{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T21:04:42Z","timestamp":1793394282079,"version":"4.5.0"},"reference-count":53,"publisher":"American Medical Association (AMA)","issue":"18","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2025,5,13]]},"abstract":"Importance<\/jats:title>Approximately 20% to 30% of patients with locoregionally advanced nasopharyngeal carcinoma (NPC) experience disease relapse despite definitive chemoradiotherapy. The programmed cell death 1 (PD-1) blockade camrelizumab has demonstrated considerable value in recurrent or metastatic NPC, while its role in locoregionally advanced NPC is unclear.<\/jats:p><\/jats:sec>Objective<\/jats:title>To evaluate the efficacy and safety of adjuvant camrelizumab for patients with locoregionally advanced NPC.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>Randomized, open-label, multicenter, phase 3 clinical trial conducted from August 2018 to November 2021 at 11 centers in China and enrolling 450 patients with T4N1M0 or T1-4N2-3M0 NPC who had completed induction-concurrent chemoradiotherapy. The final date of follow-up was March 20, 2024.<\/jats:p><\/jats:sec>Interventions<\/jats:title>Patients were randomized (1:1) to receive adjuvant camrelizumab (200 mg intravenously once every 3 weeks for 12 cycles; n\u2009=\u2009226) or observation (standard therapy group; n\u2009=\u2009224).<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary end point was event-free survival (freedom from distant metastasis, locoregional relapse, or death due to any cause). Secondary end points included distant metastasis\u2013free survival, locoregional relapse\u2013free survival, overall survival, safety, and health-related quality of life.<\/jats:p><\/jats:sec>Results<\/jats:title>Among the 450 participants (mean age, 45 [SD, 10] years; 24% women), after a median follow-up of 39 (IQR, 33-50) months, the camrelizumab group had a 3-year event-free survival rate of 86.9%, whereas the standard therapy group had a rate of 77.3% (stratified hazard ratio, 0.56; 95% CI, 0.36-0.89; P<\/jats:italic>\u2009=\u2009.01). Grade 3 or 4 adverse events were reported in 23 patients (11.2%) in the camrelizumab and 7 (3.2%) in the standard therapy group. Reactive capillary endothelial proliferation was the most common adverse event related to camrelizumab, occurring in 85.8% of patients at grade 1 or 2, while 2% of patients had grade 3 or 4 events. There was no significant deterioration in quality of life associated with camrelizumab treatment.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>Adjuvant PD-1 blockade with camrelizumab significantly improved event-free survival with manageable toxicities, highlighting its potential role in the management of locoregionally advanced NPC.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>ClinicalTrials.gov Identifier: NCT03427827<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jama.2025.1132","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T15:01:40Z","timestamp":1741878100000},"page":"1589","source":"Crossref","is-referenced-by-count":86,"title":["Adjuvant PD-1 Blockade With Camrelizumab for Nasopharyngeal Carcinoma"],"prefix":"10.1001","volume":"333","author":[{"given":"Ye-Lin","family":"Liang","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key 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