{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:39:30Z","timestamp":1759970370627,"version":"build-2065373602"},"reference-count":91,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"BeiGene (Canada) ULC"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Although the majority of patients with nasopharyngeal carcinoma (NPC) present with early-stage or locoregional disease that can be treated with definitive radiotherapy, approximately 20% of patients experience disease recurrence, and 15% present with metastatic disease that is not amenable to curative therapy. Management of patients with recurrent or metastatic (r\/m) NPC who are not candidates for local salvage therapy is challenging in Canada, as there is uncertainty in extrapolating evidence that is largely generated from Southeast China to non-endemic regions such as Canada. Currently, treatment options in Canada are limited to chemotherapy regimens that can only achieve short-term response and prolongation of survival. The addition of anti-PD-1 monoclonal antibodies to chemotherapy has been shown to extend progression-free survival in recurrent r\/m NPC compared to chemotherapy alone; however, approval of PD-1 inhibitors in Canada has lagged behind other jurisdictions where NPC is non-endemic. This paper reviews the current systemic treatment landscape for r\/m NPC in Canada, highlights unmet treatment needs for patients who are not candidates for curative therapy, and discusses the challenges and opportunities that lie in emerging therapies.<\/jats:p>","DOI":"10.3390\/curroncol32010048","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T11:24:56Z","timestamp":1737113096000},"page":"48","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Canadian Perspective on Systemic Therapy for Recurrent or Metastatic Nasopharyngeal Carcinoma"],"prefix":"10.3390","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3034-3042","authenticated-orcid":false,"given":"Anna","family":"Spreafico","sequence":"first","affiliation":[{"name":"Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2M9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8829-5979","authenticated-orcid":false,"given":"Eric","family":"Winquist","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Oncology, Western University, London, ON N6A 5W9, Canada"},{"name":"Verspeeten Family Cancer Centre at London Health Sciences Centre, London, ON N6A 5W9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5922-3984","authenticated-orcid":false,"given":"Cheryl","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, BC Cancer, University of British Columbia, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"O\u2019Sullivan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Radio-Oncology and Nuclear Medicine, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al (CHUM), Universit\u00e9 de Montr\u00e9al, Montreal, QC H2X 0C1, Canada"},{"name":"Department of Radiation Oncology, University of Toronto, Toronto, ON M5T 1P5, Canada"},{"name":"Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2M9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathaniel","family":"Bouganim","sequence":"additional","affiliation":[{"name":"Department of Oncology, McGill University Health Centre, Montreal, QC H3A 1G1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Chua","sequence":"additional","affiliation":[{"name":"Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, AB T6G 1Z2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Doucette","sequence":"additional","affiliation":[{"name":"Impact Medicom Inc., Toronto, ON M6S 3K2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3500-0540","authenticated-orcid":false,"given":"Lillian L.","family":"Siu","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2M9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1727-1205","authenticated-orcid":false,"given":"Desiree","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Arthur JE Child Comprehensive Centre, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 5G2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e49968","DOI":"10.2196\/49968","article-title":"Nasopharyngeal Cancer Incidence and Mortality in 185 Countries in 2020 and the Projected Burden in 2040: Population-Based Global Epidemiological Profiling","volume":"9","author":"Zhang","year":"2023","journal-title":"JMIR Public Health Surveill."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"Bray","year":"2018","journal-title":"CA Cancer J. 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