Integrating pre- and post-treatment Plasma Epstein-Barr Virus DNA levels for better prognostic prediction of Nasopharyngeal Carcinoma

Abstract

Background: Pre-and post-treatment plasma Epstein-Barr virus (EBV) DNA are important biomarkers for the prognosis of nasopharyngeal carcinoma (NPC). This study was performed to determine the prognostic potential of integrating EBV DNA levels in plasma measured pre-treatment (pre-EBV) and 3 months post-treatment (3 m-EBV). Materials and methods: A total of 543 incident non-metastatic NPC patients treated with intensitymodulated radiotherapy, with or without chemotherapy, were reviewed. Patients were divided into four subgroups based on pre-EBV and 3 m-EBV status. The data for pre-EBV and 3 m-EBV samples were integrated, and the predictability of the survival of patients with NPC was analyzed. Results: There were significant differences in the 5-year progression-free survival, distant metastasis-free survival, locoregional relapse-free survival, and overall survival among the four patient subgroups (P<0.001). Patients who tested negative for both pre-EBV and 3 m-EBV had the best prognosis, followed by patients who tested positive for pre-EBV and negative for 3 m-EBV, and those who tested negative for pre-EBV and positive for 3 m-EBV; however, patients who tested positive for both pre-EBV and 3 m-EBV had the poorest chances of survival. Multivariate analyses demonstrated that integration of pre-EBV and 3 m-EBV data was an independent predictor of NPC progression in patients. Receiver operating characteristic curve analysis further confirmed that the combination of pre-EBV and 3 m-EBV had a greater prognostic value than pre-EBV or 3 m-EBV alone. Conclusions: Integrating pre-EBV and 3 m-EBV data could provide more accurate risk stratification and better prognostic prediction in NPC.

Development and validation of an MRI-based radiomic model for predicting overall survival in nasopharyngeal carcinoma patients with local residual tumors after intensity-modulated radiotherapy

“…Secondly, the follow-up period of the subjects in this study was not long enough, which may impact the assessment of the 5-year prognosis. Thirdly, EBV-DNA copies at diagnosis and the end of chemoradiotherapy have been shown to be a strong prognosis predictor of NPC patients [ 33 ]. However, the data of EBV-DNA copies were unavailable during the hospitalization of this series of cases in our hospital, which may affect the models' performance.…”

Epstein–Barr virus nuclear antigen-1 is useful as therapeutic efficacy marker in serum but not in saliva of nasopharyngeal cancer patients who underwent radiotherapy

“…Li et al [ 41 ] conducted a study to determine plasma EBV DNA levels pre-treatment and post-treatment (3 months-EBV) as an important biomarker in the prognosis of NPC. It was found that integrating EBV DNA data pre-treatment and post-treatment (3 months-EBV) could predict an accurate and prognostic risk level for NPC [ 41 ].…”

Combination of smoking and Epstein-Barr virus DNA is a predictor of poor prognosis for nasopharyngeal carcinoma: a long-term follow-up retrospective study

“…Measurements of plasma EBV DNA were detected by a real-time quantitative polymerase chain reaction (PCR) before treatment, using the same method and procedure described in our previous publications [ 24 , 25 ]. All plasma EBV DNA tests were performed at the department of Laboratory Medicine of our hospital.…”

“…In this present study, there were 673 male patients with available pre-treatment plasma EBV DNA test records. Referring to our previous researches [ 24 , 25 ], the cutoff value for pre-treatment EBV DNA used to classify patients into low and high groups was 1500 copies/mL.…”