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A Phase II study of carboplatin and docetaxel followed by epstein-barr virus specific cytotoxic T Lymphocytes for refractory/relapsed EBV-positive nasopharyngeal carcinoma

      Almost all nonkeratinizing and undifferentiated nasopharyngeal carcinomas (NPC) are associated with Epstein Barr virus (EBV) infection. Historically, those with metastatic disease have a median survival of <1 year. Due to the poor prognosis and strong association with EBV in advanced stage disease, adoptive immunotherapy with EBV-specific cytotoxic T lymphocytes (EBV-CTLs) is an attractive therapeutic option. We and others have shown that EBV-CTL administration is feasible, safe and results in anti-tumor activity. While complete responses were obtained, those with bulky disease were more resistant to CTL therapy. We propose that EBV-CTL efficacy can be improved in relapsed/refractory NPC by using re-induction chemotherapy to decrease tumor burden prior to adoptive transfer.
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