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

Brigette Ma, Edwin P. Hui, Ann King, Sing F. Leung, Michael K.M. Kam, Frankie Mo, Leung Li, Ki Wang, Herbert Loong, Ashley Wong, Charles M.L. Chan, K. C.Allen Chan, S. C.Cesar Wong, Y. M.Dennis Lo, Anthony T.C. Chan

Research output: Journal article publicationJournal articleAcademic researchpeer-review

11 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)1051-1055
Number of pages5
JournalBritish Journal of Cancer
Issue number8
Early online date20 Mar 2018
Publication statusPublished - Apr 2018

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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