Jin-Ching Lin (National Yang-Ming University, Taiwan)
“Application of Plasma EBV DNA Assay in Daily Practice of NPC Management”
[Tumor Biomarkers in NPC]
– serum anti-EBV antibody
– Serum/plasma EBV DNA
– Others (many molecular markers reported bu no any one can be used clinically)
[Comparison of sensivity and specificity In J Radiat Oncol Biol Phys 2007; 67:130-7
[Ideal Tumor Markers]: non-invasive procedure, easy assay, tumor-specific, highly correlated with tumor burden (stage)
EBV DNA rises in remission cases always appear before imaging in
Uses of plasma EBV DNA in NPC status
– avoid unnecessary neck Ex/dissection
– Another case —> melanoma associated nasopharynx
[Treatment strategy guidance]
Long-term survival analysis of NPC by plasma EBV DNA levels Cancer 2013 119(5):963-70
Conclusion: pEBV DNA was identified as an independent prognostic marker for NPC
NEJM 2001 paper
Background support adjCT trials for selected cases
1. Distant failure is the most frequent site of relapse
2. ConCT and IndCT are more frequently used
3. Only some patients fail after RT+IndCT/ConCT
Int J Radiatojn Pncol 2014:
HK NPC0502. Screened for post-RT EBV FNAS: 78 (100%)
Possible causes for the trial of AdjCT
1. Too high % of post-RT pEBV DNA(+)
2. poor compliance (too toxic),
3. less effective in Adj setting
RTPG1305-NPC phase III proposal
NRG-HN001
To investigate the pEBV DNA concentrations nd clearance rate as a predictive/prognostic ,marker for re/met NPC patients.
Confirming study (Mar, Britten. BJC 2018:118. )
Other cases: Multiple bone meta, multiple lung meta, pregnancy with liver,bone meta ..all can be detected by elevation of plasma EBV DNA