Tislelizumab Combined With Capecitabine for Nasopharyngeal Carcinoma With Residual EBV DNA After Radiotherapy

Inclusion criteria

• Age ≥18 years;
• Histologically confirmed nasopharyngeal carcinoma;
• Expected survival time ≥12 weeks;
• ECOG performance status: 0-1;
• Received definitive radiotherapy (± induction and/or concurrent chemotherapy);
• Plasma EBV DNA >0 copies/mL within the period from 1 week before to 4 weeks after completion of radiotherapy ;
• Adequate organ function meeting the following criteria: Hematological: a. Hemoglobin (HB) ≥90 g/L; b. Absolute neutrophil count (ANC) ≥1.0×10⁹/L; c. Platelet count (PLT) ≥80×10⁹/L; Biochemical: a. Total bilirubin (BIL) <1.5× upper limit of normal (ULN); b. ALT and AST <2.5×ULN; c. Serum creatinine (Cr) ≤ULN, and creatinine clearance rate ≥50 mL/min (calculated by Cockcroft-Gault formula); d. Normal myocardial enzymes and thyroid function; e. Normal cardiac function assessed by echocardiography.
• Signed informed consent with willingness to comply with the study protocol.

Exclusion criteria

• Histologically confirmed keratinizing squamous cell carcinoma (WHO I)；
• Distant metastasis detected by pre-treatment clinical or imaging examinations;
• History of allergy to any component of monoclonal antibodies, tislelizumab, or capecitabine;
• History of autoimmune diseases, except for the following conditions (eligible after evaluation):

• Autoimmune-related hypothyroidism on stable thyroid hormone replacement therapy;
• Type I diabetes mellitus under stable insulin therapy with controlled blood glucose;
• Previous or concurrent malignancies (except those cured and disease-free for >5 years, e.g., basal cell carcinoma, cervical carcinoma in situ);
• Positive pregnancy test in women of childbearing potential;
• Concurrent medical conditions that may compromise patient enrollment or safety during the study;
• History of idiopathic pulmonary fibrosis, drug-induced pneumonitis, organizing pneumonia, idiopathic pneumonia, or other active pulmonary diseases;
• Active psychiatric disorders or other mental conditions affecting informed consent comprehension;
• Uncontrolled active infections, including tuberculosis, hepatitis B (HBsAg+), hepatitis C, or HIV (HIV antibody+);
• Significant cardiovascular diseases: NYHA Class II or higher, myocardial infarction within 1 year, unstable angina, or supraventricular/ventricular arrhythmias requiring clinical intervention;
• Factors affecting drug administration, distribution, metabolism, or excretion (e.g., psychiatric/neurological disorders, chronic diarrhea, ascites, pleural effusion);
• Unwillingness to sign informed consent.