Dynamic Changes of Post-Radiotherapy Plasma Epstein–Barr Virus DNA in a Randomized Trial of Adjuvant Chemotherapy Versus Observation in Nasopharyngeal Cancer
| العنوان: | Dynamic Changes of Post-Radiotherapy Plasma Epstein–Barr Virus DNA in a Randomized Trial of Adjuvant Chemotherapy Versus Observation in Nasopharyngeal Cancer |
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| المؤلفون: | Leung Li, Y.M. Dennis Lo, Ann D. King, Kwan Hung Wong, W K Jacky Lam, Kenneth C.W. Wong, Anthony T.C. Chan, Qi-yong Hemis Ai, Thomas K.H. Lau, Brigette B.Y. Ma, Darren M.C. Poon, Frankie Mo, K.C. Allen Chan, Edwin P. Hui, Macy Tong, Daisy C.M. Lam, Chi Hang Wong |
| المصدر: | Clinical Cancer Research. 27:2827-2836 |
| بيانات النشر: | American Association for Cancer Research (AACR), 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | 0301 basic medicine, Epstein-Barr Virus Infections, Herpesvirus 4, Human, Cancer Research, medicine.medical_specialty, Randomization, medicine.medical_treatment, Gastroenterology, Virus, law.invention, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Randomized controlled trial, law, Positron Emission Tomography Computed Tomography, Internal medicine, Biomarkers, Tumor, Clinical endpoint, Humans, Medicine, Nasopharyngeal cancer, business.industry, Surrogate endpoint, Disease Management, Nasopharyngeal Neoplasms, Viral Load, Prognosis, Combined Modality Therapy, Survival Analysis, Radiation therapy, 030104 developmental biology, Oncology, chemistry, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, DNA, Viral, Disease Progression, Disease Susceptibility, business, DNA |
| الوصف: | Purpose: To study the dynamic changes in plasma Epstein–Barr virus (pEBV) DNA after radiotherapy in nasopharyngeal cancer (NPC). Experimental Design: We conducted a randomized controlled trial of adjuvant chemotherapy versus observation in patients with NPC who had detectable pEBV DNA at 6 weeks post-radiotherapy. Randomized patients had a second pEBV DNA checked at 6 months post-randomization. The primary endpoint was progression-free survival (PFS). Results: We prospectively enrolled 789 patients. Baseline post-radiotherapy pEBV DNA was undetectable in 573 (72.6%) patients, and detectable in 216 (27.4%) patients, of whom 104 (13.2%) patients were eligible for randomization to adjuvant chemotherapy (n = 52) versus observation (n = 52). The first post-radiotherapy pEBV DNA had a sensitivity of 0.48, specificity of 0.81, area under receiver-operator characteristics curve (AUC) of 0.65, false positive (FP) rate of 13.8%, and false negative (FN) rate of 14.4% for disease progression. The second post-radiotherapy pEBV DNA had improved sensitivity of 0.81, specificity of 0.75, AUC of 0.78, FP rate of 14.3%, and FN rate of 8.1%. Patients with complete clearance of post-radiotherapy pEBV DNA (51%) had survival superior to that of patients without post-radiotherapy pEBV DNA clearance (5-year PFS, 85.5% vs. 23.3%; HR, 9.6; P < 0.0001), comparable with patients with initially undetectable post-radiotherapy pEBV DNA (5-year PFS, 77.1%), irrespective of adjuvant chemotherapy or observation. Conclusions: Patients with NPC with detectable post-radiotherapy pEBV DNA who experienced subsequent pEBV DNA clearance had superior survival comparable with patients with initially undetectable post-radiotherapy pEBV DNA. Post-radiotherapy pEBV DNA clearance may serve as an early surrogate endpoint for long-term survival in NPC. |
| تدمد: | 1557-3265 1078-0432 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d0aa541d096fdb607197d2493e07c1de https://doi.org/10.1158/1078-0432.ccr-20-3519 |
| رقم الأكسشن: | edsair.doi.dedup.....d0aa541d096fdb607197d2493e07c1de |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15573265 10780432 |
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