Chiara Trevisiol1, Massimo Gion2, Alberto Vaona3, Aline S C Fabricio4, Elisa Roca5, Lisa Licitra6, Salvatore Alfieri7, Paolo Bossi5. 1. Veneto Institute of Oncology IOV - IRCCS, Padua, Italy. Electronic address: chiara.trevisiol@iov.veneto.it. 2. Regional Center for Biomarkers, Department of Clinical Pathology and Transfusion Medicine, AULSS3 Serenissima, Venice, Italy. 3. Primary Care, ULSS 9 Scaligera, Verona, Italy. 4. Veneto Institute of Oncology IOV - IRCCS, Padua, Italy. 5. Medical Oncology, Department of Medical & Surgical Specialties, Radiological Sciences & Public Health, University of Brescia, ASST Spedali Civili, 25123 Brescia, Italy. 6. Head and Neck Medical Oncology 3 Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy; University of Milan, Milan, Italy. 7. Head and Neck Medical Oncology 3 Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.
Abstract
BACKGROUND: In EBV-related nasopharyngeal carcinoma (NPC), quantitative determination of circulating EBV-DNA (cEBV-DNA) can potentially be applied as disease marker. The aim of the study was to investigate if the clinical utility of cEBV-DNA is established in clinical practice guidelines and if recommendations are provided to standardize the quantitative cEBV-DNA determination. METHODS: A systematic literature search for NPC guidelines published since 2011 was performed. Information for cEBV-DNA detection method and use in clinical practice was synthesized in consecutive steps of increasing simplification. RESULTS: From 570 titles and abstracts identified by the search, 16 guidelines were included. The selected documents were further clustered as either being based on a systematic literature revision to generate recommendations (4/16) or not (12/16). cEBV-DNA was evaluated in only one guideline based on a systematic revision and in 8 guidelines without systematic revision. Half of available guidelines provide recommendation for its clinical use. Methodological issues on cEBV-DNA determination are discussed by 31% of guidelines, without providing any recommendation on method standardization. CONCLUSIONS: Due to its prognostic value, cEBV-DNA is suggested in the pre-treatment work-up and in the follow-up. Guideline producers need to take into more consideration methodological aspects impacting the actual reliability and generalizability of laboratory results.
BACKGROUND: In EBV-related nasopharyngeal carcinoma (NPC), quantitative determination of circulating EBV-DNA (cEBV-DNA) can potentially be applied as disease marker. The aim of the study was to investigate if the clinical utility of cEBV-DNA is established in clinical practice guidelines and if recommendations are provided to standardize the quantitative cEBV-DNA determination. METHODS: A systematic literature search for NPC guidelines published since 2011 was performed. Information for cEBV-DNA detection method and use in clinical practice was synthesized in consecutive steps of increasing simplification. RESULTS: From 570 titles and abstracts identified by the search, 16 guidelines were included. The selected documents were further clustered as either being based on a systematic literature revision to generate recommendations (4/16) or not (12/16). cEBV-DNA was evaluated in only one guideline based on a systematic revision and in 8 guidelines without systematic revision. Half of available guidelines provide recommendation for its clinical use. Methodological issues on cEBV-DNA determination are discussed by 31% of guidelines, without providing any recommendation on method standardization. CONCLUSIONS: Due to its prognostic value, cEBV-DNA is suggested in the pre-treatment work-up and in the follow-up. Guideline producers need to take into more consideration methodological aspects impacting the actual reliability and generalizability of laboratory results.
Authors: Sukhkaran S Aulakh; Dustin A Silverman; Kurtis Young; Steven K Dennis; Andrew C Birkeland Journal: Cancers (Basel) Date: 2022-06-16 Impact factor: 6.575