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Plasma Epstein-Barr virus DNA as a biomarker for nasopharyngeal carcinoma.

Chan KC - Chin J Cancer (2014)

Bottom Line: Plasma EBV DNA, when quantitatively analyzed using real-time polymerase chain reaction (PCR), has been developed as a biomarker for NPC.In this review, the different clinical applications of plasma EBV DNA in the management of NPC, including screening, monitoring, and prognostication, are discussed.In addition, the biological issues of circulating EBV DNA, including the molecular nature and clearance kinetics, are also explored.

View Article: PubMed Central - PubMed

Affiliation: Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China. allen@cuhk.edu.hk.

ABSTRACT
Nasopharyngeal carcinoma (NPC) is common in southern China and Southeast Asia. Epstein-Barr virus (EBV) infection is an important etiology for NPC, and EBV genome can be detected in almost all tumor tissues of NPC in this region. Plasma EBV DNA, when quantitatively analyzed using real-time polymerase chain reaction (PCR), has been developed as a biomarker for NPC. In this review, the different clinical applications of plasma EBV DNA in the management of NPC, including screening, monitoring, and prognostication, are discussed. In addition, the biological issues of circulating EBV DNA, including the molecular nature and clearance kinetics, are also explored.

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Progression-free survival curves for patients with NPC and with different concentrations of plasma EBV DNA after curative-intent treatment.Posttreatment plasma EBV DNA is a powerful predictor for patient survival. All patients with plasma EBV DNA concentrations of ≥500 copies/mL had developed clinical relapse within 2 years. In contrast, patients with undetectable plasma EBV DNA after treatment had very good survival. The staging is according to the AJCC/UICC system.
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cjc-33-12-598-g002: Progression-free survival curves for patients with NPC and with different concentrations of plasma EBV DNA after curative-intent treatment.Posttreatment plasma EBV DNA is a powerful predictor for patient survival. All patients with plasma EBV DNA concentrations of ≥500 copies/mL had developed clinical relapse within 2 years. In contrast, patients with undetectable plasma EBV DNA after treatment had very good survival. The staging is according to the AJCC/UICC system.

Mentions: Among different prognosticators, posttreatment plasma EBV DNA level is the most powerful single predictor for disease recurrence and long-term survival[27]–[31]. After treatment with curative intent, residual cancer cells can be sensitively detected with plasma EBV DNA analysis. Chan et al.[27] followed up a cohort of 170 patients with NPC, without metastatic disease at presentation, for a median of 116 weeks. Plasma EBV DNA concentrations were measured at 6 to 8 weeks after the completion of radiotherapy. All patients with plasma EBV DNA concentrations≥500 copies/mL developed disease progression within 2 years, whereas patients with undetectable plasma EBV DNA after treatment had a progression-free survival rate >95% at 2 years (Figure 2)[27]. Patients with detectable plasma EBV DNA but <500 copies/mL had a moderate prognosis[27]. These results were confirmed by different groups in patients with different ethnic origins and different clinical stages of diseases[28]–[31]. Because patients with significant levels of plasma EBV DNA after treatment have a high chance of disease progression, further treatment before clinical progression may be useful for improving treatment outcome. To this end, an international, multicenter, randomized clinical trial has been initiated to investigate if preemptive chemotherapy given to patients with detectable plasma EBV DNA after treatment can improve overall and progression-free survival. A harmonization program has been undertaken to standardize EBV DNA assays to ensure that the quantitative plasma EBV DNA results from different centers are comparable[32].


Plasma Epstein-Barr virus DNA as a biomarker for nasopharyngeal carcinoma.

Chan KC - Chin J Cancer (2014)

Progression-free survival curves for patients with NPC and with different concentrations of plasma EBV DNA after curative-intent treatment.Posttreatment plasma EBV DNA is a powerful predictor for patient survival. All patients with plasma EBV DNA concentrations of ≥500 copies/mL had developed clinical relapse within 2 years. In contrast, patients with undetectable plasma EBV DNA after treatment had very good survival. The staging is according to the AJCC/UICC system.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4308655&req=5

cjc-33-12-598-g002: Progression-free survival curves for patients with NPC and with different concentrations of plasma EBV DNA after curative-intent treatment.Posttreatment plasma EBV DNA is a powerful predictor for patient survival. All patients with plasma EBV DNA concentrations of ≥500 copies/mL had developed clinical relapse within 2 years. In contrast, patients with undetectable plasma EBV DNA after treatment had very good survival. The staging is according to the AJCC/UICC system.
Mentions: Among different prognosticators, posttreatment plasma EBV DNA level is the most powerful single predictor for disease recurrence and long-term survival[27]–[31]. After treatment with curative intent, residual cancer cells can be sensitively detected with plasma EBV DNA analysis. Chan et al.[27] followed up a cohort of 170 patients with NPC, without metastatic disease at presentation, for a median of 116 weeks. Plasma EBV DNA concentrations were measured at 6 to 8 weeks after the completion of radiotherapy. All patients with plasma EBV DNA concentrations≥500 copies/mL developed disease progression within 2 years, whereas patients with undetectable plasma EBV DNA after treatment had a progression-free survival rate >95% at 2 years (Figure 2)[27]. Patients with detectable plasma EBV DNA but <500 copies/mL had a moderate prognosis[27]. These results were confirmed by different groups in patients with different ethnic origins and different clinical stages of diseases[28]–[31]. Because patients with significant levels of plasma EBV DNA after treatment have a high chance of disease progression, further treatment before clinical progression may be useful for improving treatment outcome. To this end, an international, multicenter, randomized clinical trial has been initiated to investigate if preemptive chemotherapy given to patients with detectable plasma EBV DNA after treatment can improve overall and progression-free survival. A harmonization program has been undertaken to standardize EBV DNA assays to ensure that the quantitative plasma EBV DNA results from different centers are comparable[32].

Bottom Line: Plasma EBV DNA, when quantitatively analyzed using real-time polymerase chain reaction (PCR), has been developed as a biomarker for NPC.In this review, the different clinical applications of plasma EBV DNA in the management of NPC, including screening, monitoring, and prognostication, are discussed.In addition, the biological issues of circulating EBV DNA, including the molecular nature and clearance kinetics, are also explored.

View Article: PubMed Central - PubMed

Affiliation: Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China. allen@cuhk.edu.hk.

ABSTRACT
Nasopharyngeal carcinoma (NPC) is common in southern China and Southeast Asia. Epstein-Barr virus (EBV) infection is an important etiology for NPC, and EBV genome can be detected in almost all tumor tissues of NPC in this region. Plasma EBV DNA, when quantitatively analyzed using real-time polymerase chain reaction (PCR), has been developed as a biomarker for NPC. In this review, the different clinical applications of plasma EBV DNA in the management of NPC, including screening, monitoring, and prognostication, are discussed. In addition, the biological issues of circulating EBV DNA, including the molecular nature and clearance kinetics, are also explored.

Show MeSH
Related in: MedlinePlus