鼻咽癌 (NPC) 是一种常见的头颈部恶性肿瘤，约 70% 的患者确诊时已处于局部晚期。尽管对放疗和化疗有反应，局部晚期鼻咽癌 (LANPC) 的 5 年生存率仍保持在 80% 左右。因此，迫切需要新的治疗策略来改善 LANPC 患者的预后。大量研究表明免疫检查点抑制剂（ICIs）在复发/转移性鼻咽癌中的疗效。因此，LANPC 免疫疗法的潜力正在研究中。利用临床试验网络，我们确定了 84 项探索 NPC 免疫治疗的相关试验，其中包括 17 项针对 LANPC 的 ICI 试验。多项试验的初步结果表明，将 ICI 添加到 LANPC 的主要治疗中可显着提高客观缓解率和无进展生存期，且安全性可控。然而，这些试验中 ICI 纳入 LANPC 标准初级治疗的类型、剂量和整合时间（诱导期、同时期和辅助期）各不相同，需要进一步研究。本综述概述了 NPC 的免疫治疗原理，讨论了 LANPC 主要治疗中与 ICI 相关的最新进展和挑战，这些进展和挑战源自已发表和正在进行的临床试验，并概述了 LANPC 中其他免疫疗法的现状，例如过继细胞疗法、 LANPC 中的免疫调节剂和肿瘤疫苗。这些见解旨在为临床实践提供信息并指导未来的研究。版权所有 © 2024。由 Elsevier Ltd 出版。

Nasopharyngeal carcinoma (NPC) is a prevalent malignant tumor of the head and neck, with approximately 70 % of patients being diagnosed at a locally advanced stage. Despite the responsiveness to radiotherapy and chemotherapy, the 5-year survival rate of locally advanced NPC (LANPC) remains at approximately 80 %. Hence, there is an urgent need for novel treatment strategies to improve the prognosis of patients with LANPC. Numerous studies have illustrated the efficacy of immune checkpoint inhibitors (ICIs) in recurrent/metastatic NPC. Hence, the potential of immunotherapy for LANPC is under investigation. Using the Web of Clinical Trials, we identified 84 relevant trials exploring immunotherapy for NPC, encompassing 17 trials focusing on ICIs for LANPC. Preliminary findings from several trials suggest that adding ICIs into the primary treatment for LANPC significantly enhances the objective response rate and progression-free survival, with manageable safety profiles. However, the type, dosage, and timing of integration (induction phase, concurrent phase, and adjuvant phase) of ICIs into standard primary treatment of LANPC varies among these trials and further researches are warranted. This review provides an overview of immunotherapy principles in NPC, discusses recent advances and challenges associated with ICIs in the primary treatment for LANPC derived from published and ongoing clinical trials, and outlines the current landscape of other immunotherapies in LANPC, such as adoptive cell therapy, immunomodulatory agents, and tumor vaccines in LANPC. These insights aim to inform clinical practice and guide future researches.Copyright © 2024. Published by Elsevier Ltd.