Prospective Evaluation of Plasma Epstein-Barr Virus DNA Clearance and Fluorodeoxyglucose Positron Emission Scan in Assessing Early Response to Chemotherapy in Patients with Advanced or Recurrent Nasopharyngeal Carcinoma

Overview

Journal Br J Cancer

Specialty Oncology

Date 2018 Mar 21

PMID 29555989

Citations 13

Authors

Brigette Ma

Edwin P Hui

Ann King

Sing F Leung

Michael Km Kam

Frankie Mo

Leung Li

Ki Wang

Herbert Loong

Ashley Wong

Charles Ml Chan

K C Allen Chan

S C Cesar Wong

Y M Dennis Lo

Anthony Tc Chan

Affiliations

Soon will be listed here.

Abstract

Background: Plasma Epstein-Barr virus (pEBV) DNA and fluorodeoxyglucose positron emission (PET) reflect tumour burden in advanced NPC. This study hypothesised that a dual endpoint based on assessing pEBV DNA clearance and PET response could predict early drug response.

Methods: Eligible patients underwent a computed tomography (CT) scan and dual PET-CT at baseline, a PET-CT at 4 weeks, and then a CT scan at 10 weeks after starting palliative or induction chemotherapy. Plasma EBV DNA clearance was determined.

Results: Fifty-eight out of 70 enrolled patients completed all imaging and 50/58 had falling pEBV DNA level, which allowed calculation of the clearance. At a median follow-up of 29.1 months, the dual endpoint (pEBV DNA clearance ≤ 10 days and > 50% drop in sum of SUVmax of target lesions) was an independent indicator of overall survival (hazard ratio (HR) = 0.135, 95% CI = 0.039 to 0.466, p = 0.0015) and progression-free survival (HR = 0.136, 95% CI = 0.048 to 0.385, p = 0002). This dual endpoint could predict subsequent response by Response Evaluation Criteria In Solid Tumours (RECIST) criteria at 10 weeks after chemotherapy.

Conclusions: Early PET-CT response and pEBV DNA clearance could predict survival and subsequent response. This dual endpoint is an innovative tool for assessing early drug response.

Citing Articles

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