Nasopharyngeal Carcinoma at the Virology Precision Oncology Nexus: Decoding Molecular Alterations for Early Intervention and Therapeutic Innovation

Nasopharyngeal carcinoma (NPC) represents an Epstein–Barr virus (EBV)-associated malignancy showing elevated incidence in East and Southeast Asia. Early detection remains vital, as molecular abnormalities precede visible histological changes during tumor development. This review summarizes recent progress in decoding NPC’s molecular profile, including genetic mutations, epigenetic alterations, non-coding RNA networks and proteomic alterations. Importantly, these molecular discoveries are increasingly informing clinical approaches to disease management. Modern diagnostic integration of histopathology, EBV biomarkers and advanced imaging has improved detection, yet locoregional recurrence and distant metastasis remain major causes of mortality. Immunotherapy shows promising efficacy in recurrent/metastatic NPC, underscoring the potential of molecular insights to guide therapeutic innovation.