***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose To establish the safety profile and antitumor activity of the anti-programmed death 1 receptor monoclonal antibody , pembrolizumab , in patients with recurrent or metastatic nasopharyngeal carcinoma ( RM-NPC ) that expressed programmed death-lig and 1 ( PD-L1 ) . Patients and Methods KEYNOTE-028 ( NCT02054806 ) is a nonr and omized , multicohort , phase Ib trial of pembrolizumab in patients with PD-L1-positive advanced solid tumors . Key eligibility criteria for the NPC cohort included unresectable or metastatic disease , failure on prior st and ard therapy , and PD-L1 expression in 1 % or more of tumor cells or tumor-infiltrating lymphocytes . Patients received pembrolizumab 10 mg/kg every 2 weeks up to 2 years or until disease progression or unacceptable toxicity . Primary end point was objective response rate ( ORR ) per investigator review . Tumor response was assessed according to Response Evaluation Criteria in Solid Tumors ( RECIST ; version 1.1 ) every 8 weeks for the first 6 months and every 12 weeks thereafter . Results Twenty-seven patients received pembrolizumab . Median age was 52.0 years ( range , 18 to 68 years ) ; 92.6 % received prior therapies for RM-NPC ; 70.4 % had received three or more therapies .  Partial response and stable disease were observed in seven and 14 patients , respectively , for an ORR of 25.9 % ( 95 % CI , 11.1 to 46.3 ) over a median follow-up of 20 months . ORR by central review was similar ( 26.3 % ) . Drug-related adverse events that occurred in 15 % or more of patients included rash ( 25.9 % ) , pruritus ( 25.9 % ) , pain ( 22.2 % ) , hypothyroidism ( 18.5 % ) , and fatigue ( 18.5 % ) . Grade ≥ 3 drug-related adverse events occurred in eight patients ( 29.6 % ) , and there was one drug-related death ( sepsis ) . As of the data cutoff ( June 20 , 2016 ) , two patients remained on pembrolizumab treatment . Conclusion Pembrolizumab demonstrated antitumor activity and a manageable safety profile in patients with RM-NPC The effects of docetaxel , platinum , and fluorouracil ( TPF ) induction chemotherapy plus concurrent chemoradiotherapy ( CCRT ) on locoregionally advanced nasopharyngeal cancer ( NPC ) are unclear . This study examined the long‐term outcomes of the addition of this regimen to CCRT for stage III and IVA/B NPC Background Concurrent chemoradiotherapy ( CCRT ) is superior to radiotherapy alone for treating locoregionally advanced nasopharyngeal carcinoma ( NPC ) . Whether adding induction chemotherapy ( IC ) further improves the outcome warrants investigation . Patients and methods This open-label multicenter phase III trial was conducted at 11 institutions in Taiwan . Patients with stage IVA or IVB NPC were r and omized to receive IC followed by CCRT ( I-CCRT ) or CCRT alone . Patients in the I-CCRT arm received three cycles of mitomycin C , epirubicin , cisplatin , and 5-fluorouracil/leucovorin ( MEPFL ) . All patients received 30 mg/m2 cisplatin weekly during radiotherapy , which was delivered as 1.8 - 2.2 Gy per fraction with five daily fractions per week , to a total dose of 70 Gy or greater to the primary tumor and 66 - 70 Gy to the involved neck . The primary end point was disease-free survival ( DFS ) . Results In this study , 240 and 239 patients were r and omized to CCRT and I-CCRT arm , respectively . The most prominent toxicities of induction were leukopenia ( grade 3 and 4 : 47 % and 12 % ) and thrombocytopenia ( grade 3 and 4 : 24 % and 3 % ) . During radiotherapy , severe mucositis was the major side-effect in both arms ; an increased number of patients in the I-CCRT arm had myelosuppression ; hence , discontinuation of weekly cisplatin was more common . After a median follow-up of 72.0 months , the I-CCRT arm had significantly higher DFS than that of the CCRT arm [ 5-year rate 61 % versus 50 % ; hazard ratio=0.739 , 95 % confidence interval (CI)=0.565 - 0.965 ; P = 0.0264 ] , after stratified for N3b and LDH , and adjusted for T stage . Conclusion Induction with MEPFL before CCRT was tolerable and significantly improved the DFS of patients with stage IVA and IVB NPC though overall survival not improved . Clinical trial information NCT00201396 BACKGROUND Platinum-based doublet chemotherapy regimens , preferentially gemcitabine plus cisplatin , are generally considered the first-line st and ard of care for patients with recurrent or metastatic nasopharyngeal carcinoma . However , no consensus has been reached regarding treatment following progression after first-line therapy . Camrelizumab ( SHR-1210 ) is a humanised anti-programmed death-1 ( anti PD-1 ) antibody . We present safety and preliminary antitumour activity of camrelizumab alone as second-line therapy in patients with recurrent or metastatic nasopharyngeal carcinoma and combined with gemcitabine and cisplatin as first-line therapy in this patient population . METHODS We report the results from two single-arm , phase 1 trials . Both trials included patients aged 18 - 70 years with histologically or cytologically confirmed nasopharyngeal carcinoma and confirmed metastatic disease or locoreginal recurrence , and an Eastern Cooperative Oncology Group performance status of 0 or 1 . Patients who received at least one previous line of treatment were enrolled at five academic hospitals in China into the dose-escalation and expansion trial to receive camrelizumab monotherapy intravenously at escalating doses of 1 mg/kg , 3 mg/kg , and 10 mg/kg , and a bridging dose of 200 mg per dose once every 2 weeks ( monotherapy trial ) . Treatment-naive patients were enrolled from a single centre in China to receive six cycles of camrelizumab 200 mg ( day 1 ) , gemcitabine 1 g/m2 ( days 1 and 8) , and cisplatin 80 mg/m2 ( day 1 ) every 3 weeks followed by camrelizumab 200 mg maintenance once every 3 weeks ( combination trial ) . The primary endpoint of both trials was the safety and tolerability of the study treatment . Analyses were done per protocol . Both trials are registered with Clinical Trials.gov , number NCT02721589 ( camrelizumab monotherapy trial ) and NCT03121716 ( camrelizumab combination trial ) . Both trials are ongoing , but are no longer enrolling patients . FINDINGS In the camrelizumab monotherapy trial , between March 31 , 2016 , and Sept 20 , 2017 , 121 patients were assessed for eligibility , of whom 93 patients were enrolled across the dose-escalation and expansion cohorts and received at least one dose of camrelizumab ( safety population ) . 15 ( 16 % ) of 93 patients had treatment-related adverse events of grade 3 or 4 , the most common of which were elevated conjugated bilirubin concentration ( three [ 3 % ] of 93 patients ) , stomatitis , anaemia , and increased concentrations of aspartate aminotransferase , alanine aminotransferase , and total bilirubin , each of which occurred in two ( 2 % ) patients . Eight ( 9 % ) patients had a treatment-related serious adverse event . No dose-limiting toxic effects were observed during the dose-escalation phase . 31 ( 34 % ; 95 % CI 24 - 44 ) of 91 evaluable patients on camrelizumab monotherapy had an overall response with a median follow-up of 9·9 months ( IQR 8·1 - 11·7 ) . In the camrelizumab combination trial , between April 18 , 2017 , and Aug 15 , 2017 , 24 patients were assessed for eligibility , of whom 23 patients were enrolled and treated ( safety population ) . 20 ( 87 % ) of 23 patients had grade 3 or 4 treatment-related adverse events : neutropenia ( 13 [ 57 % ] of 23 patients ) , anaemia ( 11 [ 48 % ] patients ) , leucopenia ( 11 [ 48 % ] patients ) , thrombocytopenia ( seven [ 30 % ] patients ) , oedema ( two [ 9 % ] patients ) , hyponatraemia ( two [ 9 % ] patients ) , hypochloraemia ( one [ 4 % ] patients ) , and rash ( one [ 4 % ] patient ) . Two patients had treatment-related serious adverse events . No treatment-related deaths occurred in these trials . 20 ( 91 % [ 95 % CI 72 - 97 ] ) of 22 evaluable patients had an overall response with a median follow-up time of 10·2 months ( IQR 9·7 - 10·8 ) . INTERPRETATION Camrelizumab is a well tolerated , potential treatment option for patients with recurrent or metastatic nasopharyngeal carcinoma . The combination of camrelizumab plus gemcitabine and cisplatin has a manageable toxicity profile and promising preliminary antitumour activity for this disease in treatment-naive patients . R and omised controlled trials are needed to further establish the role of immune checkpoint inhibition for nasopharyngeal carcinomas . FUNDING Hengrui Medicine Co , Chinese National Natural Science Foundation project , Science and Technology Program of Guangdong , Pearl River Nova Program of Guangzhou To report long-term results of a r and omized controlled trial that compared cisplatin/fluorouracil/docetaxel ( TPF ) induction chemotherapy ( IC ) plus concurrent chemoradiotherapy ( CCRT ) with CCRT alone in locoregionally advanced nasopharyngeal carcinoma ( NPC ) . Patients with stage III-IVB ( except T3 - 4 N0 ) NPC were r and omly assigned to receive IC plus CCRT ( n = 241 ) or CCRT alone ( n = 239 ) . IC included three cycles of docetaxel ( 60 mg/m2 d1 ) , cisplatin ( 60 mg/m2 d1 ) , and fluorouracil ( 600 mg/m2 /d civ d1 - 5 ) every 3 weeks . Patients from both groups received intensity-modulated radiotherapy concurrently with three cycles of 100 mg/m2 cisplatin every 3 weeks . After a median follow-up of 71.5 months , the IC plus CCRT group showed significantly better 5-year failure-free survival ( FFS , 77.4 % vs. 66.4 % , p = 0.019 ) , overall survival ( OS , 85.6 % vs. 77.7 % , p = 0.042 ) , distant failure-free survival ( 88 % vs. 79.8 % , p = 0.030 ) , and locoregional failure-free survival ( 90.7 % vs. 83.8 % , p = 0.044 ) compared to the CCRT alone group . Post hoc subgroup analyses revealed that beneficial effects on FFS were primarily observed in patients with N1 , stage IVA , pretreatment lactate dehydrogenase ≥170 U/l , or pretreatment plasma Epstein-Barr virus DNA ≥6000 copies/mL. Two nomograms were further developed to predict the potential FFS and OS benefit of TPF IC . The incidence of grade 3 or 4 late toxicities was 8.8 % ( 21/239 ) in the IC plus CCRT group and 9.2 % ( 22/238 ) in the CCRT alone group . Long-term follow-up confirmed that TPF IC plus CCRT  significantly improved survival in locoregionally advanced NPC with no marked increase in late toxicities and could be an option of treatment for these patients BACKGROUND Initial 3-year results from our clinical trial in locoregionally advanced nasopharyngeal carcinoma ( NPC ) patients showed that induction chemotherapy ( IC ) with cisplatin and fluorouracil result ed in improved disease-free survival ( DFS ) with a marginally significant effect on distant metastasis-free survival ( DMFS ) , but the effect of IC on locoregional relapse-free survival and overall survival ( OS ) did not differ significantly . Here , we present 5-year follow-up results . PATIENTS AND METHODS Our trial was a r and omised , open-label phase III trial comparing IC followed by concurrent chemoradiotherapy ( CCRT ) versus CCRT alone in patients with stage III-IVB ( except T3N0 - 1 ) NPC . The IC followed by CCRT group received cisplatin ( 80 mg/m2 d1 ) and fluorouracil ( 800 mg 
    Output:
    
We present the aggregate response rates , survival rates and incidences of drug-related adverse events for recurrent or metastatic nasopharyngeal carcinoma patients receiving PD-1/PD-L1 blockage treatment , which could provide useful information for future design of clinical studies .