PURPOSE: To investigate the prognostic effect of the concentrations and clearance rates of plasma EBV DNA in metastatic/recurrent nasopharyngeal carcinoma (NPC). EXPERIMENTAL DESIGN: Thirty relapsed and four previously nontreated metastatic NPC patients were treated according to the consensus guidelines of the head and neck cancer team in our hospital (i.v. chemotherapy first, followed by local irradiation boost and oral maintenance chemotherapy where applicable). Multiple plasma samples were collected during the first month of chemotherapy. Circulating EBV DNA concentrations were measured by a real-time quantitative PCR. The half-life values (t(1/2)) of plasma EBV DNA clearance were calculated. The associations between clinical outcome and plasma EBV DNA assays were analyzed. RESULTS: Tumor response evaluated after 12 weeks of treatment showed 14 complete responses (41.2%), 12 partial responses (35.3%), 7 stable diseases (20.6%), and 1 progression disease (2.9%). The plasma EBV DNA concentrations have no significant effects on outcome prediction. The t(1/2) of plasma EBV DNA clearance ranged from 1.85 to 28.29 days (median, 3.99). Patients with a short t(1/2) of plasma EBV DNA clearance have significantly higher complete response rate and overall survival than those with long t(1/2). Multivariate analysis revealed a significant effect of the t(1/2) of plasma EBV DNA clearance on survival. CONCLUSIONS: The clearance rates of plasma EBV DNA during the first month of chemotherapy can predict tumor response and patient survival. Early change of chemotherapy regimen may be considered for patients with slow plasma EBV DNA clearance rate.
PURPOSE: To investigate the prognostic effect of the concentrations and clearance rates of plasma EBV DNA in metastatic/recurrent nasopharyngeal carcinoma (NPC). EXPERIMENTAL DESIGN: Thirty relapsed and four previously nontreated metastatic NPCpatients were treated according to the consensus guidelines of the head and neck cancer team in our hospital (i.v. chemotherapy first, followed by local irradiation boost and oral maintenance chemotherapy where applicable). Multiple plasma samples were collected during the first month of chemotherapy. Circulating EBV DNA concentrations were measured by a real-time quantitative PCR. The half-life values (t(1/2)) of plasma EBV DNA clearance were calculated. The associations between clinical outcome and plasma EBV DNA assays were analyzed. RESULTS:Tumor response evaluated after 12 weeks of treatment showed 14 complete responses (41.2%), 12 partial responses (35.3%), 7 stable diseases (20.6%), and 1 progression disease (2.9%). The plasma EBV DNA concentrations have no significant effects on outcome prediction. The t(1/2) of plasma EBV DNA clearance ranged from 1.85 to 28.29 days (median, 3.99). Patients with a short t(1/2) of plasma EBV DNA clearance have significantly higher complete response rate and overall survival than those with long t(1/2). Multivariate analysis revealed a significant effect of the t(1/2) of plasma EBV DNA clearance on survival. CONCLUSIONS: The clearance rates of plasma EBV DNA during the first month of chemotherapy can predict tumor response and patient survival. Early change of chemotherapy regimen may be considered for patients with slow plasma EBV DNA clearance rate.
Authors: Sharon D Stoker; Maarten A Wildeman; Zlata Novalic; Renske Fles; Vincent van der Noort; Remco de Bree; Weibel W Braunius; Guido B van den Broek; Bas Kreike; Kenneth W Kross; Hedy Juwana; Octavia Ramayanti; Sandra A W M Verkuijlen; Jan Paul de Boer; Astrid E Greijer; Jaap M Middeldorp; I Bing Tan Journal: Eur Arch Otorhinolaryngol Date: 2015-05-01 Impact factor: 2.503
Authors: Sharon D Stoker; Zlata Novalić; Maarten A Wildeman; Alwin D R Huitema; Sandra A W M Verkuijlen; Hedy Juwana; Astrid E Greijer; I Bing Tan; Jaap M Middeldorp; Jan Paul de Boer Journal: J Cancer Res Clin Oncol Date: 2015-04-29 Impact factor: 4.553
Authors: Nancy Y Lee; Qiang Zhang; David G Pfister; John Kim; Adam S Garden; James Mechalakos; Kenneth Hu; Quynh T Le; A Dimitrios Colevas; Bonnie S Glisson; Anthony Tc Chan; K Kian Ang Journal: Lancet Oncol Date: 2011-12-15 Impact factor: 41.316