***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 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 
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Conclusions Our meta- analysis indicated that higher/positive expression of PD-L1/PD-1 may not serve as suitable biomarkers for the prognosis of NPC , which was not in consistent with some previous studies about the prognostic value of PD-L1/PD-1 in other types of tumors .