Nasopharyngeal carcinoma outcomes in a predominantly African American population: A single-center experience.

Abstract

e18020 Background: Nasopharyngeal carcinoma (NPC) is an aggressive and unique subtype of head and neck cancer, largely associated with Epstein-Barr virus (EBV) and endemic in East Asian populations. Current treatment paradigms are based on studies predominantly involving these populations, with limited data on patients from other racial or ethnic groups. We present a retrospective analysis from our institution, which primarily serves an African American (AA) population. Methods: We evaluated a single-center’s cancer registry data from January 2013 to December 2023, identifying 30 patients with histologically confirmed NPC. Detailed chart reviews were conducted to assess demographics, clinical features, and treatment patterns. All tumors were restaged using the AJCC 8th edition criteria. Results: Of the 30 patients, 16 were AA, 8 of European ancestry (EA), 5 of Asian ancestry (AS), and 1 unknown. EBV status (EBER IHC) was evaluable in 28/30 cases, with EBV positivity observed in 12/16 (75%) AA, 4/7 (57%) EA, and 5/5 (100%) AS patients. The mean age at diagnosis was 55.43 years (range from 24-82 years). Alcohol (50%) and tobacco consumption (50%) were common. Majority of tumors (23/30) were classified as non-keratinizing subtype, with no notable racial differences. Most patients presented with locally advanced (LA) stage III or IVA (83%, 25/30) and none had distant metastases at initial presentation. For LA, non-metastatic NPCs treated with definitive intent (n=23), only five patients received the current standard-of-care regimen as established in 2019 (Induction chemotherapy [I] → Chemoradiation [CRT]), achieving the best outcomes (median overall survival [mOS] not reached). Outcomes for CRT → Adjuvant chemotherapy (AC) showed a median OS of 82 months, while CRT alone had the poorest outcomes (mOS 39 months, p=0.1851). AA patients associated with worse OS (HR = 2.71, p = 0.050), although the small sample size limited robust multivariate analysis. For patients treated with definitive intent, recurrence was noted in 10/23 (43%) with distant recurrence/metastases being most common (8/10, 80%). 9/10 patients who had recurrences belonged to CRT (3) or CRT->AC (6) treatment group. Conclusions: This analysis reports outcomes for NPC in a cancer center with predominantly AA population, demonstrating worse survival outcomes compared to other groups. Additionally, although limited by size, our data indicates the importance of appropriate treatment sequencing to achieve optimal outcomes.