What is the recommended treatment approach for stage III/IVA nasopharyngeal cancer that is p16 negative and EBV positive?

The recommended treatment approach for stage III/IVA EBV-positive nasopharyngeal cancer is induction chemotherapy with gemcitabine/cisplatin followed by concurrent chemoradiotherapy with cisplatin.

This was established in a phase 3 trial that compared induction chemotherapy plus concurrent chemoradio...

While the paper from NEJM is compelling, the authors follow up in 2022 with their "final" analysis in JCO

• Zhang et al., PMID 35709465

The overall results hold up, with an ~9% absolute OS improvement at 5 years; however, they did do a subgroup analysis by serum free EBV-DNA dividing by >4000 copies/m...