NasoPharyngeal Carcinoma (NPC) with an incidence well below 1/100.000 in Europe, and of 2-5/100.000 in Mediterranean area is a rare cancer (in accordance with EU definition of an incidence < 6/100.000/year), while in southern Asia is a more common neoplasm (incidence 15-20/100.000).
Several molecular abnormalities have been detected, but only a minority have been considered druggable with a targeted therapy and with a limited activity when employed in clinical trials. The most suitable viral prognostic marker is plasma EBV DNA, that has been extensively studied in endemic areas in curative setting and to a lesser extent also in recurrent/metastatic (RM) disease. There are other recognized strong clinical prognostic factor for patients with locally-advanced and with RM NPC. However, they have been identified and validated mainly in endemic areas. From a biomolecular point of view and considering the different genetics of the populations, there are several issues with NPC that need to be investigated in non-endemic areas.