Prospective observation: Clinical utility of plasma Epstein–Barr virus DNA load in EBV‐associated gastric carcinoma patients

Abstract

Epstein–Barr virus (EBV)‐associated gastric carcinomas (EBVaGCs) may account for 8–9% of all gastric cancer (GC) patients. All previous reports on EBVaGC were retrospective. Prospective study is warranted to evaluate the exact role of EBV status in predicting the prognosis of GC. It is of special interest to figure out whether dynamic detection of plasma EBV‐DNA load could be a feasible biomarker for the monitor of EBVaGC. From October 2014 to September 2017, we consecutively collected GC patients (n = 2,760) from Sun Yat‐sen University Cancer Center for EBER examination. We detected EBV‐DNA load in plasma and tissue samples of EBVaGC patients at baseline. Subsequently, plasma EBV‐DNA load was dynamically monitored in EBVaGC patients. The overall prevalence of EBVaGC is 5.1% (140/2,760). The incidence rate of EBVaGC decreased with advanced AJCC 7th TNM stage (p < 0.001), with the corresponding percentages of 9.3, 9.9, 6.7 and 1.4% for Stage I, II, III and IV patients. EBVaGC patients were predominately young males with better histologic differentiation and earlier TNM stage than EBV‐negative GC (EBVnGC) patients. EBVaGC patients were confirmed to had a favorable 3‐year survival rate (EBVaGC vs. EBVnGC: 76.8% vs. 58.2%, p = 0.0001). Though only 52.1% (73/140) EBVaGC patients gained detectable EBV‐DNA and 43.6% (61/140) reached a positive cutoff of 100 copies/ml, we found the plasma EBV‐DNA load in EBVaGC decreased when patients got response, while it increased when disease progressed. Our results suggested that plasma EBV‐DNA is a good marker in predicting recurrence and chemotherapy response for EBVaGC patients.

Clinicopathologic features, tumor immune microenvironment and genomic landscape of Epstein-Barr virus-associated intrahepatic cholangiocarcinoma

“…To date, the EBV infection status of ICC in southern China, with the highest incidence of EBV-associated NPC [12], still remains unknown. Our results revealed for the first time that the overall prevalence of EBVaICC was 6.6%, which was similar to that of EBVaGC (5.1%) in this area [7]. In addition, all EBVaICCs were positive for EBNA1, without immunostaining for LMP1 and EBNA2, which indicated that EBV harbored in ICC was a latency type I infection.…”

“…Epstein-Barr virus (EBV) has been linked to several carcinomas of the aerodigestive tract, especially undifferentiated nasopharyngeal carcinoma (NPC) [6] and EBV-associated gastric carcinoma (EBVaGC) [7], but the relationship between EBV infection and ICC pathogenesis has not been well characterized. The current level of evidence on EBV-associated ICC (EBVaICC) is solely based on case reports and small series [8][9][10][11].…”

Clinical relevance of blood-based ctDNA analysis: mutation detection and beyond

“…In a 2019 large prospective study of 2760 gastric cancer patients, 52.1% (73/140) of EBV-associated gastric carcinomas had detectable EBV-DNA. 135 Furthermore, the plasma EBV-DNA load was found to be associated with treatment response, with the load decreasing in responders but increasing with disease progression.…”

Gastric cancer: genome damaged by bugs

“…By measuring immune-related proteins in plasma of patients with EBV-positive tumors and EBV-negative tumors, Camargo et al found some chemokines and PD-L1 in plasma that could be used for the diagnosis of EBV status [165]. The plasma EBV-DNA load in EBVaGC patients decreases when the patients show response to the treatment, while load increases when the disease progresses, suggesting that plasma EBV-DNA serves as an ideal marker in predicting recurrence and chemotherapy response [166].…”