Nasopharyngeal carcinoma (NPC) is a rare malignancy in most parts of the world and it is one of the most confusing, commonly misdiagnosed and poorly understood diseases. The cancer is an Epstein-Barr virus-associated malignancy with a remarkable racial and geographical distribution. It is highly prevalent in Southern Asia where the disease occurs at a prevalence about 100-fold higher compared with other populations not at risk. The etiology of NPC is thought to be associated with a complex interaction of genetic, viral, environmental, and dietary factors. Because of advancements in genomics, proteomics, and bioinformatics in recent decades, more understanding of its etiology, carcinogenesis, and progression has been gained. Research into these components may unravel the pathways in NPC development and potentially decipher the molecular characteristics of the malignancy. For example, pathway analyses revealed novel insights into the mechanisms lead to NPC, whereby upregulation of NFκB2 and survivin play central roles in increasing resistance to apoptosis, and changes in integrin and WNT/β-catenin signaling lead to uncontrolled proliferation. The role of survivin in resisting apoptosis in NPC was confirmed by RNA interference (RNAi). Deregulation of key proteins involved in apoptosis (BCL2-related protein A1 and the Fas apoptotic inhibitory molecule), cell cycle checkpoints (AKIP, SCYL1, and NIN), and metastatic potential (matrix metalloproteinase 1) are closely correlated with the levels of Epstein-Barr virus gene expression in NPC. In the era of molecular medicine, specific treatment of the potential target, using technologies such as immunotherapy and RNAi, becomes possible with “bench to bedside” application, thus making molecular biomarker discovery more meaningful in the management of NPC. In this presentation, the latest molecular biomarker discoveries and progress in NPC is summarized with respect to diagnosis, monitoring, treatment and prognosis.

98th AACR Annual Meeting-- Apr 14-18, 2007; Los Angeles, CA