AUTHOR=Liu Guo-Ying , Xia Wei-Xiong , Bi Zhuo-Fei , Lu Nian , Li Wang-Zhong , Bei Wei-Xin , Liang Hu , Xie Jun-Zhi , Liu Yi-Min , Yao He-Rui , Xiang Yan-Qun 

TITLE=Plasma Circulating Tumor Epstein–Barr Virus for the Surveillance of Cancer Progression in Bone-Only Metastatic Nasopharyngeal Carcinoma

JOURNAL=Frontiers in Oncology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.860700

DOI=10.3389/fonc.2022.860700

ISSN=2234-943X

ABSTRACT=Abstract:
Background: Plasma Epstein-Barr virus DNA (EBV-DNA) is a sensitive and specific biomarker for nasopharyngeal carcinoma (NPC). We investigated whether longitudinal monitoring of EBV-DNA could accurately detect clinical disease progression in NPC patients with bone-only metastases. 

Methods: In this retrospective study, a total of 105 patients with bone-only metastatic NPC who were treated with platinum-based first-line chemotherapy were enrolled. Undetectable EBV-DNA after first-line chemotherapy was defined as biochemical complete response (BCR). The correlation of the EBV-DNA dynamic status with overall survival (OS) and progression-free survival (PFS) were determined by Cox regression. The correlation between non-normalized EBV-DNA period and PFS period were determined.

Results: After a median follow-up time of 53.4 months (IQR: 42.8-80.6), 64 patients had disease progression. Thirty-nine of 105 patients (37.1%) had BCR at all follow-up time points and none of these 39 patients had disease progression, corresponding to a negative predictive value (NPV) of 100%. Sixty-six patients had a detectable EBV-DNA during surveillance, with 64 diagnosed as disease progression at last follow-up, for a positive predictive value (PPV) of 97.0%. Actuarial 3-year OS rates were 45.0% for patients with detectable EBV-DNA during posttreatment surveillance and 100% for patients with undetectable EBV-DNA. Lastly, median lead time between non-normalized EBV-DNA and clinical-proven progression was 5.87± 0.67 months.

Conclusions: Taken together, EBV-DNA provided predictive value regarding progression of bone-only metastatic NPC patients. The clinical impact should be confirmed in prospective randomized studies.