What changes do you make in the management of non-endemic nasopharynx cancer compared to endemic?

a) There are 3 varieties of NPC; EBER +ve, HPV +, and non-viral

There is only decent data for Induction (IC) for EBER +ve for a small survival benefit with cis-gem, and the group's follow-up suggested that pre-treatment DNA titers only showed benefit for those with high titers.

I am not a HN med onc...

Agree with Dr. @Dr. First Last. I would note that in our experience with non-endemic EBV- NPC, the prognosis was worse than the endemic ones, with local recurrence a major pattern and with a lesser metastasis risk compared with the EBV+ ones (Stenmark et al., PMID 24521676). Surprisingly, those who ...