021; OS, P = 0.009) and had detectable EBV-DNA (PFS, P = 0.051; OS, P = 0.005) post-treatment had inferior PFS and OS. The addition of PD-1 inhibitors to chemotherapy offers better clinical efficacy for patients with dnMNPC. Patients with OM and undetectable EBV-DNA after chemoimmunotherapy exhibit improved survival outcomes.