本研究旨在评估复发/转移性鼻咽癌（R/M NPC）患者使用抗-PD1治疗失败后，采用抗血管生成或抗EGFR治疗再次使用抗-PD1治疗的疗效和安全性。被纳入研究的患者被分为组合组和化疗组。共有145名患者被纳入。两组的中位无进展生存期（mPFS）分别为7.9个月和4.4个月。与化疗组相比，组合组表现出显著更长的无进展生存期（HR=0.363，p<0.001），以及更好的疾病控制比率（DCR，p=0.022）。在组合组中，与其他患者相比，那些在先前治疗中接受了不同的PD1抑制剂、达到了来自先前抗-PD1治疗的客观反应率（ORR），以及在治疗前EBV DNA≤1500拷贝/毫升的患者表现出更长的无进展生存期。从先前抗-PD1治疗中进展的R/M NPC患者可以从抗-PD1联合抗血管生成剂或抗EGFR药物的再次使用中获益。资料可获得性说明：所有原始数据均在文章和补充材料中呈现。进一步的查询可从通讯作者处获得。版权所有 © 2023 Elsevier B.V.

We aim to evaluate the efficacy and safety of anti-PD1 rechallenge in combination with anti-angiogenesis or anti-EGFR treatment in recurrent/metastatic nasopharyngeal carcinoma (R/M NPC) patients who progressed to previous anti-PD1 therapy. Enrolled patients were divided into a combination group and a chemotherapy only group. A total of 145 patients were enrolled. The median progress-free survival (mPFS) was 7.9 months and 4.4 months, respectively for the two groups. The combination group exhibited significantly longer PFS (HR=0.363, p<0.001), and better disease control ratio (DCR, p=0.022) compared with the chemotherapy group. Among the combination group, longer PFS was found in those patients who received different PD1 inhibitor from prior therapy, reached object response rate (ORR) from prior anti-PD1 therapy, and EBV DNA ≤1500 copy/ml before therapy, comparing to the corresponding other patients. R/M NPC patients who progressed from prior anti-PD1 therapy could benefit from the anti-PD1 rechallenge in combination with anti-angiogenesis or anti-EGFR agents. DATA AVAILABILITY STATEMENT: All original data are presented in the article and supplementary material. Further inquiries can be obtained from the corresponding author.Copyright © 2023. Published by Elsevier B.V.