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Denosumab + gemcitabine + platinum is a combination chemo-immunotherapy regimen being evaluated by the Gruppo Oncologico del Nord-Ovest (GONO) for the treatment of recurrent or metastatic Epstein-Barr Virus (EBV)-related nasopharyngeal carcinoma (NPC). The regimen utilizes denosumab, a monoclonal antibody targeting the Receptor Activator of Nuclear Factor Kappa-B Ligand (RANKL), as an immunologic primer to modulate the tumor microenvironment before and during standard chemotherapy with gemcitabine and a platinum agent (cisplatin or carboplatin). This approach aims to exploit the RANK/RANKL pathway's role in immune evasion in EBV-driven malignancies to improve clinical outcomes in patients with advanced NPC.
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