Inclusion Criteria:

- Histologically confirmed diagnosis of nasopharyngeal carcinoma (NPC) (either at
initial diagnosis or at recurrence).

- Patients with recurrent or metastatic NPC that has progressed following one line of
prior platinum-based chemotherapy.

- Disease must be not amenable to potentially curative radiotherapy or surgery.

- Measurable disease according to RECIST.

- Age 18 or above; ECOG performance 0 or 1.

- Adequate bone marrow, renal and hepatic reserve.

Exclusion Criteria:

- Presence of local recurrence

- Presence of neck lymph node recurrence invading vascular structure;

- Presence of central lung lesions involving major blood vessels;

- History of hemoptysis or epistaxis within 4 weeks;

- Preexisting uncontrolled hypertension defined as more than 140/90 mmHg despite
adequate medical therapy;

- Gastrointestinal abnormalities, including inability to take oral medication or
malabsorption syndrome;

- Concurrent use or anticipated need for treatment with known potent CYP3A4 inhibitors
or CYP3A4 /CYP1A2 inducers.