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Clinical Study

Efficacy and safety of induction immunotherapy plus chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma: a meta-analysis

British Journal of Cancer volume 133, pages 1518–1525 (2025)Cite this article

Subjects

Abstract

Background

Locally advanced nasopharyngeal carcinoma (LA-NPC) has a heterogeneous prognosis, with approximately one-fourth of patients experiencing poor outcomes. Studies have explored the application of induction chemoimmunotherapy followed by chemoradiotherapy, but its efficacy was controversial.

Methods

The protocol was registered in the Prospective Register of Systematic Reviews (PROSPERO, CRD42024619387). The primary outcome measures were objective response rate (ORR), complete response rate (CRR), and the incidence of treatment-related adverse events (TRAEs). Meta-analysis was performed using Cochrane Collaboration Review Manager 5.4.1 and Meta-Analyst Beta 3.13 statistical software.

Results

The meta-analysis involving 1680 patients with LA-NPC from 7 studies showed that the induction chemoimmunotherapy group had significantly better ORR (odds ratio[OR] = 2.03, 95% confidence interval [CI]:1.44–2.86, P < 0.01), and CRR (OR = 2.61, 95% CI:1.55–4.38, P < 0.01) than the induction chemotherapy group. The pooled ORR and CRR of induction chemoimmunotherapy were 92.7% (95% CI: 90.7–94.7%) and 24.3% (95% CI: 15.2–33.6%), respectively. There was no significant difference of TRAEs between induction chemotherapy group and induction chemoimmunotherapy group (OR = 1.13; 95% CI: 0.92–1.39, P = 0.23).

Conclusions

Induction chemoimmunotherapy could be a promising induction treatment option for LA-NPC patients, improving ORR and CRR with an acceptable safety profile. However, due to limitations in this meta-analysis, further large-scale, well-designed clinical trials are required to validate these results and optimise treatment strategies.

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Fig. 1
Fig. 2: Forest plots for the objective response rate and the complete response rate.
Fig. 3: Forest plot for treatment-related adverse events.
Fig. 4: Forest plot for immune-related adverse events.

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Data availability

The data that support the findings of this study are available on request from the corresponding author.

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Acknowledgements

This work was partially presented at the American Society of Clinical Oncology (ASCO) Annual Meeting, Chicago, IL (May 30-June 3, 2025).

Funding

This study was supported by grants from the Medical Scientific Research Foundation of Guangdong Province (Grant No.B2023476), the High-level Hospital Construction Project of Heyuan People’s Hospital (Grant No.YNKT202203, Grant No.YNKT202218), Guangdong Basic and Applied Basic Research Foundation (Grant No. 2024A1515030265), and Youth science and technology innovation talent of Guangdong Special Branch Plan (Grant No.KY012024253).

Author information

Author notes

  1. These authors contributed equally: Kun-Peng Wu, Xu-Qiang Luo, Qing-Qing Li.

Authors and Affiliations

  1. Department of Oncology, Heyuan People’s Hospital, Guangdong Provincial People’s Hospital Heyuan Hospital, Heyuan, Guangdong, China

    Kun-Peng Wu, Xu-Qiang Luo, Qing-Qing Li, Hong-Cheng Yang, Mei-Chen Ji, Xie Zhu, Yan-Zhen Lai, Yun Li, Hai-Jing Yang, Dan Tian & Yang-Si Li

  2. Heyuan Key Laboratory of Molecular Diagnosis & Disease Prevention and Treatment, Doctors Station of Guangdong Province, Heyuan People’s Hospital, Heyuan, Guangdong, China

    Kun-Peng Wu, Xu-Qiang Luo, Qing-Qing Li, Hong-Cheng Yang, Mei-Chen Ji, Xie Zhu, Yan-Zhen Lai, Yun Li, Hai-Jing Yang, Dan Tian & Yang-Si Li

  3. Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China

    Lei Chen

  4. State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China

    Lei Chen

  5. United Laboratory of Frontier Radiotherapy Technology of Sun Yat-sen University & Chinese Academy of Sciences, Ion Medical Technology Co., Guangzhou, China

    Lei Chen

  6. Guangdong Lung Cancer Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China

    Yang-Si Li

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Contributions

KPW, LC, and YSL conceived the study and contributed to study design and data interpretation. KPW, XQL, HCY, MCJ, XZ, and YZL did the literature search, data extraction, and data analysis. XQL and QQL accessed and verified the data. KPW, XQL, and QQL wrote the manuscript. YL, HJY, and DT provided material support. All authors have read and approved the final version of the manuscript.

Corresponding authors

Correspondence to Lei Chen or Yang-Si Li.

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The authors declare no competing interests.

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This meta-analysis was performed by following the PRISMA guideline. Ethical approval was not requested because this study retrieved and synthesised data from already published studies.

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Wu, KP., Luo, XQ., Li, QQ. et al. Efficacy and safety of induction immunotherapy plus chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma: a meta-analysis. Br J Cancer 133, 1518–1525 (2025). https://doi.org/10.1038/s41416-025-03169-0

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