Recent advances in Nasopharyngeal cancer management: from diagnosis to theranostics

Nasopharyngeal cancer [NPC] is one of the most common head and neck cancers. NPC differs significantly from other cancers in its etiology, epidemiology, clinical behavior, and treatment. Being highly radiosensitive, the standard treatment for NPC is radiotherapy. However, radioresistance hampers the success of treatment and may cause local recurrence and distant metastases in NPC patients. In this review, we discuss the updated protocols for NPC diagnosis and treatment based on recent literature with an emphasis on the mechanisms of radioresistance at the molecular level with a special focus on genetic and epigenetic events, affecting genes involved in xenobiotic detoxification and DNA repair. We also highlight the importance of some cellular and Epstein Barr viral miRNAs targeting specific DNA repair factors and consequently promoting NPC radioresistance. These molecular markers may serve as promising tools for diagnosis, prognosis, and radioresistance prediction to guide theranostics of patients with NPC in the future.