Where nasopharyngeal carcinoma treatment is heading

Nasopharyngeal carcinoma starts behind the nose and is closely tied to the Epstein-Barr virus. It is uncommon in the US (about 2,000 cases a year) but far more common in southern China and Southeast Asia, which is where most trials run. Radiation with chemotherapy cures most people with localized disease. Immunotherapy, now FDA approved for advanced disease, is moving into curative treatment, and blood tests for viral DNA increasingly guide how much treatment people need.

• 319studies open or running
• 99phase 3 trials
• 1,092papers published this year
• 40NIH-funded projects

1. Now

   Nov 2026

   Immunotherapy after chemoradiationHappened 86.9% event-free at 3 years

   A year of camrelizumab raised 3-year event-free survival from 77.3% to 86.9%.

   86.9%: event-free at 3 years, vs 77.3% with standard treatment.

   • DIPPER trial

   Skipping cisplatin during radiationHappened 88.3% failure-free at 3 years

   With toripalimab, dropping concurrent cisplatin kept 3-year failure-free survival at 88.3% and halved vomiting.

   88.3%: failure-free at 3 years without concurrent cisplatin, vs 87.6% with it.

   • DIAMOND trial

   An antibody-drug conjugate for advanced diseaseHappened 54.6% response rate

   Iza-bren shrank tumors in 54.6% vs 27.0% with chemotherapy after two earlier treatments.

   54.6%: response rate, vs 27.0% with chemotherapy.

   • Izalontamab brengitecan phase 3

   Blood tests guide treatment intensityHappened 89.1% failure-free at 3 years

   Adjusting treatment by how fast viral DNA cleared from the blood: 89.1% failure-free at 3 years.

   89.1%: failure-free at 3 years with ctDNA-guided treatment.

   • ctDNA-guided treatment study

2. 6 months

   by May 2027

   Iza-bren survival dataPossible

   Mature survival results from the phase 3 trial will show whether the response advantage lengthens life.

   • Izalontamab brengitecan phase 3

3. 12 months

   by Nov 2027

   Less radiation for people who respondPossible

   A Sun Yat-sen trial (593 people) tests lower-dose radiation for stage III disease that responds well to induction; due February 2027.

   • Reduced-dose radiation trial

   Dual immunotherapy with chemoradiationPossible

   GEMSTONE (490 people) tests cadonilimab, a PD-1/CTLA-4 bispecific, with chemoradiation; due August 2027.

   • GEMSTONE

4. 3 years

   by late 2029

   A US trial of immunotherapy for advanced diseasePossible

   A National Cancer Institute trial (430 people) tests atezolizumab and/or bevacizumab with chemotherapy; due December 2027.

   • NCI trial

   Immunotherapy added to induction chemotherapyPossible 86.9% event-free (DIPPER)

   Navigation (466 people) adds toripalimab to gemcitabine-cisplatin induction; due November 2028.

   86.9%: event-free at 3 years, vs 77.3% with standard treatment.

   • DIPPER trial
   • Navigation

5. 5 years

   by late 2031

   Blood-test-guided treatment in the USPossible 89.1% failure-free (ctDNA study)

   NRG-HN001 (924 people) adjusts chemotherapy after radiation based on viral DNA in the blood; due January 2029.

   89.1%: failure-free at 3 years with ctDNA-guided treatment.

   • ctDNA-guided treatment study
   • NRG-HN001

The research paths

Borrowed from other cancers

Open to join now

• Stage III, after induction

  Reduced-dose radiation

  Phase 3 · 26 sites

  Locations and eligibility →

• Locally advanced

  QL1706 with chemoradiation

  Phase 3 · 19 sites

  Locations and eligibility →

• Advanced

  Relatlimab added to immunotherapy

  Phase 2 · 95 sites

  Locations and eligibility →

• Nasopharyngeal carcinoma

  Nivolumab with chemotherapy

  Phase 2 · 86 sites

  Locations and eligibility →

See every recruiting Nasopharyngeal cancer trial →

When the trials finish

Completion dates the trials registered. Results usually follow 3 to 12 months later.

What just happened

Standard treatment today

• Early (stage I-II)Radiation alone or with cisplatin.
• Locally advanced (stage III-IVA)Induction chemotherapy (gemcitabine-cisplatin), then radiation with cisplatin; immunotherapy increasingly added.
• Recurrent or metastatic, first treatmentGemcitabine-cisplatin plus toripalimab or penpulimab.
• After first treatmentClinical trials; antibody-drug conjugates in development.

See Nasopharyngeal cancer trials recruiting now →