Abstract： Objective To assess the short-term effects and adverse reactions of combination regimen of gemcitabine, nedaplatin and paclitaxel for patients with metastatic cisplatin-resistant nasopharyngeal carcinoma (NPC). Methods A total of 15 patients with metastatic cisplatin-resistant NPC were enrolled. All patients were treated with a combination regimen including gemcitabine with 1000 mg/m2 on day 1st and 8th, nedaplatin with 70 mg/m2 on day 1st and paclitaxel with 135 mg/m2 on day 1st, repeated every 21 days. Response was evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) criteria 3.0. Results The overall response rate was 40.0 %, with a complete response rate of 6.7 % (1/15) and a partial response rate of 33.3 % (5/15). Six patients (40.0 %) had stable disease and 3 patients (20.0 %) had progressive disease. The median time to progression (TTP) was 4.7 months and the median overall survival was 6.3 months. Hematological toxicities were the adverse reaction with 40.0 % of leucopenia, 6.7 % of anemia and 20.0 % thrombocytopenia. One patient needed for platelet transfusion. Other adverse reactions were mild. Conclusion The combination regimen of gemcitabine, nedaplatin and paclitaxel is feasible as second-line chemotherapy in patients with metastatic cisplatin-resistant NPC.